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Rodrigues J, Evangelopoulos E, Anagnostopoulos I, Sachdev N, Ismail A, Samsudin R, Khalaf K, Pattanaik S, Shetty SR. Impact of class II and class III skeletal malocclusion on pharyngeal airway dimensions: A systematic literature review and meta-analysis. Heliyon 2024; 10:e27284. [PMID: 38501020 PMCID: PMC10945137 DOI: 10.1016/j.heliyon.2024.e27284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 02/24/2024] [Accepted: 02/27/2024] [Indexed: 03/20/2024] Open
Abstract
Background This study is a pioneer systematic review and meta-analysis aimed at comparing the influence of Class II and Class III skeletal malocclusions on pharyngeal airway dimensions. It stands as the inaugural comprehensive assessment to collate and analyze the disparate findings from previously published articles on this topic. The objective of this study was to identify published articles that compare the effects of class II and class III skeletal malocclusion on the pharyngeal airway dimensions. Methods An all-inclusive search for existing published studies was done to identify peer-reviewed scholarly articles that compared the influence of class II and class III skeletal malocclusion on pharyngeal airway dimensions. The search was done via five electronic databases: Cochrane Library, EMBASE, Scopus, Web of Science, and PubMed. Screening of the articles was done and the eligible studies were critically assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Results The initial search yielded 476 potential articles of which, nine were finally included in this study for a total of 866 patients. Three studies were of cross-sectional design and six were of retrospective study design. Following a critical analysis and review of the studies, class III skeletal malocclusion had significantly larger volume and area measurements compared to class II skeletal malocclusion. Conclusion Research in the field of literature has established that variations in skeletal classifications have a discernible effect on the size of the pharyngeal airways. With the advancement of skeletal malocclusions to a class III, there is an observed increase in both the volume and cross-sectional area of the airways.
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Affiliation(s)
- Jensyll Rodrigues
- College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | | | | | | | - Ahmad Ismail
- College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Rani Samsudin
- College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Khaled Khalaf
- Institute of Dentistry, University of Aberdeen, United Kingdom
| | - Snigdha Pattanaik
- College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Shishir Ram Shetty
- College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
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Ahmed MMS, Zhao Y, Al-Hadad SA, Li C, Wang L, Hu W, Ahmed MMS, Musa M, Chen X, Alhammadi MS. Three-dimensional evaluation of upper pharyngeal airway, hyoid bone, and craniocervical changes following stabilization splint therapy in adult patients with temporomandibular joint disorders and mandibular deviation: A retrospective study. J Stomatol Oral Maxillofac Surg 2023; 124:101646. [PMID: 37751814 DOI: 10.1016/j.jormas.2023.101646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 09/23/2023] [Indexed: 09/28/2023]
Abstract
OBJECTIVE This study aimed primarily to analyze the three-dimensional (3D) changes in the pharyngeal airway (PA), and secondarily, the hyoid bone (HB) and the craniocervical (CC) following stabilization splint (SS) therapy in adult patients with temporomandibular joint disorders (TMD) and mandibular deviation (MD). METHODS Thirty-five adult patients with TMD and MD, who were treated using SS with a mean age of 25.14 ± 6.11 years, were enrolled in this retrospective clinical study. Pre- and post-therapeutic cone-beam computed tomography (CBCT) scans were analyzed. PA dimension,nasopharyngeal, oropharyngeal, hypopharyngeal, sub-hypopharyngeal, and total pharyngeal airway spaces were measured in surface area, volume, minimum constricted area (MCA) and width, HB position, and CC posture were analyzed three-dimensionally using InVivo 6.0.3 and Dolphin 11.95 software. Wilcoxon rank-sum or Paired t-test was conducted, and P < 0.05 was considered significant. RESULTS SS therapy was administered for a period of 9.49 ± 4.02 months. The oropharyngeal airway space showed a significant decrease in sagittal width. The hypopharyngeal surface area, volume, MCA, and sagittal width decreased significantly. In terms of HB, hyoid-mandibular plane (H-MP), retrognathia-third vertebra's most inferior-anterior (RGN-C3ia), and retrognathia-Sella (RGN-S) distances significantly decreased. The Nasion-Sella line and the line that passes through C2ip to the odontoid process posterior tangent (NSL-OPT) angle in CC posture also decreased significantly. CONCLUSION SS therapy in TMD patients with MD mainly results in narrowing of the hypopharyngeal region, no change in HB position and improvement in head posture. These results undoubtedly assist in diagnosis and treatment of clinical conditions.
