Influence of orthodontic rapid maxillary expansion on nocturnal enuresis (bedwetting) in children.

Children with nocturnal enuresis will be enrolled to the study. Parents or legal guardians will fill in the initial information survey. Intensity level of nocturnal enuresis will be described with the use of a 4-grade scale prepared for the purposes of the examination, that is 4 – a couple of times during the night, 3 – once during the night, 2 – once or a couple of times during the week and 1 – once or a couple of times during the month. The orthodontic part will involve preparing and analysis of diagnostic dental casts. The analysis of dental casts will be performed in comparison to generally assumed standards for white Caucasian race. Patients implementing inclusion criteria will be subjected to rapid maxillary expansion (RME). RME widens the skeletal structure of upper jaw by means of the mechanism of distraction osteogenesis. Bone distraction takes place on the level of palatal suture with special expansion device (for example Hyrax appliance). The device is applied once for the whole period of treatment and remains in the patient's mouth for about 9 weeks. By means of a special long key, the expansion screw can be unscrewed, so that a narrow upper jaw achieves the correct relationship with the lower jaw. Children from both groups A (subjected to RME and B (without RME) will be monitored in monthly intervals for the period of 12 months towards the intensification of bed-wetting. After 3 years of observation, at the end of research, parents and guardians of children from both groups A and B will be asked to reply to the question concerning the occurrence and frequency of bed-wetting.