Effects of rapid maxillary expansion in pediatric patients affected by obstructive sleep apnea syndrome: a literature review

Abstract

Introduction: Obstructive sleep apnea syndrome (OSAS) is a breathing disorder during sleep, characterized by upper airway obstruction with many subsequent daytime and nocturnal symptoms. Children with OSAS may show abnormalities of the maxillary structure. This review aims to evaluate the effectiveness of rapid maxillary expansion (RME) as a treatment for OSAS in children to reduce apnea/hypopnea index and oxygen saturation.

Evidence acquisition: An electronic search for all articles published in English from January 2004 to February 2022. The study focused on children between 5 and 12 years old and meeting the following inclusion criteria: clinical signs of malocclusion, no syndromic children, adenotonsillar hypertrophy, underwent an otolaryngology evaluation and no previous treatment for OSAS. The device was fixed to the second deciduous molars. After 12 months, the RME was removed.

Evidence synthesis: The investigation recorded a statistically significant reduction in AHI (apnea/hypopnea index) (on average 60-65%) and an increase in oxygen saturation ranging from 95% to 97%.

Conclusions: This review shows that RME, through the enlargement of dental arches and nasal-maxillary structures, may be a helpful approach in children with malocclusion and OSAS.