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Affiliation(s)
- Madiha Mohammed Saleh Ahmed
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China; Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Aden University, Aden, Republic of Yemen
| | - Yunshan Zhao
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China
| | - Saba Ahmed Al-Hadad
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China; Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Ibb University, Ibb, Republic of Yemen
| | - Chunshen Li
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China
| | - Lu Wang
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China
| | - Wangqing Hu
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China
| | - Moutaz Mohammed Saleh Ahmed
- Chengdu University of Traditional Chinese Medicine, International Education College, Chengdu, Sichuan, People's Republic of China
| | - Mazen Musa
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China; Department of Orthodontics, Al Tegana Dental Teaching Hospital, University of Science and Technology, Omdurman, Khartoum 11111, Sudan
| | - Xi Chen
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China.
| | - Maged S Alhammadi
- Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Saudi Arabia
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Kurbanova A, Aksoy S, Nalça Andrieu M, Öz U, Orhan K. Evaluation of the influence of hyoid bone position, volume, and types on pharyngeal airway volume and cephalometric measurements. Oral Radiol 2023; 39:731-742. [PMID: 37330936 DOI: 10.1007/s11282-023-00691-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 06/09/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVES We aimed to explore the position, morphological, and morphometric properties of the hyoid bone (HB) and to investigate the effect of HB on the pharyngeal airway (PA) volume and cephalometric measurements. METHODS A total of 305 patients with CT images were included in the study. DICOM images were transferred to the InVivoDental three-dimensional imaging software. The position of the HB was determined based on the cervical vertebra level and in volume render tab, the bone was classified into six types after all structures around the HB were removed. Also, final bone volume was recorded. In the same tab, the pharyngeal airway volume was divided and measured in three groups (nasopharynx-oropharynx-hypopharynx). The linear and angular measurements were performed on the 3D cephalometric analysis tab. RESULTS HB was most commonly located in C3 vertebra level (80.3%). While B-type was found to be the most frequent (34%), V-type was the least frequent (8%). The volume of the HB was found to be significantly higher in male (3205 mm3) than female (2606 mm3) patients. Also, it was significantly higher in the C4 vertebra group. The vertical height of the face was positively correlated with the HB volume, C4 level position, and increased oro-nasopharyngeal airway volume. CONCLUSION The volume of the HB is found to differ significantly between genders and can potentially serve as a valuable diagnostic tool for understanding respiratory disorders. Its morphometric features are associated with increased face height and airway volume; however, are not related with the skeletal malocclusion classes.
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Affiliation(s)
- Aida Kurbanova
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Near East University, Nicosia, Cyprus.
| | - Seçil Aksoy
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Near East University, Nicosia, Cyprus
| | - Meltem Nalça Andrieu
- Department of Radiation Oncology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Ulaş Öz
- Department of Orthodontics, Faculty of Dentistry, Final International University, Nicosia, Cyprus
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
- Medical Design Application and Research Center (MEDITAM), Ankara University, Ankara, Turkey
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Meng X, Mao F, Mao Z, Xue Q, Jia J, Hu M. Multi-stage Unet segmentation and automatic measurement of pharyngeal airway based on lateral cephalograms. J Dent 2023; 136:104637. [PMID: 37506811 DOI: 10.1016/j.jdent.2023.104637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 07/17/2023] [Accepted: 07/25/2023] [Indexed: 07/30/2023] Open
Abstract
OBJECTIVES Orthodontic treatment profoundly impact the pharyngeal airway (PA) of patients. Airway examination is an integral part of daily orthodontic diagnosis, and lateral cephalograms (LC) are reliable to reveal PA structures. This study attempted to develop a simple method to help clinicians make a preliminary judgement of patients' PA conditions and assess the impact of orthodontic treatment on their airways. METHODS LCs of 764 patients were used to train a multistage unit segmentation model. Another 130 images were used to validate the model and more 130 images were used to test the model. RESULTS Unet was used as the backbone, with a mean dice value of 0.8180, precision of 0.8393, and recall of 0.8188. Furthermore, we identified seven key points and measured related indices. The length of the line separating the nasopharynx and oropharynx and the line separating the oropharynx and hypopharynx were manually measured thrice and the average values was compared. The intraclass correlation coefficient (ICC) for the two lines was 0.599 and 0.855. Then, we performed a single linear regression analysis, which indicated a strong correlation between the predictions and measurements for the two lines. CONCLUSIONS This method is reliable for segmenting three regions (nasopharynx, oropharynx, and hypopharynx) of the PA and calculating related indices. However, the predictions obtained from this model still have errors, and it is necessary for clinical practitioners to assess and adjust the predictions. CLINICAL SIGNIFICANCE Our model can help orthodontists formulate personalised treatment plans and evaluate the risk of airway stenosis during orthodontic treatment. This method may mark the beginning of a new and simpler approach for PA obstruction detection, specifically tailored to orthodontic patients.
