Maxillary expansion therapy in children with Down syndrome.

Purpose: The purpose of this study was to evaluate orthodontic treatment with maxillary expanders (MEs) in a group of Down syndrome (DS) children while also analyzing the rate of activation of the appliance, the complications during the expansion phase, and the expansion outcomes.

Methods: Thirty-two DS children underwent ME treatment. Sixty-four controls matched for age, sex, and type of ME were selected. The variables analyzed were previous dental treatment, orthodontic diagnosis, and ME treatment.

Results: Slow activation of the ME was used in 28% of the DS patients vs 9% of controls (P > .03). Complications during expansion occurred in 10 DS patients (31%) but in none of the controls (P < .001). The most common complication was the appearance of oral ulcers. At the end of the expansion, the results were considered to be clinically successful in 21 DS patients (66%) and in 50 controls (78%).

Conclusions: Maxillary expansion can be undertaken in DS children and is successful in a high proportion of cases if correct case selection has been performed. These patients, however, may require a slow activation of the appliance during the expansion phase and are more susceptible to the appearance of oral ulceration, which can affect the course of treatment.