Effects of rapid maxillary expansion on respiratory and bruxism indexes in children with obstructive sleep apnea: a pilot study

Cranio. 2026 May;44(3):503-510. doi: 10.1080/08869634.2025.2552537. Epub 2025 Sep 4.

Abstract

Objective: The aim of this study was to investigate the impact of rapid maxillary expansion (RME) on sleep bruxism (SB) and respiratory indexes in pediatric patients.

Methods: Twenty-four subjects needing orthodontic treatment and with suspicion of obstructive sleep apnea (OSA) were recruited. Before orthodontics, a clinical and anamnestic evaluation as well as a polygraphic recording was performed. The subjects underwent rapid palatal expansion and, after 6 months, the evaluations were repeated for the participants with an apnea-hypopnea index (AHI) > 1.

Results: Mean AHI was 2.3±1.4 and 2.2±1.2 at T0 and T1, respectively, while sleep bruxism events (SBEs) values were 15.1± 17 and 23.1±14.5. No significant differences between pre and post treatment values could be detected.

Conclusions: At the study population level, no statistically significant differences in the main (i.e., AHI and SBEs) and secondary outcomes with RME treatment were described. Specific phenotypes might be identified with future studies.

Keywords: Sleep bruxism; obstructive sleep apnea; palatal expansion; rapid palatal expander; sleep-disordered breathing; upper airways.

MeSH terms

  • Adolescent
  • Child
  • Female
  • Humans
  • Male
  • Palatal Expansion Technique*
  • Pilot Projects
  • Polysomnography
  • Respiration
  • Sleep Apnea, Obstructive* / physiopathology
  • Sleep Apnea, Obstructive* / therapy
  • Sleep Bruxism* / physiopathology
  • Sleep Bruxism* / therapy
  • Treatment Outcome