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Sleep Breath (2015) 19:12651271 DOI 10.1007/s11325-015-1156-4
ORIGINAL ARTICLE
The effect of rapid palatal expansion on sleep bruxism in children
Audrey Bellerive & Andre Montpetit &
Hicham El-Khatib & Maria Clotilde Carra &
Claude Remise & Eve Desplats & Nelly Huynh
Received: 8 October 2014 /Revised: 6 January 2015 /Accepted: 25 February 2015 /Published online: 20 March 2015 # Springer-Verlag Berlin Heidelberg 2015
AbstractBackground Sleep bruxism (SB) is a movement described as an involuntary mastication movement during sleep, also defined as rhythmic masticatory muscle activity (RMMA). It is observed in 240 % of the pediatric population. A link was suggested between respiratory events and RMMA. Rapid palatal expansion (RPE) is an effective orthopedic treatment for correcting maxillary transverse deficiency and sleep-disordered breathing (SDB) in children. The aim was to evaluate the possible reduction of SB after rapid palatal expansion (RPE) therapy.
Methods A total of 32 patients (814 years old; 22 girls and 10 boys) received an orthodontic treatment for transverse maxillary deficiency (5 mm or more) at the orthodontics department of the Universit de Montral. They underwent an ambulatory polysomnography (PSG) before, after expansion with the expander, and at the end of the study without the expander. They were classified into three subgroups based on sleep electromyography (EMG) data.
Results Total sleep time and stage NREM 3 presented significant differences between the types of appliances. Moreover, there was a time effect observed for total sleep time, sleep cycles, stage NREM 2, and stage REM, while only a trend suggested for stage NREM 3. Significant differences were ob-served between subgroups for both RMMA episodes and burst
indexes, similarly, for the oxygen desaturation index (ODI). A total of 50 % of the patients were classified as responders when RMMA episodes index decreased by more than 25 % when comparing treatment efficacy at baseline night.
Conclusion Most bruxers (65 %) reduced their RMMA episode index after expansion, but sleep and respiratory variables remained unchanged.
Keywords Rapid palatal expansion . Sleep bruxism . Rhythmic masticatory muscle activity . Polysomnography . Maxillary deficiency . Children
AbbreviationsAHI Apnea-hypopnea indexECG ElectrocardiographyEEG ElectroencephalographyEMG ElectromyographyEOG ElectrooculographyNREM Non rapid eye movementODI Oxygen desaturation indexOSA Obstructive sleep apneaPSG PolysomnographyRMMA Rhythmic activity of masticatory muscles REM Rapid eye movementRME Rapid maxillary expansionRPE Rapid palatal expansionSB Sleep bruxismSDB...