title: Bimaxillary expansion therapy for pediatric sleep-disordered breathing.
abstract: The aim of this retrospective study was to evaluate the results of bimaxillary expansion as a treatment option for pediatric sleep-disordered breathing.
  
  
  
  Forty-five children, aged 3-14 years, with sleep-disordered breathing underwent bimaxillary expansion. They were subjected to baseline clinical evaluations, cephalometric X-rays, and polygraphic sleep studies. Three to six months after bimaxillary expansion, posttreatment sleep studies were performed. Data were analyzed with nonparametric Wilcoxon signed-rank test, and Spearman's correlations were performed to correlate cephalometric facial structures to the effectiveness of treatment.
  
  
  
  The majority of the children (n = 30) showed improvement in their sleep scores and symptoms after bimaxillary expansion. The initial severity of the obstructive sleep apnea (OSA) indicated by the apnea-hypopnea index (AHI) was a much better predictor of positive results. However, in the "mild OSA" group, patients with smaller MP-SN or counterclockwise mandibular growth, worsened with bimaxillary expansion, while patients with clockwise mandibular growth showed greater improvement; in the "severe OSA" group, patients who initially had shorter mandibular base lengths showed lesser AHI improvements.
  
  
  
  Bimaxillary expansion can be a treatment option for improving respiratory parameters in children with sleep-disordered breathing. This study also suggests that retrognathia in an anterior growth rotation pattern may not respond to efforts of bimaxillary expansion.
authors.affiliation: School of Dentistry, University of California at San Francisco, San Francisco, CA, USA.
authors.forename: Stacey D
authors.initials: SD
authors.lastname: Quo
authors.affiliation: Faculty of Dentistry, Université de Montréal, Montréal, Canada.
authors.forename: Nelly
authors.initials: N
authors.lastname: Hyunh
authors.affiliation: Sleep Medicine Division, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: cguil@stanford.edu.
authors.forename: Christian
authors.initials: C
authors.lastname: Guilleminault
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010155:Palatal Expansion Technique; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D016896:Treatment Outcome
keywords: Bimaxillary expansion; Obstructive sleep apnea; Orthodontics; Pediatrics; Sleep-disordered breathing