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Affiliation(s)
- Xiangquan Meng
- School of Mathematics, Jilin University, Changchun 130012, China
| | - Feng Mao
- Hospital of Stomatology, Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun 130021, China
| | - Zhi Mao
- Hospital of Stomatology, Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun 130021, China
| | - Qing Xue
- Hospital of Stomatology, Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun 130021, China
| | - Jiwei Jia
- School of Mathematics, Jilin University, Changchun 130012, China; National Applied Mathematical Center (Jilin), Changchun 130012, China
| | - Min Hu
- Hospital of Stomatology, Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun 130021, China.
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Kim DY, Woo S, Roh JY, Choi JY, Kim KA, Cha JY, Kim N, Kim SJ. Subregional pharyngeal changes after orthognathic surgery in skeletal Class III patients analyzed by convolutional neural networks-based segmentation. J Dent 2023:104565. [PMID: 37308053 DOI: 10.1016/j.jdent.2023.104565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/03/2023] [Accepted: 05/27/2023] [Indexed: 06/14/2023] Open
Abstract
OBJECTIVES To evaluate the accuracy of fully automatic segmentation of pharyngeal volume of interests (VOIs) before and after orthognathic surgery in skeletal Class III patients using a convolutional neural network (CNN) model and to investigate the clinical applicability of artificial intelligence for quantitative evaluation of treatment changes in pharyngeal VOIs. METHODS 310 cone-beam computed tomography (CBCT) images were divided into a training set (n=150), validation set (n=40), and test set (n=120). The test datasets comprised matched pairs of pre- and posttreatment images of 60 skeletal Class III patients (mean age 23.1±5.0 years; ANB<-2⁰) who underwent bimaxillary orthognathic surgery with orthodontic treatment. A 3D U-Net CNNs model was applied for fully automatic segmentation and measurement of subregional pharyngeal volumes of pretreatment (T0) and posttreatment (T1) scans. The model's accuracy was compared to semi-automatic segmentation outcomes by humans using the dice similarity coefficient (DSC) and volume similarity (VS). The correlation between surgical skeletal changes and model accuracy was obtained. RESULTS The proposed model achieved high performance of subregional pharyngeal segmentation on both T0 and T1 images, representing a significant T1-T0 difference of DSC only in the nasopharynx. Region-specific differences among pharyngeal VOIs, which were observed at T0, disappeared on the T1 images. The decreased DSC of nasopharyngeal segmentation after treatment was weakly correlated with the amount of maxillary advancement. There was no correlation between the mandibular setback amount and model accuracy. CONCLUSIONS The proposed model offers fast and accurate subregional pharyngeal segmentation on both pretreatment and posttreatment CBCT images in skeletal Class III patients. CLINICAL SIGNIFICANCE We elucidated the clinical applicability of the CNNs model to quantitatively evaluate subregional pharyngeal changes after surgical-orthodontic treatment, which offers a basis for developing a fully integrated multiclass CNNs model to predict pharyngeal responses after dentoskeletal treatments.
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Affiliation(s)
- Dong-Yul Kim
- Department of Dentistry, Graduate School, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Seoyeon Woo
- Department of Convergence Medicine, Asan Medical Institute of Convergence, Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil Songpa-Gu, Seoul, 05505, Republic of Korea
| | - Jae-Yon Roh
- Department of Dentistry, Graduate School, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Jin-Young Choi
- Department of Orthodontics, Kyung Hee University Dental Hospital, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Kyung-A Kim
- Department of Orthodontics, School of Dentistry, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Jung-Yul Cha
- Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, 50-1 Yonseiro, Seodaemun-gu, Seoul, 03722, Korea
| | - Namkug Kim
- Department of Convergence Medicine, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - Su-Jung Kim
- Department of Orthodontics, School of Dentistry, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
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Bellon M, Boutin F, Haddad R, Frapier L. Effectiveness of orthopaedic treatments on the enlargement of the upper airways: Overview of systematic reviews. Int Orthod 2023; 21:100745. [PMID: 36871416 DOI: 10.1016/j.ortho.2023.100745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVE The aims of this overview are to evaluate the three-dimensional effects of orthopaedic treatment (OT) and myofunctional therapy (MT) on the enlargement of the upper airways (UA). METHODS A search of the MEDLINE/PubMed and EMBASE databases was conducted up to July 2022 and completed by hand search. After selection of the title and abstract, systematic reviews (SR) dealing with the impact of OT and/or MT on UA containing only controlled studies were included. The methodological quality of the SR was assessed by the AMSTAR-2, Glenny and ROBIS tools. A quantitative analysis was done with Review Manager 5.4.1. RESULTS Ten SR were included. The risk of bias was judged low for one SR according to ROBIS. Two SR presented a high level of evidence according to AMSTAR-2. In the quantitative analysis and about the orthopaedic mandibular advancement therapies (OMA), while a significant increase in superior (SPS) [(Mean difference (MD): 1.19; CI 95% [0.59; 1.78]; P<0.0001)] and middle (MPS) pharyngeal space [(MD: 1.10; CI 95% [0.22; 1.98]; P=0.01)] existed in the short-term for both OMA, it was greater for removable. On the other hand, there was no significant change in the inferior pharyngeal space (IPS). Four other SR targeted the short-term efficacy of class III OT. Only treatments with face mask (FM) or face mask+rapid maxillary expansion (FM+RME) allowed a significant increase in SPS [(MD FM: 0.97; CI 95% [0.14; 1.81]; P=0.02/MD FM+RME: 1.54; CI 95% [0.43; 2.66]; P=0.006)]. This was neither the case for chin cup nor in all cases in IPS. The last two SR explored the effectiveness of RME, whether or not associated with bone anchorage, on the dimensions of the UA or on the reduction of the apnoea/hypopnea index (AHI). A significant superiority of the effects of the devices with mixed or only bone anchorages existed concerning the width of the nasal cavity, the nasal airflow and the reduction of the nasal resistance. But, the qualitative analysis showed no significant reduction in AHI after RME. CONCLUSIONS Despite the heterogeneity of the included systematic reviews and their unfortunately not always low risk of bias, this synthesis showed that orthopaedics could provide some short-term improvement in AU dimensions, mainly in the upper and middle areas. Indeed, no devices improved the IPS. Class II orthopaedics improved SPS and MPS; class III orthopaedics, except for the chin cup, improved only SPS. RME, optimised with bone or mixed anchors, mostly improved the nasal floor.
