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The effect of rapid palatal expansion on sleep bruxism in children

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Abstract

Background

Sleep bruxism (SB) is a movement described as an involuntary mastication movement during sleep, also defined as rhythmic masticatory muscle activity (RMMA). It is observed in 2–40 % of the pediatric population. A link was suggested between respiratory events and RMMA. Rapid palatal expansion (RPE) is an effective orthopedic treatment for correcting maxillary transverse deficiency and sleep-disordered breathing (SDB) in children. The aim was to evaluate the possible reduction of SB after rapid palatal expansion (RPE) therapy.

Methods

A total of 32 patients (8–14 years old; 22 girls and 10 boys) received an orthodontic treatment for transverse maxillary deficiency (5 mm or more) at the orthodontics department of the Université de Montréal. They underwent an ambulatory polysomnography (PSG) before, after expansion with the expander, and at the end of the study without the expander. They were classified into three subgroups based on sleep electromyography (EMG) data.

Results

Total sleep time and stage NREM 3 presented significant differences between the types of appliances. Moreover, there was a time effect observed for total sleep time, sleep cycles, stage NREM 2, and stage REM, while only a trend suggested for stage NREM 3. Significant differences were observed between subgroups for both RMMA episodes and burst indexes, similarly, for the oxygen desaturation index (ODI). A total of 50 % of the patients were classified as responders when RMMA episodes index decreased by more than 25 % when comparing treatment efficacy at baseline night.

Conclusion

Most bruxers (65 %) reduced their RMMA episode index after expansion, but sleep and respiratory variables remained unchanged.

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Abbreviations

AHI:

Apnea-hypopnea index

ECG:

Electrocardiography

EEG:

Electroencephalography

EMG:

Electromyography

EOG:

Electrooculography

NREM:

Non rapid eye movement

ODI:

Oxygen desaturation index

OSA:

Obstructive sleep apnea

PSG:

Polysomnography

RMMA:

Rhythmic activity of masticatory muscles

REM:

Rapid eye movement

RME:

Rapid maxillary expansion

RPE:

Rapid palatal expansion

SB:

Sleep bruxism

SDB:

Sleep-disordered breathing

SEM:

Standard error mean

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Acknowledgments

The authors would like to thank Dr. Gilles Lavigne, Pierre Rompré, and the participants for their input and support. The ambulatory devices were graciously provided by Dr. Gilles Lavigne.

Conflict of interest

The authors declare that they have no conflict of interest.

Sources of funding

This study was funded by the GramDENT scholarship, Geoffrion fund project both at the Université de Montréal, as well as the FRQ–S (RSBO) subvention.

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Authors and Affiliations

  1. Faculté de Médecine Dentaire, Université de Montréal, CP 6128 succ. Centre-ville, Montreal, QC, H3C 3J7, Canada

    Audrey Bellerive, Andrée Montpetit, Hicham El-Khatib, Maria Clotilde Carra, Claude Remise & Nelly Huynh

  2. Faculté de Médecine Dentaire, Université de Laval, 2420 rue de la Terrasse, Pavillon Médcine Dentaire, Quebec (Que.), G1V 0A6, Canada

    Audrey Bellerive

  3. Centre de Recherche du CHU Sainte-Justine, 3175, Chemine de la Côte-Sainte-Catherine, Montrea (Que.), H3T 1C5, Montreal, Canada

    Eve Desplats & Nelly Huynh

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  1. Audrey Bellerive
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  2. Andrée Montpetit
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  3. Hicham El-Khatib
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  4. Maria Clotilde Carra
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  7. Nelly Huynh
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Correspondence to Nelly Huynh.

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Bellerive, A., Montpetit, A., El-Khatib, H. et al. The effect of rapid palatal expansion on sleep bruxism in children. Sleep Breath 19, 1265–1271 (2015). https://doi.org/10.1007/s11325-015-1156-4

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  • DOI: https://doi.org/10.1007/s11325-015-1156-4

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