Evaluation of Respiratory Conditions in Individuals Undergoing Rapid Maxillary Expansion: A Computational Fluid Dynamics Study

<b>Background/Objectives:</b> The effect of rapid maxillary expansion (RME) on the nasal and pharyngeal airways in children remains uncertain. This retrospective study utilized computational fluid dynamics (CFD) to assess the changes in ventilation parameters caused by RME in children. &...

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Main Authors: Arzu Alan, Mehmet Ugurlu, İbrahim Sevki Bayrakdar, Fehmi Gonuldas, Sergio Lucio Pereira de Castro Lopes, Andre Luiz Ferreira Costa, Kaan Orhan
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/5/527
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author Arzu Alan
Mehmet Ugurlu
İbrahim Sevki Bayrakdar
Fehmi Gonuldas
Sergio Lucio Pereira de Castro Lopes
Andre Luiz Ferreira Costa
Kaan Orhan
author_facet Arzu Alan
Mehmet Ugurlu
İbrahim Sevki Bayrakdar
Fehmi Gonuldas
Sergio Lucio Pereira de Castro Lopes
Andre Luiz Ferreira Costa
Kaan Orhan
author_sort Arzu Alan
collection DOAJ
description <b>Background/Objectives:</b> The effect of rapid maxillary expansion (RME) on the nasal and pharyngeal airways in children remains uncertain. This retrospective study utilized computational fluid dynamics (CFD) to assess the changes in ventilation parameters caused by RME in children. <b>Methods:</b> Pre- and post-RME cone beam computed tomography (CBCT) images of 20 patients (4 males, mean age 13 ± 2 years) treated with RME for maxillary transverse insufficiency were evaluated. The RME treatment was conducted using two distinct techniques: tooth-borne and tooth-bone-borne. CFD simulations were used to investigate the airflow conditions (pressure and velocity) in the whole upper airway, nasal airway, and maxillary sinus. Morphological alterations and variations in ventilation parameters before and after RME treatment were statistically compared. The extent of changes in the morphological and ventilatory characteristics of the upper airway, depending on the type of RME, was assessed. Additionally, changes in the ventilation conditions of the upper airway, nasal airway, and maxillary sinus after RME treatment were statistically analyzed. Statistical analyses using IBM SPSS v22 (New York, USA) software included paired <i>t</i>-tests, Mann–Whitney U tests, Wilcoxon matched-pairs signed-rank tests, intraclass correlation coefficients, and coefficients of variation (<i>p</i> < 0.05). <b>Results:</b> The CFD study revealed a notable reduction in both air flow velocity and pressure after the RME treatment (<i>p</i> < 0.05). A statistically significant increase was seen in the parameters used to assess the morphological changes following RME treatment, including nasal width, anterior and posterior nasal cross-sectional area, intermaxillary and intermandibulary molar width, and oropharyngeal airway width (<i>p</i> < 0.05). Regarding the change in airway ventilation, there was no statistically significant difference between tooth-borne and tooth-bone-borne RME treatments (<i>p</i> > 0.05). <b>Conclusions:</b> RME not only treats orthodontic issues in childhood but also increases airflow, which enhances ventilation. CDF is an effective method for the detection of ventilation improvement.