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Ceylan Eser N, Arslan C, Altuğ AT. Validation of a Finite Element Model for Clinical and Virtual Evaluation of the Changes in Airway Dimensions Following Class III Bimaxillary Orthognathic Surgery. J Maxillofac Oral Surg 2023; 22:217-225. [PMID: 36703662 PMCID: PMC9871107 DOI: 10.1007/s12663-022-01781-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/05/2022] [Indexed: 01/29/2023] Open
Abstract
Introduction The aim of this study was to evaluate pharyngeal airway changes in adult skeletal Class III cases whose bimaxillary surgical treatments were planned with different amounts of maxillary and mandibular movement using lateral cephalometric radiographs and finite element analysis (FEA). Our null hypothesis was that bimaxillary orthognathic surgery in which maxillary forward movement (MF) is greater than mandibular backward movement (MB) will result in more expansion of the pharyngeal airway. Materials and Methods A total of 31 individuals (11 females, 20 males) with class III skeletal deformity were included in the study. Patients who underwent bimaxillary orthognathic surgery with greater maxillary advancement (MF > MB) were categorized in Group 1 (n = 15), and those with greater mandibular set-back (MB > MF) as Group 2 (n = 16). Changes in airway dimensions were evaluated from lateral cephalometric radiographs. In addition, FEA modeling was used to determine pharyngeal airway changes with 5 different MF/MB combinations performed in skeletal class III bimaxillary surgeries. Results Nasopharyngeal and oropharyngeal airway dimensions increased in direct proportion to the amount of MF. Hypopharyngeal volume decreased compared to preoperative value in direct proportion to the decrease in MB. According to the FEA models, total pharyngeal airway volume decreased when MF was less than or equal to MB, was nearly unchanged when MF was 2 mm greater than MB, and increased when MF was 4 mm greater than MB. The results of FEA and lateral cephalometric analysis were compatible. Conclusion Our results supported the null hypothesis. We concluded that when possible, planning slightly more maxillary advancement than mandibular set-back will not have an adverse impact on the airway. Although the skeletal deformity only causes forward displacement of the mandible, dividing the skeletal correction between the maxilla and mandible may be considered to avoid the risk to patients' quality of life in terms of respiratory function.
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Affiliation(s)
| | - Can Arslan
- Department of Orthodontics, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
- Yeditepe Üniversitesi Diş Hastanesi, Bağdat Caddesi, Istanbul, 34728 Turkey
| | - Ayşe Tuba Altuğ
- Department of Orthodontics, Faculty of Dentistry, Ankara University, Ankara, Turkey
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Karaman A, Güdük Z, Genc E. Evaluation of pharyngeal airway dimensions and cephalometric changes after premolar extraction and nonextraction orthodontic treatment in adolescent and adult patients. J Stomatol Oral Maxillofac Surg 2023; 124:101275. [PMID: 36064145 DOI: 10.1016/j.jormas.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/24/2022] [Accepted: 08/31/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study was to investigate the effects of premolar extraction and non-extraction for orthodontic treatment on the skeletal, dentoalveolar and pharyngeal airway. MATERIAL AND METHOD The study was carried out with the radiographs of a total of 130 patients at the ages of 14 to 25, including 59 male and 71 female patients. The cases were divided into two groups as the "extraction" group(2 upper premolar teeth) (n = 66) and the "non extraction" group (n = 64). RESULTS Extraction Group:In both age groups, there was a statistically significant increase in the mean interincisal angle (U1xL1) and lower anterior facial height (ANS-Me) values(p < 0.05). In the 14-18 age group, there was a significant increase in the mean upper airway thickness, inferior airway space, hyoid position, soft palate length(PNSP) and upper pharynx values(p < 0.05). In both sexes, while the mean U1xL1 and ANS-Me values significantly increased, the mean upper incisors inclination values decreased significantly(p < 0.05). Non Extraction Group:In both age groups, the mean ANS-Me values increased significantly from T0 to T1(p < 0.05). In the 14-18 age group, the increase in the mean upper adenoid thickness, tongue length,PNSP, softpalate thickness and vertical airway length values was significant(p < 0.05). In the male patients, the mean U1xL1 value decreased significantly(p < 0.05). CONCLUSION The premolar teeth extraction performed in the patients receiving orthodontic treatment did not affect airway dimensions to a high extent.It was determined that the position of the hyoid bone and tongue length was not affected in the patients with premolar extraction and non extraction.
