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Cranio. 2019 Nov 2:1-6. doi: 10.1080/08869634.2019.1685217. [Epub ahead of print]

Changes in pediatric paranasal sinuses following biomimetic oral appliance therapy: 3 case reports.

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Private Practice, Yecheon-eup, Yecheon-gun, South Korea.
Lakeside Allergy ENT, Rockwall, TX, USA.
Vivos Therapeutics, Inc., NM, USA.


Objective: In this pilot study, craniofacial changes associated with biomimetic oral appliance therapy (BOAT) were investigated to test the hypothesis of non-surgical remodeling of the maxillary air sinuses in rhinosinusitis.Methods: Three consecutive Korean patients (mean age 9.3 yrs) presented to a dental office with a history of chronic rhinosinusitis. After obtaining informed consent, 3D cone-beam CT scans were taken that showed circumferential mucosal thickening and inflammatory maxillary sinus disease, obstructed ostiomeatuses, and enlarged inferior turbinates. All cases were treated using BOAT (DNA appliance®).Results: Approximately 10 months after BOAT, the paranasal sinuses were aerated without mucosal thickening; the sinus walls were intact, and the ostiomeatal units were patent. All mean craniofacial parameters measured increased, except the transpalatal bone width, which remained unchanged.Discussion: Although enhancement of the maxillary air sinuses through non-surgical remodeling is suspected in these three cases of pediatric rhinosinusitis, additional studies are warranted.


Biomimetic; oral appliance therapy; palatal expansion; upper airway

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