Skeletal and nasal airflow changes in late adolescents and young adults after RPE vs MARPE: a randomized clinical trial.

Objectives: To compare differential changes in nasal patency and dentoskeletal morphology after rapid palatal expansion (RPE) vs hybrid miniscrew-assisted rapid maxillary expansion (MARPE).

Materials and methods: Thirty patients presenting with bilateral crossbite were randomized into RPE or hybrid MARPE treatment groups. MARPE patients were treated using the two-point hyrax appliance and RPE patients were treated using the conventional hyrax appliance. Nasal patency was evaluated using rhinomanometry and dentoskeletal changes were evaluated using cone beam computed tomography images.

Results: The success of suture opening was 46.6% and 60% in the RPE (mean age: 17.36 ± 1.80) and MARPE groups (mean age: 18.52 ± 1.80), respectively. The MARPE group showed significantly increased nasal airflow and decreased nasal resistance during inspiration and expiration compared to the RPE group after 4 months of treatment. The RPE group demonstrated nonsignificant changes in the same parameters after 4 months. Although significant differences between groups were observed in nasal flow during inspiration and expiration for both nostrils, intergroup differences in nasal resistance were not significant (P > .05). The MARPE group exhibited greater expansion in nasal, maxillary basal, and alveolar widths compared to the RPE group. A more pronounced decrease in buccal bone thickness was observed in the RPE group. The buccal inclination of the first premolars and molars significantly increased in both groups.

Conclusions: Although similar success rates for sutural opening were observed between MARPE and RPE, MARPE facilitated more pronounced changes in nasal patency and skeletal maxillary expansion compared to conventional RPE.