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Affiliation(s)
- Ahmet Karaman
- Department of Orthodontics, Faculty of Dentistry, Istanbul Aydın University, Istanbul, Turkey.
| | - Zekeriya Güdük
- Department of Orthodontics, Faculty of Dentistry, Istanbul Aydın University, Istanbul, Turkey
| | - Esra Genc
- Orthodontic private practice, Kayseri, Turkey
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Habumugisha J, Mohamed AS, Cheng B, Liu L, Zou R, Wang F. Analysis of maxillary arch morphology and its relationship with upper airway in mouth breathing subjects with different sagittal growth patterns. J Stomatol Oral Maxillofac Surg 2023; 124:101386. [PMID: 36646284 DOI: 10.1016/j.jormas.2023.101386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/05/2022] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVE This three-dimensional cone beam computed tomography(CBCT) study assessed pharyngeal airway and maxillary arch in mouth breathing subjects with different skeletal classifications and analyzed the factors associated with the upper airway morphological variations in mouth breathing (MB) and nasal breathing (NB) subjects. METHODS One hundred and five subjects (52 MB and 53 NB children), divided into three skeletal groups: Class I (1° ≤ ANB° ≤ 5°), Class II (ANB° >5°), and Class III (ANB°<1°). An independent t-test and one-way ANOVA test were utilized in the group analysis of normal distributed data. The linear multiple regression test was applied to create a model for the airway volumes based on the maxillary arch parameters in different skeletal groups. RESULTS In three skeletal groups, NB individuals had greater oropharyngeal airway volume (OPV) and total pharyngeal airway volume (TPV) than MB. Maxillary arch parameters of intermolar width (IMW), intercanine width (ICW), and maxillary width of canines (MWC) were larger in NB participants than in MB subjects. In the MB group, we discovered that Class II individuals had lower NPV (nasopharyngeal airway volume) than Class I and Class III. MWC was lower in Class II subjects compared to Class I and Class III in both the NB and MB groups. CONCLUSION NB individuals had greater pharyngeal airway and maxillary arch parameters than MB subjects. Our model equation revealed that the inter-molar width (IMW) and palatal area (PA) parameters were the strongest predictors of total pharyngeal airway volume (TPV) in the skeletal Class II and Class I groups.
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Fang MR, Yan XZ, Ni JL, Gu YG, Meng L, Yuan LC, Cai HY, Wang LR, Qin JW, Cai Q, Zhang Y, Guo SY. Study of pharyngeal airway morphology with CBCT: Benefits of four premolar extraction orthodontic treatments. Niger J Clin Pract 2022; 25:1955-1962. [PMID: 36537450 DOI: 10.4103/njcp.njcp_1815_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND AND AIM Four premolars extractions are routine procedures for correction of malocclusion, but will inevitably lead to a reduction of tongue space, whether this will weaken the pharyngeal airway remains a controversy. PATIENTS AND METHODS Cone-beam computed tomography (CBCT) radiographs of 80 patients who completed four premolar extraction orthodontic treatments were collected and divided into three anteroposterior skeletal groups according to the ANB (angle subspinale to nasion to supramentale) value. Linear, angular, cross-sectional area, and volumetric dimensions of the pharyngeal airway were measured using Dolphin Imaging 11.9 software. One-way analysis of variance and Pearson's correlation coefficient test were performed to assess the intergroup comparisons. Treatment changes were evaluated with two-sample t-tests. RESULTS In intergroup comparisons, vertical linear and cross-sectional area differences were identified in S-Go/N-Me, VD1, VD1/N-Me, VD2/N-Me, AA, OAA and OMINI (p<0.05), while other measurements showed no significant differences. Angle2, the tilting degree of the pharyngeal airway, showed a positive correlation with ANB (p<0.05). As for the treatment changes, a significant increase was found in the pharyngeal airway in the Class I group (OUA p<0.05, VD1 p<0.001, VD2 p<0.05) and Class II group (VD1 p<0.001. VD2, p<0.05), and inversely, a significant decrease was found in the pharyngeal airway in the Class III group (OAA p<0.05, OMINI p<0.05, OUA p<0.05). No volumetric difference was identified. Interestingly, regarding the preoperative pharyngeal airway size, values trended to the mean value significantly. CONCLUSION Four premolar extraction orthodontic treatments did not affect the pharyngeal airway volume except for the vertical liner and cross-sectional area dimensions. The trend of the gold standard suggested a positive influence of four premolar extraction orthodontic treatments.
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Affiliation(s)
- M R Fang
- Jiangsu Key Laboratory of Oral Diseases; Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - X Z Yan
- Jiangsu Key Laboratory of Oral Diseases; Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - J L Ni
- Jiangsu Key Laboratory of Oral Diseases; Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Y G Gu
- Department of Stomatology, Affiliated Hospital of Lian Yungang, Xuzhou Medical University, Lianyungang, China
| | - L Meng
- Jiangsu Key Laboratory of Oral Diseases; Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - L C Yuan
- Jiangsu Key Laboratory of Oral Diseases; Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - H Y Cai
- Jiangsu Key Laboratory of Oral Diseases; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - L R Wang
- Jiangsu Key Laboratory of Oral Diseases; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - J W Qin
- Jiangsu Key Laboratory of Oral Diseases; Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Q Cai
- Department of Stomatology, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Y Zhang
- Jiangsu Key Laboratory of Oral Diseases; Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - S Y Guo
- Jiangsu Key Laboratory of Oral Diseases; Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
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Khaghaninejad MS, Khojastehpour L, Danesteh H, Changizi M, Ahrari F. Changes in the pharyngeal airway after different orthognathic procedures for correction of class III dysplasia. Maxillofac Plast Reconstr Surg 2022; 44:23. [PMID: 35678935 PMCID: PMC9184694 DOI: 10.1186/s40902-022-00352-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/24/2022] [Indexed: 12/02/2022] Open
Abstract
Objective This study was conducted to compare changes in pharyngeal airway after different orthognathic procedures in subjects with class III deformity. Methods The study included CBCT scans of 48 skeletal class III patients (29 females and 19 males, mean age 23.50 years) who underwent orthognathic surgery in conjunction with orthodontic treatment. The participants were divided into three groups of 16, as follows: Group 1, mandibular setback surgery; group 2, combined mandibular setback and maxillary advancement surgery; and group 3, maxillary advancement surgery. CBCT images were taken 1 day before surgery (T0), 1 day (T1), and 6 months (T2) later. The dimensions of the velopharynx, oropharynx, and hypopharynx were measured in CBCT images. Results In all groups, there was a significant decrease in airway variables immediately after surgery, with a significant reversal 6 months later (P < 0.05). In subjects who underwent maxillary advancement, the airway dimensions were significantly greater at T2 than the T0 time point (P < 0.05), whereas in the mandibular setback and bimaxillary surgery groups, the T2 values were lower than the baseline examination (P < 0.05). The alterations in airway variables were significantly different between the study groups (P < 0.05). Conclusions The mandibular setback procedure caused the greatest reduction in the pharyngeal airway, followed by the bimaxillary surgery and maxillary advancement groups, with the latter exhibiting an actual increase in the pharyngeal airway dimensions. It is recommended to prefer a two-jaw operation instead of a mandibular setback alone for correction of the prognathic mandible in subjects with predisposing factors to the development of sleep-disordered breathing.
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Affiliation(s)
- Mohammad Saleh Khaghaninejad
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Khojastehpour
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Danesteh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Changizi
- Oral and Maxillofacial Surgery Resident, Department of Oral and Maxillofacial Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farzaneh Ahrari
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
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12
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Elagib T, Kyung HM, Hung BQ, Hong M. Assessment of pharyngeal airway in Korean adolescents according to skeletal pattern, sex, and cervical vertebral maturation: A cross-sectional CBCT study. Korean J Orthod 2022; 52:345-353. [PMID: 36148641 PMCID: PMC9512630 DOI: 10.4041/kjod21.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 04/18/2022] [Accepted: 05/12/2022] [Indexed: 11/24/2022] Open
Abstract
Objective To investigate airway volumes using cone-beam computed tomography (CBCT) by skeletal patterns, sex, and cervical vertebral maturation (CVM) stages in Korean adolescents. Methods The sample consisted of pretreatment CBCT and cephalograms of 95 adolescents (aged 12–19) obtained out of 1,611 patients examined for orthodontic treatment from 2018 to 2020 in Kyungpook National University Dental Hospital. The samples were classified into two sex groups; three skeletal pattern groups, four chronological age groups and four CVM stages. Nasopharyngeal volumes (NPV), oropharyngeal volumes (OPV), total pharyngeal airway volume (TAV) and minimum cross-sectional area (MCA) measurements were taken from the CBCT. Multiple linear regression analyses to find out which one of the independent variables are good predictors for airway variables. Significant factors were analyzed by two-way multivariate analysis of variance (MANOVA) then multiple comparisons were analyzed using a t-test, and Fisher least significant difference. Results Age, sex, CVM, and Sella-Nasion-B point have significant influence on airway variable. Males and females showed similar patterns of change in chronological age groups 1–3; however, males had larger NPV, OPV, and MCA at CVM in group 4. According to CVM stages, males had larger OPV, TAV, and MCA at CVM stage 6 (p-value 0.019, 0.021, 0.015, respectively) and no sex differences at CVM stages 3, 4, and 5. Conclusions Skeletal patterns have an effect on airway volume. Sex differences were found in CVM 6.
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Affiliation(s)
- Tassneem Elagib
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Hee-Moon Kyung
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Bui Quang Hung
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Mihee Hong
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, Korea
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Batra A, Shetty V. Effect of Twin-block Appliance on Pharyngeal Airway, Sleep Patterns, and Lung Volume in Children with Class II Malocclusion. J Contemp Dent Pract 2022; 23:66-73. [PMID: 35656660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
AIM In this study, we sought to evaluate the effect of the twin-block appliance on pharyngeal airway dimensions, sleep patterns, and lung volumes in growing children with class II malocclusion with a retrognathic mandible. MATERIALS AND METHODS Twenty children aged 9-12 years with class II malocclusion with a retrognathic mandible participated in the study. A validated sleep questionnaire assessed the sleep patterns and the sleep problems of the children. The pre-treatment cephalometric variables and the pharyngeal airway passage (PAP) dimensions were analyzed. Spirometry tests were performed to evaluate lung volumes. A custom-made twin-block appliance was fabricated, and children were instructed to wear it for a minimum of 10 months. All variables including sleep problems, cephalometric variables, and pharyngeal airway measurements were evaluated post-treatment. Spirometry tests were re-evaluated at the end of the twin-block treatment. All data were statistically analyzed. RESULTS Post-twin-block appliance treatment, there was a definite decrease in snoring, noisy breathing, and sleeping with mouth open. The sella-nasion to B point angle (SNB), mandibular length, the depths of oropharynx, nasopharynx, and hypopharynx as well as the height of nasopharynx (HNP) were significantly increased post-treatment (p <0.001). The length and thickness of soft palate (SPI) increased significantly (p <0.001), while its inclination decreased significantly (p <0.001). We found improvements in forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1); however, the changes were statistically not significant (p = 0.88 and p = 0.78). CONCLUSION Twin-block appliance significantly increased the pharyngeal airway dimensions and improved the length and thickness of the soft palate in children with class II malocclusion. Post-twin-block treatment showed a considerable reduction in the sleep problems of the children. The lung volume measurements showed improvement; however, it was not statistically significant. CLINICAL SIGNIFICANCE Twin block may be used not only to correct the facial disharmony of children with a retrognathic mandible but also to improve the airway dimensions and lung volume as well as to reduce the sleep-disordered symptoms.
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Affiliation(s)
- Akriti Batra
- Department of Pediatric and Preventive Dentistry, AB Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be University), Mangaluru, Karnataka, India
| | - Vabitha Shetty
- Department of Pediatric and Preventive Dentistry, AB Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be University), Mangaluru, Karnataka, India, Phone: +91 9448770874, e-mail:
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Hassing GJ, The V, Shaheen E, Politis C, de Llano-Pérula MC. Long-term three-dimensional effects of orthognathic surgery on the pharyngeal airways: a prospective study in 128 healthy patients. Clin Oral Investig 2021; 26:3131-3139. [PMID: 34826028 DOI: 10.1007/s00784-021-04295-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/11/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To investigate volumetric and circumferential pharyngeal airway space (PAS) changes and stability over time as evaluated with cone beam computed tomography (CBCT) before and after orthognathic surgery 2 years postoperatively. MATERIALS AND METHODS One hundred twenty-eight patients underwent bimaxillary orthognathic surgery at the Department of Maxillofacial Surgery of University Hospitals, Leuven, Belgium, were recruited prospectively. Patients were divided into 4 groups based on the amount of mandibular advancement in 5 mm increments (< 0 mm, 0-5 mm, 5-10 mm, or > 10 mm). CBCT data was acquired preoperatively and 1-6 weeks, 6 months, 1 year, and 2 years postoperatively. Patients with a history of maxillofacial trauma or surgery, obstructive sleep apnoea syndrome, or craniofacial anomalies were excluded. Nasopharyngeal, oropharyngeal, and hypopharyngeal PAS volumes and constriction surface areas (mCSA) were measured and compared between each time point with a paired t-test. RESULTS The largest significant increase in oropharyngeal volume and mCSA were observed in the 5-10 mm (+ 13.3-21.7%, + 51.3-83.0%)) and > 10 mm (+ 23.3-44.6%, + 92.3-130.0%) mandibular advancement groups. This increase only remained stable 2 years postoperatively in the > 10 mm group. In other mandibular advancement groups, short-term oropharyngeal volume and mCSA increases were noticed, which returned to baseline levels 6 months to 1 year postoperatively. CONCLUSION Bimaxillary advancement osteotomy significantly increases oropharyngeal volume and mCSA, which remains stable between 6 months to 1 year postoperatively. CLINICAL RELEVANCE Long-term stable volumetric and mCSA enlargements were found with > 10 mm mandibular advancements over a period of 2 years. Return towards baseline levels was observed in the other mandibular advancement groups.
