Skip to main content
SpringerLink
Log in

Miniscrew-Assisted Maxillary Expansion Techniques for Treatment of Obstructive Sleep Apnea

  • Chapter
  • First Online:
Management of Obstructive Sleep Apnea

Abstract

Transverse maxillary deficiency is one of several common craniofacial structure characteristics observed in patients with obstructive sleep apnea (OSA). Conventional maxillary expander treatment has been used in children with OSA to expand constricted maxilla to increase nasal flow and to allow the tongue to protrude forward and upward. With the introduction of temporary skeletal anchorage devices, orthodontists have utilized miniscrews to secure a maxillary expander on the palate directly in order to achieve more efficient skeletal expansion and to decrease undesired dentoalveolar effects in skeletally mature patients. This chapter discusses various miniscrew-anchored RME expansion designs and protocols with or without corticotomy as a pathway to achieving maximum improvement of OSA.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 49.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 64.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 69.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Cistulli PA. Craniofacial abnormalities in obstructive sleep apnoea: implications for treatment. Respirology. 1996;1(3):167–74.

    Article  CAS  PubMed  Google Scholar 

  2. Cistulli PA, Richards GN, Palmisano RG, Unger G, Berthon-Jones M, Sullivan CE. Influence of maxillary constriction on nasal resistance and sleep apnea severity in patients with Marfan's syndrome. Chest. 1996;110(5):1184–8.

    Article  CAS  PubMed  Google Scholar 

  3. Zambon CE, Ceccheti MM, Utumi ER, et al. Orthodontic measurements and nasal respiratory function after surgically assisted rapid maxillary expansion: an acoustic rhinometry and rhinomanometry study. Int J Oral Maxillofac Surg. 2012;41(9): 1120–6.

    Article  CAS  PubMed  Google Scholar 

  4. Iwasaki T, Saitoh I, Takemoto Y, et al. Tongue posture improvement and pharyngeal airway enlargement as secondary effects of rapid maxillary expansion: a cone-beam computed tomography study. Am J Orthod Dentofac Orthoped. 2013;143(2):235–45.

    Article  Google Scholar 

  5. Cistulli PA, Palmisano RG, Poole MD. Treatment of obstructive sleep apnea syndrome by rapid maxillary expansion. Sleep. 1998;21(8):831–5.

    Article  CAS  PubMed  Google Scholar 

  6. Pirelli P, Saponara M, Guilleminault C. Rapid maxillary expansion (RME) for pediatric obstructive sleep apnea: a 12-year follow-up. Sleep Med. 2015;16(8):933–5.

    Article  PubMed  Google Scholar 

  7. Persson M, Thilander B. Palatal suture closure in man from 15 to 35 years of age. Am J Orthod. 1977;72(1):42–52.

    Article  CAS  PubMed  Google Scholar 

  8. Krebs A. Midpalatal suture expansion studies by the implant method over a seven-year period. Rep Congr Eur Orthod Soc. 1964;40:131–42.

    CAS  PubMed  Google Scholar 

  9. Mosleh MI, Kaddah MA, Abd ElSayed FA, ElSayed HS. Comparison of transverse changes during maxillary expansion with 4-point bone-borne and tooth-borne maxillary expanders. Am J Orthod Dentofac Orthoped. 2015;148(4):599–607.

    Article  Google Scholar 

  10. Deeb W, Hansen L, Hotan T, Hietschold V, Harzer W, Tausche E. Changes in nasal volume after surgically assisted bone-borne rapid maxillary expansion. Am J Orthod Dentofac Orthoped. 2010;137(6):782–9.

    Article  Google Scholar 

  11. Liu SY, Guilleminault C, Huon LK, Yoon A. Distraction osteogenesis maxillary expansion (DOME) for adult obstructive sleep apnea patients with high arched palate. Otolaryngol Head Neck Surg. 2017;157(2):345–8.

    Article  PubMed  Google Scholar 

  12. Yoon A, Guilleminault C, Zaghi S, Liu SY. Distraction Osteogenesis Maxillary Expansion (DOME) for adult obstructive sleep apnea patients with narrow maxilla and nasal floor. Sleep Med. 2020;65:172–6.

    Article  PubMed  Google Scholar 

  13. Lee SC, Park JH, Bayome M, Kim KB, Araujo EA, Kook YA. Effect of bone-borne rapid maxillary expanders with and without surgical assistance on the craniofacial structures using finite element analysis. Am J Orthod Dentofac Orthop. 2014;145(5):638–48.

