Date of Award

9-27-2024

Department

Department of Orthodontics

First Advisor

Jonas Bianchi

Abstract

Objectives: This study aimed to compare nasal airway space and anatomy changes in growing patients treated with MARPE, RPE, and a control group, using a novel methodology involving 3D cranial base superimposition to identify stable reference points for more reliable and reproducible measurements. 3D volume segmentation and reconstruction were performed to visualize the changes in nasal cavity structures, including the inferior turbinate. Methods: The sample included 90 growing patients (ages 12-16 years) divided equally (n=30) into three groups: MARPE, RPE, and control, age and sex-matched. Pre- (T1) and post-treatment (T2) CBCT scans were analyzed. Stable reference points were identified via 3D cranial base superimposition. Nasal cavity, inferior turbinate, and airway space widths were measured in three regions (anterior, middle, and posterior). 3D segmentation assessed nasal airway and inferior turbinate changes. Statistical analysis included Student’s t-tests, ANOVA, Post-Hoc Tukey, Wilcoxon signed-rank, Kruskal-Wallis, and Mann-Whitney U tests. Results: The mean ages at T1 for the MARPE, RPE, and control groups were 13.54, 13.05, and 13.32 years, respectively, with no significant differences among the groups. Treatment duration was significantly longer for the MARPE (30.43 months) and RPE (29.63 months) groups compared to the control (23.37 months). Nasal cavity width increased in all three groups, particularly in the middle and posterior regions, with the MARPE group showing the greatest increase. Only the MARPE group showed significant increases in inferior turbinate width (5.20 mm) and volume (344.10 mm3). Nasal airway space significantly increased in both the MARPE and RPE groups, with no significant difference between them, while the control group exhibited no significant changes. 3D reconstructions of the inferior turbinate confirmed these changes, especially in MARPE patients. Conclusions: This study found significant differences in nasal airway space and inferior turbinate changes among MARPE, RPE, and control groups, with MARPE showing the greatest increase in nasal cavity width and turbinate dimensions. Both MARPE and RPE groups significantly expanded nasal airway space. These findings can help guide clinical decisions in treating maxillary transverse deficiency and nasal airway constriction. The novel 3D methodology allowed precise comparisons of nasal structures.

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