title: Effects of rapid maxillary expansion and mandibular advancement on upper airways in Marfan's syndrome children: a home sleep study and cephalometric evaluation.
abstract: OBJECTIVE
  Evaluation of the effects of rapid maxillary expansion and mandibular advancement using Propulsor Universal Light appliance on the upper airways in Marfan's syndrome children through home sleep studies, Epworth Sleepiness Scale questionnaire, and cephalometric analysis of the upper airways on lateral radiographs.
  
  
  METHODS
  The study sample consisted of 30 children with Marfan's syndrome, and the control group consisted of 30 untreated and matched children. For Marfan subjects, data were taken at different time points compared to treatment: at T0 (before treatment), T1 (after rapid maxillary expansion), and T2 (after mandibular advancement). For control subjects, data were taken at similar intervals, at three follow-up visits: at T0 (as a starting screening tool), T1 (after approximately 2 years), and T2 (in proximity of the peak skeletal growth).
  
  
  RESULTS
  Apnea-hypopnea and oxygen desaturations were significantly higher in the study group at T0 and T1 compared with control children. At T2, the values were not significant (p value 0.442 for both apnea-hypopnea index (AHI) and oxygen desaturation index (ODI)). Horizontal airway dimensions were significantly reduced, and vertical airway values were significantly increased in Marfan's syndrome at T0 and T1 but not at T2 (p values at T2: 0.071 for Phw1-Psp, 0.106 for Phw1-Psp', 0.101 for Phw2-Tb, 0.559 for UAL in male and 0.560 for UAL in female).
  
  
  CONCLUSIONS
  Early rapid maxillary expansion and mandibular advancement using Propulsor Universal Light appliance significantly improved airway patency of Marfan's syndrome children and are strongly encouraged as a routine treatment for both correction of class II malocclusions and prevention of obstructive sleep apnea.
authors: Department of Biomedical and Neuromotor Sciences (DIBINEM), Dentistry for Special Need Patients Division, Dental School, Alma Mater Studiorum, University of Bologna, Via San Vitale 59, 40125, Bologna, Italy. marcotaddei76@hotmail.it.|Hospital of Livorno, Public Health Service of Tuscany, Dentistry and Orthodontics Division, Viale Alfieri 36, 57124, Livorno, Italy. marcotaddei76@hotmail.it.
authors: M
authors: M
authors: Taddei
authors: Department of Biomedical and Neuromotor Sciences (DIBINEM), Dentistry for Special Need Patients Division, Dental School, Alma Mater Studiorum, University of Bologna, Via San Vitale 59, 40125, Bologna, Italy.|Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia.
authors: N
authors: N
authors: Alkhamis
authors: Department of Biomedical and Neuromotor Sciences (DIBINEM), Dentistry for Special Need Patients Division, Dental School, Alma Mater Studiorum, University of Bologna, Via San Vitale 59, 40125, Bologna, Italy.
authors: T
authors: T
authors: Tagariello
authors: Department of Biomedical and Neuromotor Sciences (DIBINEM), Dentistry for Special Need Patients Division, Dental School, Alma Mater Studiorum, University of Bologna, Via San Vitale 59, 40125, Bologna, Italy.
authors: G
authors: G
authors: D'Alessandro
authors: Department Cardio-Thoracic-Vascular, Marfan Center, Polyclinic S.Orsola-Malpighi, University of Bologna, Bologna, Italy.
authors: E M
authors: EM
authors: Mariucci
authors: Department of Biomedical and Neuromotor Sciences (DIBINEM), Dentistry for Special Need Patients Division, Dental School, Alma Mater Studiorum, University of Bologna, Via San Vitale 59, 40125, Bologna, Italy.
authors: G
authors: G
authors: Piana
mesh_terms: D016022:Case-Control Studies; D002508:Cephalometry; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019186:Mandibular Advancement / Q000295:instrumentation / Q000379:methods*; D008382:Marfan Syndrome / Q000503:physiopathology* / Q000601:surgery*; D016382:Orthodontic Appliance Design; D009967:Orthodontic Appliances; D010155:Palatal Expansion Technique / Q000295:instrumentation*; D017286:Polysomnography; D012123:Pulmonary Ventilation / Q000502:physiology*; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology* / Q000601:surgery*
keywords: Cephalometric analysis; Mandibular advancement device; Marfan’s syndrome; Obstructive sleep apnea; Rapid maxillary expansion; Sleep studies and questionnaire