title: Changes in pharyngeal aerobic microflora in oral breathers after palatal rapid expansion.
abstract: BACKGROUND
  The purpose of this study was to investigate in oral breathing children the qualitative and quantitative effects on aerobic and facultatively anaerobic oropharyngeal microflora of respiratory function improved by rapid palatal expansion (RPE).
  
  
  METHODS
  In an open clinical trial, we studied 50 oral breathers, aged 8 to 14 years and suffering from both maxillary constriction and posterior cross-bite. At baseline, patients were examined by a single otorhinolaryngologist (ENT), confirming nasal obstruction in all subjects by posterior rhino-manometric test. Patients were evaluated three times by oropharyngeal swabs:1) at baseline (T = 0); 2) after palatal spreading out (T = 1); and 3) at the end of RPE treatment (T = 2). With regard to the microbiological aspect, the most common and potentially pathogenic oral microrganisms (i.e. Streptococcus pyogenes, Diplococcus pneumoniae, Staphylococcus aureus, Haemophilus spp, Branhamella catarrhalis, Klebsiella pneumoniae, Candida albicans) were specifically detected in proper culture plates, isolated colonies were identified by means of biochemical tests and counted by calibrated loop. The data were analyzed by means of the following tests: Chi-square test, Fisher's exact test and Wilcoxon's test.
  
  
  RESULTS
  After the use of RME there was a statistically significant decrease of Staphylococcus aureus stock at CFU/mLat T1(P = 0.0005; Z = -3,455 by Wilcoxon Rank test) and T2 (P < 0.0001; Z = -4,512 by Wilcoxon Rank test) vs T0. No significant changes were found for the other examined microrganisms.
  
  
  CONCLUSIONS
  Our data suggest that RPE therapy in oral breathers may strongly reduce the pathogenic aerobic and facultatively anaerobic microflora in the oral pharynx after a normalization of the upper airways function, and may reduce the risk of respiratory infections.
authors.affiliation: Department of Dentistry ad Surgery, University of Bari, Bari, Italy. promoge@odonto.unipa.it
authors.forename: Angela Pia
authors.initials: AP
authors.lastname: Cazzolla
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Campisi
authors.forename: Grazia Maria
authors.initials: GM
authors.lastname: Lacaita
authors.forename: Marco Antonino
authors.initials: MA
authors.lastname: Cuccia
authors.forename: Antonio
authors.initials: A
authors.lastname: Ripa
authors.forename: Nunzio Francesco
authors.initials: NF
authors.lastname: Testa
authors.forename: Domenico
authors.initials: D
authors.lastname: Ciavarella
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Lo Muzio