"Impact of maxillary expansion on enuresis and quality of life in children with mouth breathing: a randomized clinical study".

Maxillary expansion may be an alternative treatment method for children with nocturnal enuresis, with a positive response, the literature presents a low quality of the existing evidence, which weakens the recommendation of this procedure in children with enuresis. PRIMARY

OBJECTIVE

To evaluate changes provided by rapid or slow maxillary expansion on enuresis. SECONDARY

OBJECTIVES

To assess the impact of maxillary expansion on quality of life and body mass index (BMI) in children with mouth breathing.  METHODOLOGY: Randomized clinical trial with two parallel arms, composed of children between 8 and 11 years of age, submitted to rapid or slow maxillary expansion with the Haas expander. Enuresis was assessed through the Dysfunctional Symptom Score (DVSS) questionnaire and quality of life related to oral health by the Children Oral Health Quality of Life (COHQoL) index. The variables were measured before the installation of the Haas expander (T0), one month after without screw activation (T1), immediately after expansion (T2), in the post-retention period (T3) and one year after expansion (T4), through mixed-model ANOVA and BMI through ANCOVA, with a significance level of 5%.

RESULTS

In a sample of 28 children, maxillary expansion, with no difference between slow or rapid, resulted in a significant reduction in the enuresis index (p < 0.001). Among patients who were followed up to T4 (n = 21), the results were maintained up to one year after the end of the expansion. Regardless of the expansion protocol, there was an initial negative impact (T1)(p < 0.0001), of the expansion on quality of life, which diminished over time, being smaller at T4 (p < 0.0410) than at T0 (p < 0.5656). Changes in BMI did not have any difference in the two protocols (p = 0.117), with no difference between T0, T1, T2 and T3, but with an increase at T4 (p < 0.001).

CONCLUSION

Maxillary expansion, whether slow or rapid, produces a significant reduction in enuresis in children with mouth breathing, which is maintained one year after expansion. The installation of the expander causes an initial negative impact on quality of life, but an improvement occurs after expansion, regardless of the protocol applied. The BMI at the end of the study shows a significant increase, improving the body mass condition of the children.