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Rapid maxillary expansion (RME) is a conventional treatment for MTD; however, its association with nasal microbiota composition in mouth-breathing children remains unclear. This study aimed to evaluate nasal microbial community composition before and after RME.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a prospective cohort study. Thirty-two children aged 5\u201314\u00a0years were enrolled, including 16 with maxillary transverse deficiency (8 mouth-breathing and 8 nasal-breathing) and 16 healthy controls. Nasal swabs were collected before and one month after RME in the MTD groups and once in the control group. Microbial DNA was sequenced using the Illumina MiSeq platform. Analyses included alpha diversity, taxonomic composition, and differential abundance across groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No significant differences in alpha diversity were observed between mouth-breathing children and controls, or before and after RME.\n                      <jats:italic>Firmicutes, Proteobacteria, and Actinobacteria<\/jats:italic>\n                      were dominant across groups, and compositional differences were observed after RME. In the mouth-breathing subgroup, the relative abundance of\n                      <jats:italic>Streptococcus<\/jats:italic>\n                      significantly decreased after RME (P\u2009&lt;\u20090.05), while the relative abundance of\n                      <jats:italic>Actinobacteria<\/jats:italic>\n                      increased. Overall, post-RME samples in the mouth-breathing subgroup showed compositional shifts, including a trend toward a profile more similar to that observed in healthy controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RME was associated with short-term changes in nasal microbiota composition while overall alpha diversity remained relatively stable. In mouth-breathing children, post-RME compositional shifts included reduced Streptococcus relative abundance. These findings should be interpreted as exploratory associations, and further studies with longer follow-up, standardized breathing-pattern reassessment, and clinical\/inflammatory outcome measures are needed to clarify their clinical significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      Chinese Clinical Trial Registry (ChiCTR), ChiCTR2500112875, registered on November 20, 2025. Retrospectively registered. Available at:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.chictr.org.cn\/showproj.html?proj=290888\" ext-link-type=\"uri\">https:\/\/www.chictr.org.cn\/showproj.html?proj=290888<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12903-026-08148-2","type":"journal-article","created":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T01:24:50Z","timestamp":1774661090000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of rapid maxillary expansion on nasal microbiota in mouth-breathing children: a prospective cohort study"],"prefix":"10.1186","volume":"26","author":[{"given":"Ruoan","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiying","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianfeng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limin","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,28]]},"reference":[{"key":"8148_CR1","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1016\/s0889-5406(00)70202-2","volume":"117","author":"JA McNamara","year":"2000","unstructured":"McNamara JA. 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The protocol was approved by the Ethics Committee of the Affiliated Stomatology Hospital of Wenzhou Medical University (Approval No. WYKQ2024003). Written informed consent was obtained from the parents or legal guardians of all participating children. The study was registered in the Chinese Clinical Trial Registry (ChiCTR) under registration number ChiCTR2500112875 on November 20, 2025. The full trial details are available at:\n                      \n                      .","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"798"}}