Effet de l’expansion palatine sur le bruxisme du sommeil chez des enfants en comparant des appareils d’expansion palatine rapide collé ou bagué
Introduction: Sleep bruxism (SB) is a movement disorder described as an involuntary mastication movement during sleep. This parafunction is observed in 14-38% of the child population. A link was found between respiratory events and episodes of bruxism. Rapid palatal expansion (RPE) in children is an orthopedic treatment that is effective in correcting maxillary transverse deficiency and in reducing obstructive apnea syndrome (OAS) by increasing airway capacity. Objectives : Since bruxism is related to respiratory events and RPE increases respiratory capacity, the objective of this study is to evaluate the possible reduction of bruxism after RPE therapy. Material and Methods : This prospective randomized controlled clinical pilot study recruited 27 children (8-14 years old, 8 boys, 19 girls) with or without sleep bruxism. These patients were seeking treatment for transverse maxillary deficiency (5 mm or more) at the orthodontics department of the University of Montreal. Patients underwent an ambulatory polysomnography before (T0) and after expansion (T1). Sleep parameters, rhythmic muscular masticatory activity index were evaluated. Results : The results show a reduction of bruxism in 60% of bruxer patients (9 participants). The interaction between the treatment and the groups (Br and ctl) was significant (p=0,05, repeated measures ANOVA). A reduction of bruxism is shown for bruxers (p=0,04, paired t-test). The sleep parameters stayed stable after RPE (Stage N1/N2/N3, REM, sleep efficiency) as well as the breathing parameters and snoring data. The medians (min, max) of bruxism group went from 3,11 (2,06; 7,68) to 2,85 (0,00; 9,51). Conclusion : During this study, a reduction of bruxism was observed but a larger sample size is needed to conclude on the subject.
rapid palatal expansion sleep bruxism children polysomnography maxillary transverse deficiency