    Article  Google Scholar 

  14. Landes CA, Laudemann K, Schubel F, et al. Comparison of tooth- and bone-borne devices in surgically assisted rapid maxillary expansion by three-dimensional computed tomography monitoring: transverse dental and skeletal maxillary expansion, segmental inclination, dental tipping, and vestibular bone resorption. J Craniofac Surg. 2009;20(4):1132–41.

    Article  PubMed  Google Scholar 

  15. Gunbay T, Akay MC, Gunbay S, Aras A, Koyuncu BO, Sezer B. Transpalatal distraction using bone-borne distractor: clinical observations and dental and skeletal changes. J Oral Maxillofac Surg. 2008;66(12):2503–14.

    Article  PubMed  Google Scholar 

  16. Lee RJ, Moon W, Hong C. Effects of monocortical and bicortical mini-implant anchorage on bone-borne palatal expansion using finite element analysis. Am J Orthod Dentofac Orthoped. 2017;151(5):887–97.

    Article  Google Scholar 

  17. Yu JC, Fearon J, Havlik RJ, Buchman SR, Polley JW. Distraction osteogenesis of the craniofacial skeleton. Plast Reconstr Surg. 2004;114(1):1E–20E.

    Article  PubMed  Google Scholar 

  18. Swennen G, Schliephake H, Dempf R, Schierle H, Malevez C. Craniofacial distraction osteogenesis: a review of the literature: part 1: clinical studies. Int J Oral Maxillofac Surg. 2001;30(2):89–103.

    Article  CAS  PubMed  Google Scholar 

  19. Villa MP, Rizzoli A, Miano S, Malagola C. Efficacy of rapid maxillary expansion in children with obstructive sleep apnea syndrome: 36 months of follow-up. Sleep Breath. 2011;15(2):179–84.

    Article  PubMed  Google Scholar 

  20. Vinha PP, Eckeli AL, Faria AC, Xavier SP, de Mello-Filho FV. Effects of surgically assisted rapid maxillary expansion on obstructive sleep apnea and daytime sleepiness. Sleep Breath. 2015;

    Google Scholar 

  21. Bazargani F, Magnuson A, Ludwig B. Effects on nasal airflow and resistance using two different RME appliances: a randomized controlled trial. Eur J Orthod. 2017;

    Google Scholar 

  22. Lin L, Ahn HW, Kim SJ, Moon SC, Kim SH, Nelson G. Tooth-borne vs bone-borne rapid maxillary expanders in late adolescence. Angle Orthod. 2015;85(2):253–62.

    Article  PubMed  Google Scholar 

  23. Nie P, Zhu M, Lu XF, Fang B. Bone-anchored maxillary expansion and bilateral interoral mandibular distraction osteogenesis in adult with severe obstructive sleep apnea syndrome. J Craniofac Surg. 2013;24(3):949–52.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Stanford Sleep Medicine Center Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA

    Audrey Jung-Sun Yoon

  2. Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA

    Stanley Yung-Chuan Liu

  3. Sleep Medicine Program, Stanford University Sleep Disorders Clinic, Stanford, CA, USA

    Christian Guilleminault

Authors
  1. Audrey Jung-Sun Yoon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stanley Yung-Chuan Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christian Guilleminault
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Orthodontics, Saint Louis University Orthodontics, Saint Louis, MO, USA

    Ki Beom Kim

  2. Orthodontics, Saint Louis University Orthodontics, Saint Louis, MO, USA

    Reza Movahed

  3. Washington University in St. Louis School of Medicine, Saint Louis, MO, USA

    Raman K. Malhotra

  4. Otolaryngology-Head and Neck Surgery, University of Michigan–Ann Arbor, Ann Arbor, MI, USA

    Jeffrey J. Stanley

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Yoon, A.JS., Liu, S.YC., Guilleminault, C. (2021). Miniscrew-Assisted Maxillary Expansion Techniques for Treatment of Obstructive Sleep Apnea. In: Kim, K.B., Movahed, R., Malhotra, R.K., Stanley, J.J. (eds) Management of Obstructive Sleep Apnea. Springer, Cham. https://doi.org/10.1007/978-3-030-54146-0_20

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-54146-0_20

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-54145-3

  • Online ISBN: 978-3-030-54146-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation