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. 2016 May;86(3):481-6.
doi: 10.2319/051515-329.1. Epub 2015 Aug 13.

Rapid maxillary expansion in therapy-resistant enuretic children: An orthodontic perspective

Farhan Bazargani  1 , Ingrid Jönson-Ring  2 , Tryggve Nevéus  3
Affiliations

Rapid maxillary expansion in therapy-resistant enuretic children: An orthodontic perspective

Farhan Bazargani et al. Angle Orthod. 2016 May.

Abstract

Objective: To evaluate whether rapid maxillary expansion (RME) could reduce the frequency of nocturnal enuresis (NE) in children and whether a placebo effect could be ruled out.

Methods: Thirty-four subjects, 29 boys and five girls with mean age of 10.7 ± 1.8 years suffering from primary NE, were recruited. All subjects were nonresponders to the first-line antienuretic treatment and therefore were classified as "therapy resistant." To rule out a placebo effect of the RME appliance, all children were first treated with a passive appliance for 4 weeks. Rhinomanometry (RM), acoustic rhinometry (AR), polysomnographic registration, and study casts were made at different time points.

Results: One child experienced severe discomfort from the RME appliance and immediately withdrew from the study. Following RME, the long-term cure rate after 1 year was 60%. The RM and AR measurements at baseline and directly after RME showed a significant increase in nasal volume and nasal airflow, and there was a statistically significant correlation between reduction in enuresis and increase in nasal volume. Six months postretention, a 100% relapse of the dental overexpansion could be noted.

Conclusions: RME has a curative effect in some children with NE, which could be connected to the positive influence of RME on the sleep architecture. Normal transverse occlusion does not seem to be a contraindication for moderate maxillary expansion in attempts to cure NE in children.

Keywords: Nocturnal enuresis; Rapid maxillary expansion.

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Figures

Figure 1. Rapid maxillary expansion (RME) appliance.
Figure 1.
Rapid maxillary expansion (RME) appliance.
Figure 2. Flow chart.
Figure 2.
Flow chart.
Figure 3. Antienuretic effect. The number of wet nights per week before, after, and 1 year posttreatment.
Figure 3.
Antienuretic effect. The number of wet nights per week before, after, and 1 year posttreatment.
See this image and copyright information in PMC

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