Sleep Apnea Syndromes Clinical Trial
Official title:
Polygraphic Evaluation of the Effects of Different Rapid Maxillary Expansion Appliances on Sleep Quality: A Randomized Clinical Trial
Rapid maxillary expansion (RME) is a commonly used orthodontic treatment in patients with maxillary constriction to provide skeletal expansion, correct posterior crossbite and resolve naso-respiratory problems by reducing oral respiration.The aim of this randomized controlled trial was to evaluate the effects of tooth-borne, tooth tissue-borne and bone-borne RME appliances on sleep quality with polygraphy. The null hypothesis was that there is no difference for the sleep quality between the appliances.
Introduction. The aim of this 3-arm randomized controlled trial (RCT) was to evaluate the
effects of tooth tissue-borne (KBME), tooth-borne (Hyrax), and bone-borne (MIDME) rapid
maxillary expansion (RME) appliances on sleep quality with polygraphy.
Methods. This study was designed in parallel with an allocation ratio of 1:1:1. 46 patients
with narrow maxilla and OSAS were included in this study and randomly assigned to three
groups: tooth tissue-borne, tooth-borne and bone-borne expanders. Participants were
congregated from the Department of Orthodontics, Faculty of Dentistry, Izmir Katip Celebi
University, Turkey. In all groups, the expansion appliance was activated one-quarter turn
twice a day until the desired suture opening was achieved. The primary outcome of this study
was the correction of posterior crossbite. Secondary outcomes included polygraphic assessment
of sleep parameters. Each subject participated in 1 overnight sleep test with polygraphy
before the expansion (T0) and after a 3-month retention phase of treatment (T1). According to
the results of polygraphy, 7 parameters; (apnea hypopnea index (AHI), number of apnea and
hypopnea, desaturation index, lowest desaturation, average saturation, supin AHI) were
examined to evaluate the changes in sleep scores. Kruskal-Wallis analysis and Dunn-Bonferroni
test were used for inter-group comparisons and Wilcoxon analysis was used for intra-group
evalaution. P<0.05 was accepted statistically significant. Computer-generated randomization
was used with group allocation concealed using opaque, sealed envelopes. The outcome assessor
was blinded to group assignment. The outcome assessor was blinded; however, it was not
feasible to blind either operator or patients.
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