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The Effect of Upper Arch Expansion by clear aligners on Nasal Airway Volume in Children and Adults

  • Author / Creator
    Pan, Boyu

  • Obstructive sleep apnea (OSA) affects more than 900 million people around the world (Benjafield et al., 2019). OSA occurs due to obstruction of the airway at different levels of the airway, including upper and lower pharyngeal constrictions due to narrow upper jaw and underdeveloped/backward positioned lower jaw. Treatment modalities of OSA include active oxygen infusion, oral appliances or surgical expansion of the upper arch and/or surgical advancement of the lower and upper jaws; however, these modalities have many challenges and complications (Benjafield et al., 2019; American Academy of Sleep Medicine, 2015; Schwengel et al., 2014; Yaggi et al., 2005). Previous research has shown that rapid maxillary expansion can improve the nasal airway, thereby improving OSA (Peppard et al., 2000; Cordasco et al., 2012; Mônego Moreira et al., 2017). Orthodontic appliances such as clear aligners can be used for slow maxillary expansion; however, the effect of this type of treatment on both the nasal airway volume and morphology has not been investigated. Therefore, the objective of this study was to investigate the effect of clear aligners on the nasal airway volume and morphology of pediatric patients undergoing maxillary expansion. In addition, a pilot study was conducted to investigate the effect of clear aligners on the volume of the nasal airway in adults.
    We conducted a retrospective study on 13 pediatric patients (ages 6-13 years old). These patients had treatment of their malocclusion using clear aligners and their treatment involved upper arch expansion as well as initial and after treatment CBCTs (Cone Beam Computed Tomography) as part of their routine orthodontic records. We set up a control group of 8 children (7-12 years) without clear aligner treatment but having two CBCTs. Based on the treatment and control groups, we investigated whether pediatric patients treated with clear aligners had a significant increase in upper arch expansion and nasal airway volume and morphology. Secondly, we conducted a retrospective pilot study to investigate the effect of upper arch expansion using clear aligners in the adult population. We studied 6 adults (31-52 years) who were treated with clear aligners for maxillary expansion.
    The results showed a significant increase in nasal airway volume as well as intermolar distance in the treatment group of pediatric patients, but not in the control group. No correlation was found between the changes in intermolar distance and nasal airway volume in the treatment group. In the adult population, the results suggest a trend of increased nasal airway volume after maxillary expansion with clear aligners, however, the results were not statistically significant. Further study with an increased sample size may confirm the suggested trends.
    This work provides a method to investigate changes in nasal airway volume and morphology and demonstrates the potential for slow maxillary expansion with clear aligners to improve nasal airway parameters. This suggests that such treatment may be a possible solution to improve outcomes for OSA patients.

  • Subjects / Keywords
  • Graduation date
    Fall 2022
  • Type of Item
    Thesis
  • Degree
    Master of Science
  • DOI
    https://doi.org/10.7939/r3-srgy-cj46
  • License
    This thesis is made available by the University of Alberta Library with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.