Aerodynamic and anatomical changes of the upper airway after maxillary skeletal expansion in adults
4 affiliations
- 1Department of Orthodontics, The Affiliated Stomatological Hospital of Nanjing Medical University (Jiangsu Province Stomatological Hospital), Nanjing, China
- 2Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases, Nanjing Medical University), Nanjing, China
- 3Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University), Nanjing, China
- 4School of Electrical Engineering, Southeast University, Nanjing, China
Abstract
Objectives: To quantify anatomical and aerodynamic changes of the adult upper airway after maxillary skeletal expansion (MSE) using computational fluid dynamics (CFD) with in vitro validation, and to assess whether expansion magnitude correlates with aerodynamic improvement.
Materials and methods: Thirty-one skeletally mature adults treated with MSE were retrospectively included. CBCT scans at baseline (T1) and after stabilization (T2) were used to reconstruct and segment airway models into nasal and pharyngeal regions. Steady inspiratory CFD was performed at a bilateral flow rate of 30 L/min and validated in 10 patient-specific 1:1 3D-printed models.
Results: Mean expansion magnitude was 4.09 mm. Nasal cavity volume increased (Δ=+3.10 cm³, P < 0.001), whereas pharyngeal MCA showed no significant change (P = 0.083). Total pressure drop decreased (Δ=−13.95 Pa, P < 0.001), mainly due to a reduction in nasal pressure drop (Δ=−12.81 Pa, P < 0.001); the pharyngeal pressure drop change was not significant (P = 0.087). Expansion magnitude correlated with nasal pressure-drop reduction (r = − 0.412, P = 0.021) and nasal volume increase (r = 0.470, P = 0.008), but not with total pressure-drop reduction (P = 0.074).
Conclusions: MSE yields region-specific aerodynamic improvement predominantly in the nasal airway, with limited pharyngeal aerodynamic change.
Clinical relevance: Aerodynamic improvements after MSE should not be assumed to extend uniformly to the pharyngeal airway; patients with marked pharyngeal narrowing may require individualized airway evaluation and adjunctive management beyond expansion alone.
Related
- Five-Year Marginal Bone-Level Changes Around Immediately Loaded or Immediately Restored Implants After Maxillary Sinus Floor Elevation: A Retrospective Cohort Analysis of Three Implant-Site Preparation Techniques
- The Condyle–Fossa Relationship After Maxillary Expansion with Tooth-Borne and Tooth-Bone-Borne Appliances: A Retrospective Cone-Beam Computed Tomography Study at the End of Retention
- Orofacial Myofunctional Therapy to Treat Residual Obstructive Sleep Apnoea in Children Treated with Adenotonsillectomy and Maxillary Expansion: An Interventional Study
- Three-dimensional orientation changes of unerupted maxillary canines and second premolars treated with facemask therapy: a retrospective study
- Maternal hyperglycemia impairs postnatal skeletal muscle growth and induces stage-dependent gene expression changes in mouse offspring
BibTeX
@article{li2026aerodynamic,
title = {{Aerodynamic and anatomical changes of the upper airway after maxillary skeletal expansion in adults}},
author = {Zhicun Li and Sirui Zhu and Yang Xu and Wei Hou and Wei Wang and Huan Tang},
journal = {BMC Oral Health},
year = {2026},
month = jul,
doi = {10.1186/s12903-026-09456-3},
url = {https://doi.org/10.1186/s12903-026-09456-3},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Aerodynamic and anatomical changes of the upper airway after maxillary skeletal expansion in adults
AU - Zhicun Li
AU - Sirui Zhu
AU - Yang Xu
AU - Wei Hou
AU - Wei Wang
AU - Huan Tang
PY - 2026
DA - 2026/07/30
JO - BMC Oral Health
DO - 10.1186/s12903-026-09456-3
UR - https://doi.org/10.1186/s12903-026-09456-3
AB - Objectives: To quantify anatomical and aerodynamic changes of the adult upper airway after maxillary skeletal expansion (MSE) using computational fluid dynamics (CFD) with in vitro validation, and to assess whether expansion magnitude correlates with aerodynamic improvement. Materials and methods: Thirty-one skeletally mature adults treated with MSE were retrospectively included. CBCT scans at baseline (T1) and after stabilization (T2) were used to reconstruct and segment airway models into nasal and pharyngeal regions. Steady inspiratory CFD was performed at a bilateral flow rate of 30 L/min and validated in 10 patient-specific 1:1 3D-printed models. Results: Mean expansion magnitude was 4.09 mm. Nasal cavity volume increased (Δ=+3.10 cm³, P < 0.001), whereas pharyngeal MCA showed no significant change (P = 0.083). Total pressure drop decreased (Δ=−13.95 Pa, P < 0.001), mainly due to a reduction in nasal pressure drop (Δ=−12.81 Pa, P < 0.001); the pharyngeal pressure drop change was not significant (P = 0.087). Expansion magnitude correlated with nasal pressure-drop reduction (r = − 0.412, P = 0.021) and nasal volume increase (r = 0.470, P = 0.008), but not with total pressure-drop reduction (P = 0.074). Conclusions: MSE yields region-specific aerodynamic improvement predominantly in the nasal airway, with limited pharyngeal aerodynamic change. Clinical relevance: Aerodynamic improvements after MSE should not be assumed to extend uniformly to the pharyngeal airway; patients with marked pharyngeal narrowing may require individualized airway evaluation and adjunctive management beyond expansion alone.
SN - 1472-6831
ER -