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Randomized Controlled Trial
. 2022 Feb 1;23(1):3.
doi: 10.1186/s40510-021-00397-x.

Mini-implant assisted rapid palatal expansion (MARPE) effects on adult obstructive sleep apnea (OSA) and quality of life: a multi-center prospective controlled trial

Daniel Paludo Brunetto  1 , Christoph E Moschik  2 , Ramon Dominguez-Mompell  3 , Eliza Jaria  4 , Eduardo Franzotti Sant'Anna  5 , Won Moon  4   6
Affiliations
Randomized Controlled Trial

Mini-implant assisted rapid palatal expansion (MARPE) effects on adult obstructive sleep apnea (OSA) and quality of life: a multi-center prospective controlled trial

Daniel Paludo Brunetto et al. Prog Orthod. .

Abstract

Introduction: Transverse maxillary deficiency is a high prevalent growth disorder within the adult population that may lead to serious health issues, such as detrimental malocclusions and higher risk of developing obstructive sleep apnea (OSA). Mini-implant assisted rapid palatal expansion (MARPE), as it expands the mid-face and augment the nasal and oral cavities dimensions, may reduce the airflow resistance and thus play an important role on OSA therapy in some patients. The main objective of the present trial is to assess MARPE effects on the sleep and quality of life of non-obese adult OSA patients with transverse maxillary deficiency.

Methods: A total of 32 participants were divided into intervention and control groups. They underwent physical evaluation, Epworth Sleepiness Scale (EES) and Quebec Sleep Questionnaire (QSQ), cone-beam computed tomography (CBCT) and home sleep testing (HST) for OSA before MARPE (T1) and 6 months after the intervention (T2).

Results: Questionnaires EES (daytime sleepiness) and QSQ (OSA-related quality of life) presented significant statistical differences between the groups. We also found clinical and statistical (p < 0.01) differences between the groups regarding the apnea/hypopnea index (AHI), as well as others HST parameters (mean oxygen saturation and snoring duration).

Conclusion: In our sample, MARPE (without any auxiliary osteotomy) showed a good success rate (85%) and promoted important occlusal and respiratory benefits. We observed important daytime sleepiness and OSA-related quality of life improvement, as well as the AHI (65.3%), oxygen saturation and snoring duration.

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Conflict of interest statement

One of the authors (Won Moon) declares he has one patent concerning the expander used on the study, the Maxillary Skeletal Expander (MSE).

Figures

Fig. 1
Fig. 1
The study flow diagram. PE, Physical Evaluation; ESS, Epworth Sleepiness Scale; QSQ, Quebec Sleep Questionnaire; HST, Home Sleep Test; CBCT, Cone Beam Computerized Tomography; MSE, Maxillary Skeletal Expansion
Fig. 2
Fig. 2
10 mm MSE ready for delivery
Fig. 3
Fig. 3
A 24-year old male patient with a maxillary transverse deficiency, a posterior cross-bite and OSA (AHI 19.7); B The malocclusion after 8.5 mm of palatal expansion (AHI 4.8); C just after the brackets debonding and restorative composites; D 2-years retention control
Fig. 4
Fig. 4
Boxplot comparing the AHI among the groups and timepoints
See this image and copyright information in PMC

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