Effects of Rapid Maxillary Expansion on Serum Insulin-Like Growth Factor I and Pharyngeal Airway in a Prepubertal Population with Maxillary Constriction
Bibliographic record
Abstract
Introduction: Rapid maxillary expansion (RME) is a common treatment in orthodontics to correct transverse maxillary deficiencies manifested in posterior crossbites. Maxillary expansion improves the upper airway morphology by causing lateral movement of the walls of the nasal cavity which could potentially contribute to the improvement of airflow. However, it is unclear whether there is an overall increase in the pharyngeal volume after treatment. Adenotonsillar hypertrophy has been identified as a potential cause of mouth breathing in children, which, when resected with surgery, has been shown to promote growth through the increase of IGF-1, a potent hormone responsible for growth and development.(Nosetti et al. 2023) Currently, there have been no studies that have determined the effect of RME on serum concentrations of IGF-1. The objectives of this study are to determine the effect of RME on the pharyngeal volume as well as serum IGF-1 concentrations in prepubertal children with a maxillary transverse discrepancy over a period of 12 months. Materials and Methods: Forty-three individuals between the ages of 6 and 12 with maxillary skeletal constriction presented in unilateral or bilateral crossbite and crossbite tendency were selected. They were of prepubertal status and void of any medical conditions. The control group consisted of children who did not undergo skeletal expansion, whereas the treatment group received the rapid maxillary expansion with a hyrax appliance. Blood was drawn and CBCTs were taken at the start of the trial (T0) and approximately 12 months after acquiring the first set of data (T1). Blood samples were acquired and analyzed for IGF-1 levels the same day by a commercial laboratory, DynaLife Medical Labs (Edmonton, Canada). Digital Imaging and Communication in Medicine (DICOM) format files were generated from T0 and T1 CBCT scans which were subsequently imported and analyzed by the Slicer© software. Results: No statistically significant effect of maxillary expansion achieved on serum levels of IGF-1 and airway volume due to the p-values being greater than 0.05. The mean difference in IGF-1 levels were 39.2ug/L and 74.2ug/L in the control and treatment groups, respectively. The mean change in airway volumes for the control and treatment group, respectively, were 9299.6mm3 and 12231.9 mm3. Mean difference in IMW for the control and expander group were 0.36mm and 4.17mm. Conclusion: The treatment group did not experience an increase in pharyngeal volume when compared to the control group. Similarly, RME did not produce an increase serum IGF-1 in the treatment group when compared to the control group as well. Therefore, the findings of this research suggest that RME does not produce significant changes in the pharyngeal volume and may not increase IGF-1 levels in children. However, due to sample size and imaging protocols, future studies are required to obtain a more definitive conclusion in this area of study.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".