Association between Rapid Maxillary Expansion and Nocturnal Enuresis in Children: A Pilot Study for a Randomized Controlled Clinical Trial
Source abstract
Abstract
Objectives: This pilot study was conducted to test the protocol of a randomized controlled trial evaluating whether rapid maxillary expansion (RME) can relieve nocturnal enuresis (NE) and improve breathing in children, after ruling out a placebo effect, and investigating whether the effects of RME and NE are related to the morphology of the upper airway. Methods: Seventy 6–15-year-old patients with NE were assessed for eligibility (e.g., constricted maxilla). Enrolled subjects were randomized to immediate treatment with RME (Group 1) or to have the same treatment (RME) delayed for at least six weeks (Group 2). Outcomes comprised the number of wet nights per week, the nocturnal urine production, and the scores of a pediatric sleep questionnaire at baseline, after active treatment (Group 1) or delayed treatment (Group 2), and after 3 months’ retention. Cone beam computed tomographies were taken at baseline and after retention. Results: Six patients were randomized: three in each group. In four of six patients, the number of wet nights per week decreased. Moreover, in responders, nocturnal urine production was reduced following RME. Conclusions: This pilot study suggested that RME might reduce the severity of NE and showed that the protocol of this randomized controlled clinical trial was appropriate.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Obstructive Sleep Apnea Research · Neuroscience of respiration and sleep · Gastroesophageal reflux and treatments
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Section of Orthodontics, Department of Dentistry and Oral Health, Health, Aarhus University, 8000 Aarhus, Denmark
Dentistry and Health Sciences, Faculty of Medicine, Melbourne Dental School, University of Melbourne, Melbourne, VIC 3053, Australia
Department of Pediatrics, Aarhus University Hospital, 8000 Aarhus, Denmark
References (36)
Show source-provided references
1. The prevalence of infrequent bedwetting and nocturnal enuresis in childhood. A large British cohort10.1080/00365590701748054 ↗
2. Family history of nocturnal enuresis and urinary incontinence: Results from a large epidemiological study10.1016/j.juro.2011.02.040 ↗
3. Characteristics of primary nocturnal enuresis in adults: An epidemiological study10.1111/j.1464-410X.2003.04612.x ↗
4. Evaluation of and treatment for monosymptomatic enuresis: A standardization document from the International Children’s Continence Society10.1016/j.juro.2009.10.043 ↗
5. Nocturnal polyuria in monosymptomatic nocturnal enuresis refractory to desmopressin treatment10.1152/ajprenal.00134.2006 ↗
6. Nocturnal polyuria is related to 24-hour diuresis and osmotic excretion in an enuresis population referred to a tertiary center10.1016/j.juro.2007.08.029 ↗
7. Urinary calcium excretion in healthy children and children with primary monosymptomatic nocturnal enuresis10.1016/S0022-5347(06)00300-4 ↗
8. Sleep disordered breathing and nocturnal polyuria: Nocturia and enuresis10.1053/smrv.2002.0273 ↗
9. Nocturnal enuresis is associated with moderate-to-severe obstructive sleep apnea in children with snoring10.1038/pr.2014.137 ↗
10. Association between primary nocturnal enuresis and habitual snoring in children10.1016/j.urology.2006.02.021 ↗
11. Resolution of nocturnal enuresis in snoring children after treatment with nasal budesonide10.1016/j.urology.2005.01.021 ↗
12. Rapid maxillary expansion in therapy-resistant enuretic children: An orthodontic perspective10.2319/051515-329.1 ↗
13. Adenotonsillectomy Normalizes Hormones and Urinary Electrolytes in Children with Nocturnal Enuresis and Sleep-Disordered Breathing10.1016/j.urology.2015.04.011 ↗
14. Effect of rapid maxillary expansion on monosymptomatic primary nocturnal enuresis10.2319/031014-172.1 ↗
15. Craniofacial and upper airway morphology in pediatric sleep-disordered breathing and changes in quality of life with rapid maxillary expansion10.1016/j.ajodo.2013.08.015 ↗
16. Density of the midpalatal suture after RME treatment—A retrospective comparative low-dose CT-study10.1186/1746-160X-10-18 ↗
17. Effects of rapid maxillary expansion on the midpalatal suture: A systematic review10.1093/ejo/cju100 ↗
18. Does rapid maxillary expansion have long-term effects on airway dimensions and breathing?10.1016/j.ajodo.2011.02.019 ↗
19. Effect of rapid maxillary expansion on nocturnal enuresis
20. Orthodontic maxillary expansion and its effect on nocturnal enuresis
21. Rapid Palatal Expansion to Treat Nocturnal Enuretic Children: A Systematic Review and Meta-Analysis
22. Nevéus, T., Läckgren, G., Tuvemo, T., Hetta, J., Hjälmås, K., and Stenberg, A. (2000). Enuresis—Background and treatment. Scand. J. Urol. Nephrol., 1–44.10.1080/003655900750071309 ↗
23. Computer-aided design and manufacture of hyrax devices: Can we really go digital?10.1016/j.ajodo.2017.06.016 ↗
24. Pediatric sleep questionnaire (PSQ): Validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems10.1016/S1389-9457(99)00009-X ↗
25. Niu, X., Madhan, S., Cornelis, M.A., and Cattaneo, P.M. (2020). Novel three-dimensional methods to analyze the morphology of the nasal cavity and pharyngeal airway. Angle Orthod., in press.10.2319/070620-610.1 ↗
26. Treatment of long-standing nocturnal enuresis by mandibular advancement10.1007/s11325-004-0057-8 ↗
27. Nocturnal enuresis in children with upper airway obstruction10.1177/019459989110500314 ↗
28. Enuresis in children with sleep apnea10.1067/mpd.2003.158 ↗
29. Pediatric sleep-disordered breathing in the orthodontic population: Prevalence of positive risk and associations10.1016/j.ajodo.2019.05.015 ↗
30. Rapid maxillary expansion effects on nocturnal enuresis in children: A follow-up study10.2319/021407-71.1 ↗
31. Orthodontic widening of the palate may provide a cure for selected children with therapy-resistant enuresis10.1111/apa.12749 ↗
32. Effects of maxillary expansion and placebo effect of appliances on nocturnal enuresis—Preliminary results
33. Influence of Orthodontic Rapid Maxillary Expansion on Nocturnal Enuresis in Children
34. Rapid maxillary expansion in children with nocturnal enuresis: A randomized placebo-controlled trial10.2319/031819-219.1 ↗
35. Rapid maxillary expansion in the treatment of nocturnal enuresis
36. The role of sleep in the pathophysiology of nocturnal enuresis10.1016/j.smrv.2019.101228 ↗