phenylephrine-hydrochloride and Nocturnal-Enuresis

The original indication for rapid palatal expansion was to treat skeletal maxillary constriction. As positive effects were clinically proven, the number of indications for rapid palatal expansion has continuously grown. The purpose of the present article was to review the literature and to evaluate the effect of rapid palatal expansion on nose breathing, natural head position, obstructive sleep apnoea syndrome, nocturnal enuresis and conductive hearing loss.. It can be concluded that rapid palatal expansion is predominantly recommended in children with maxillary constriction. In those with normal occlusion, maxillary expansion can be considered as the really last choice of treatment when other treatment options in patients with nose breathing, obstructive sleep apnea syndrome (OSAS), nocturnal enuresis and conductive hearing loss (CHL) have failed. Therefore, collaboration between paediatricians, otolaryngologists, paediatric dentists and orthodontists will lead to the best treatment outcomes in the future.

Topics: Child; Head; Health Status; Hearing Loss, Conductive; Humans; Nocturnal Enuresis; Nose; Palatal Expansion Technique; Respiration; Sleep Apnea, Obstructive

To evaluate whether rapid maxillary expansion (RME) could reduce the frequency of nocturnal enuresis (NE) in children and whether a placebo effect could be ruled out.. Thirty-four subjects, 29 boys and five girls with mean age of 10.7 ± 1.8 years suffering from primary NE, were recruited. All subjects were nonresponders to the first-line antienuretic treatment and therefore were classified as "therapy resistant." To rule out a placebo effect of the RME appliance, all children were first treated with a passive appliance for 4 weeks. Rhinomanometry (RM), acoustic rhinometry (AR), polysomnographic registration, and study casts were made at different time points.. One child experienced severe discomfort from the RME appliance and immediately withdrew from the study. Following RME, the long-term cure rate after 1 year was 60%. The RM and AR measurements at baseline and directly after RME showed a significant increase in nasal volume and nasal airflow, and there was a statistically significant correlation between reduction in enuresis and increase in nasal volume. Six months postretention, a 100% relapse of the dental overexpansion could be noted.. RME has a curative effect in some children with NE, which could be connected to the positive influence of RME on the sleep architecture. Normal transverse occlusion does not seem to be a contraindication for moderate maxillary expansion in attempts to cure NE in children.

Topics: Cephalometry; Child; Female; Humans; Male; Maxilla; Nasal Cavity; Nocturnal Enuresis; Nose; Orthodontic Appliances; Palatal Expansion Technique; Rhinomanometry

To evaluate the effects of rapid maxillary expansion (RME) on nocturnal enuresis (NE) related to the nasal airway, nasal breathing, and plasma osmolality (as an indicator for antidiuretic hormone).. Nineteen patients with monosymptomatic primary NE, aged 6-15 years, were treated with RME for 10-15 days. To exclude a placebo effect of the RME appliance, seven patients were first treated with a passive appliance. Computed tomography of nasal cavity, rhinomanometric, and plasma osmolality measurements were made 2-3 days before and 2-3 months after the RME period. RME effects on NE were followed for three more years.. Two to three months after the expansion there were significant improvements in the breathing function and a decrease in the plasma osmolality. NE decreased significantly in all patients after the RME period, and all patients showed full dryness after 3 years.. This study demonstrates that RME causes complete dryness in all patients, with significant effects on pathophysiological mechanisms related to NE.

Topics: Adolescent; Airway Resistance; Blood Glucose; Blood Urea Nitrogen; Child; Female; Follow-Up Studies; Humans; Male; Malocclusion; Mouth Breathing; Nasal Cavity; Nocturnal Enuresis; Nose; Osmolar Concentration; Palatal Expansion Technique; Pulmonary Ventilation; Respiration; Rhinomanometry; Snoring; Sodium; Tomography, X-Ray Computed; Vasopressins