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Orthodontic widening of the palate may provide a cure for selected children with therapy‐resistant enuresis
Author(s) -
Nevéus Tryggve,
Leissner Lena,
Rudblad Stig,
Bazargani Farhan
Publication year - 2014
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12749
Subject(s) - medicine , enuresis , airway , dentistry , nocturnal , maxilla , pediatrics , anesthesia
Aim According to a number of small case series, orthodontic treatment may have anti‐enuretic effects. Thus, we evaluated whether widening of the palate can alleviate enuresis and whether prognostic information can be gained from examining children's nocturnal respiration and nasal airway dimensions. Methods Children with therapy‐resistant enuresis underwent polysomnography, focusing on nocturnal respiration, and had their nasal airways examined. Rapid maxillary expansion was performed, widening the maxilla by approximately 0.5 cm. The dental appliance was removed after 6 months. Enuresis frequency was evaluated four times: at baseline, with the orthodontic apparatus in situ , after completed maxillary expansion and 1 year post‐treatment. Results Of the 34 children recruited, one dropped out due to oral discomfort. The numbers of wet nights per week on the four assessment occasions were 5.48 ± 1.48, 5.12 ± 1.73, 3.09 ± 2.49 and 2.63 ± 2.81; p < 0.001. The proportions of responders, intermediate responders and non‐responders during treatment were 21.2%, 27.3% and 51.5%, respectively. Responders were found to have a lower enuresis frequency at baseline (p = 0.001) and to have larger nasal airway dimensions (p = 0.01). Conclusion Orthodontic widening of the palate may be curative in a subgroup of children with therapy‐resistant enuresis.