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spelling doaj-art-5a94e46393384d23bf6fce742fb8b7772025-08-20T02:05:17ZengMDPI AGDiagnostics2075-44182025-02-0115552710.3390/diagnostics15050527Evaluation of Respiratory Conditions in Individuals Undergoing Rapid Maxillary Expansion: A Computational Fluid Dynamics StudyArzu Alan0Mehmet Ugurlu1İbrahim Sevki Bayrakdar2Fehmi Gonuldas3Sergio Lucio Pereira de Castro Lopes4Andre Luiz Ferreira Costa5Kaan Orhan6Ankara 75th Year Oral and Dental Health Hospital, Ministry of Health, Ankara 06230, TürkiyeDepartment of Orhtodontic, Faculty of Dentistry, Osmangazi University, Eskisehir 26040, TürkiyeDepartment of Dentomaxillofacial Radiology, Faculty of Dentistry, Osmangazi University, Eskisehir 26040, TürkiyeDepartment of Prosthodontics, Faculty of Dentistry, Ankara University, Ankara 06560, TürkiyeDepartment of Diagnosis and Surgery, São José dos Campos School of Dentistry, São Paulo State University (UNESP), São José dos Campos 12245-000, SP, BrazilPostgraduate Program in Dentistry, Cruzeiro do Sul University (UNICSUL), São Paulo 08060-070, SP, BrazilDepartment of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara 06560, Türkiye<b>Background/Objectives:</b> The effect of rapid maxillary expansion (RME) on the nasal and pharyngeal airways in children remains uncertain. This retrospective study utilized computational fluid dynamics (CFD) to assess the changes in ventilation parameters caused by RME in children. <b>Methods:</b> Pre- and post-RME cone beam computed tomography (CBCT) images of 20 patients (4 males, mean age 13 ± 2 years) treated with RME for maxillary transverse insufficiency were evaluated. The RME treatment was conducted using two distinct techniques: tooth-borne and tooth-bone-borne. CFD simulations were used to investigate the airflow conditions (pressure and velocity) in the whole upper airway, nasal airway, and maxillary sinus. Morphological alterations and variations in ventilation parameters before and after RME treatment were statistically compared. The extent of changes in the morphological and ventilatory characteristics of the upper airway, depending on the type of RME, was assessed. Additionally, changes in the ventilation conditions of the upper airway, nasal airway, and maxillary sinus after RME treatment were statistically analyzed. Statistical analyses using IBM SPSS v22 (New York, USA) software included paired <i>t</i>-tests, Mann–Whitney U tests, Wilcoxon matched-pairs signed-rank tests, intraclass correlation coefficients, and coefficients of variation (<i>p</i> < 0.05). <b>Results:</b> The CFD study revealed a notable reduction in both air flow velocity and pressure after the RME treatment (<i>p</i> < 0.05). A statistically significant increase was seen in the parameters used to assess the morphological changes following RME treatment, including nasal width, anterior and posterior nasal cross-sectional area, intermaxillary and intermandibulary molar width, and oropharyngeal airway width (<i>p</i> < 0.05). Regarding the change in airway ventilation, there was no statistically significant difference between tooth-borne and tooth-bone-borne RME treatments (<i>p</i> > 0.05). <b>Conclusions:</b> RME not only treats orthodontic issues in childhood but also increases airflow, which enhances ventilation. CDF is an effective method for the detection of ventilation improvement.https://www.mdpi.com/2075-4418/15/5/527airway remodelingfluid dynamicsmaxillary expansionmaxillary sinusupper airway
spellingShingle Arzu Alan
Mehmet Ugurlu
İbrahim Sevki Bayrakdar
Fehmi Gonuldas
Sergio Lucio Pereira de Castro Lopes
Andre Luiz Ferreira Costa
Kaan Orhan
Evaluation of Respiratory Conditions in Individuals Undergoing Rapid Maxillary Expansion: A Computational Fluid Dynamics Study
Diagnostics
airway remodeling
fluid dynamics
maxillary expansion
maxillary sinus
upper airway
title Evaluation of Respiratory Conditions in Individuals Undergoing Rapid Maxillary Expansion: A Computational Fluid Dynamics Study
title_full Evaluation of Respiratory Conditions in Individuals Undergoing Rapid Maxillary Expansion: A Computational Fluid Dynamics Study
title_fullStr Evaluation of Respiratory Conditions in Individuals Undergoing Rapid Maxillary Expansion: A Computational Fluid Dynamics Study
title_full_unstemmed Evaluation of Respiratory Conditions in Individuals Undergoing Rapid Maxillary Expansion: A Computational Fluid Dynamics Study
title_short Evaluation of Respiratory Conditions in Individuals Undergoing Rapid Maxillary Expansion: A Computational Fluid Dynamics Study
title_sort evaluation of respiratory conditions in individuals undergoing rapid maxillary expansion a computational fluid dynamics study
topic airway remodeling
fluid dynamics
maxillary expansion
maxillary sinus
upper airway
url https://www.mdpi.com/2075-4418/15/5/527
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