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Journal of Zhejiang University SCIENCE B

ISSN 1673-1581(Print), 1862-1783(Online), Monthly

Evaluating the effect of midpalatal corticotomy-assisted rapid maxillary expansion on the upper airway in young adults using computational fluid dynamics

Abstract: Midpalatal corticotomy-assisted rapid maxillary expansion (MCRME) is a minimally invasive treatment of maxillary transverse deficiency (MTD) in young adults. However, the effect of MCRME on respiratory function still needs to be determined. In this study, we evaluated the changes in maxillary morphology and the upper airway following MCRME using computational fluid dynamics (CFD). Twenty patients with MTD (8 males, 12 females; mean age 20.55 years) had cone-beam computed tomography (CBCT) images taken before and after MCRME. The CBCT data were used to construct a three-dimensional (3D) upper airway model. The upper airway flow characteristics were simulated using CFD, and measurements were made based on the CBCT images and CFD. The results showed that the widths of the palatal bone and nasal cavity, and the intermolar width were increased significantly after MCRME. The volume of the nasal cavity and nasopharynx increased significantly, while there were no obvious changes in the volumes of the oropharynx and hypopharynx. CFD simulation of the upper airway showed that the pressure drop and maximum velocity of the upper airway decreased significantly after treatment. Our results suggest that in these young adults with MTD, increasing the maxillary width, upper airway volume, and quantity of airflow by MCRME substantially improved upper airway ventilation.

Key words: Maxillary transverse deficiency (MTD); Rapid maxillary expansion (RME); Upper airway; Computational fluid dynamics (CFD)

Chinese Summary  <23> 腭中缝骨皮质切开辅助快速扩弓对年轻成人的上气道的影响

目的:采用三维重建技术及流体动力学探究上颌宽度不足的年轻成人经腭中缝骨皮质切开辅助快速扩弓(MCRME)后上颌宽度、上气道形态和功能的变化及治疗效果。
创新点:应用三维重建技术及流体动力学评估MCRME对上气道的通气状况的影响
方法:本研究选择20例上颌宽度不足年轻成人患者作为研究对象,并分别于矫治前和MCRME治疗三个月后拍摄锥形束CT(CBCT),对其进行三维重建及流体动力学分析,比较矫正前后鼻腔宽度、上颌牙弓宽度、上颌基骨宽度、上气道体积、气流压降和速度的变化。
结论:上颌宽度不足的年轻成人采用MCRME矫正后上颌宽度扩大,鼻腔和鼻咽部上气道的体积增加,并且上气道内的气流速度减缓,气流阻力下降,上气道的通气状况整体改善。

关键词组:上颌宽度不足;快速扩弓;上气道;计算流体动力学


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DOI:

10.1631/jzus.B2000090

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On-line Access:

2021-02-07

Received:

2020-03-09

Revision Accepted:

2020-10-12

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