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Affiliation(s)
- Gert-Jan Hassing
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Vincent The
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Eman Shaheen
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Department of Oral and Facial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Constantinus Politis
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Department of Oral and Facial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium.
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Jadhav PJ, Sonawane SV, Mahajan N, Chavan BG, Korde SJ, Momin NM, Mahale PR. Correlation of Pharyngeal Airway Dimensions with Maxillomandibular Skeletal Relation and Mandibular Morphology in Subjects with Skeletal Class I and Class II Malocclusions and Different Growth Patterns: A Cephalometric Study in Selected Local Population. J Pharm Bioallied Sci 2021; 13:S1111-S1114. [PMID: 35017940 PMCID: PMC8686866 DOI: 10.4103/jpbs.jpbs_349_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 04/26/2021] [Accepted: 05/07/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To test the hypothesis that there is no positive correlation between skeletal Class II and mandibular morphology with pharyngeal dimensions in subjects with different growth patterns. MATERIALS AND METHODS Lateral cephalograms of 60 patients were collected and divided into 2 groups, comprising of 30 in each group. Group 1 consisted of cephalograms of patients having Class I malocclusion, and was further divided into subgroups. 1a) Class I with normal growth 1b) Class I with vertical growth. Group 2 consisted of cephalograms of patients having class II malocclusion and was further divided into subgroups 2a) Class II with normal growth, 2b) Class II with vertical growth. RESULTS The results showed that the estimated marginal mean for upper pharyngeal width in class I malocclusion group was 8.56 mm, for class II malocclusion group was 7.80 mm, for normal growth individuals was 9.73 mm and that for vertical growth individuals was 6.63 mm. The estimated marginal mean for lower pharyngeal width in class I malocclusion group was 9.62 mm, in class II malocclusion group was 9.10 mm, in normal growth individuals was 8.95 mm and that in vertical growth individuals was 9.77 mm. The estimated marginal mean for pharyngeal area in class I malocclusion group is 330.13 sq.mm, in class II malocclusion group is 308.17 sq.mm, in normal growth individuals is 328.47sq.mm and that in vertical growth individuals is 309.83 sq.mm. CONCLUSIONS The null hypothesis for this study, as per the statistical analysis, has been rejected.
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Affiliation(s)
- Pallavi Jeetesh Jadhav
- Department of Orthodontics and Dentofacial Orthopedics, Bharati Vidyapeeth (Deemed to be) Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Shivprasad Vasant Sonawane
- Department of Orthodontics and Dentofacial Orthopedics, SMBT Institute of Dental Sciences and Research, Nashik, Maharashtra, India,Address for correspondence: Dr. Shivprasad Vasant Sonawane, Om Moungiri Bungalow, Hare Krishna Colony, Behind KKW Engg College, Panchavati, Nashik - 422 003, Maharashtra, India. E-mail:
| | - Nikhil Mahajan
- Department of Orthodontics and Dentofacial Orthopedics, Sinhgad Dental College and Hospital, Pune, India
| | - Bhushan Gorakh Chavan
- Department of Orthodontics and Dentofacial Orthopedics, JMF's ACPM Dental College and Hospital, Dhule, Maharashtra, India
| | - Swapnil J. Korde
- Head Dentist, Smile Designers Dental Clinic and Orthodontic Care, Nashik, Maharashtra, India
| | - Naufil Mushtaque Momin
- Head Dentist, Smile Designers Dental Clinic and Orthodontic Care, Nashik, Maharashtra, India
| | - Priyanka R. Mahale
- Head Dentist, Smile Designers Dental Clinic and Orthodontic Care, Nashik, Maharashtra, India
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Kang NE, Lee DH, In Seo J, Lee JK, Song SI. Postoperative changes in the pharyngeal airway space through computed tomography evaluation after mandibular setback surgery in skeletal class III patients: 1-year follow-up. Maxillofac Plast Reconstr Surg 2021; 43:31. [PMID: 34448114 PMCID: PMC8390598 DOI: 10.1186/s40902-021-00319-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/12/2021] [Indexed: 11/10/2022] Open
Abstract
Background This study evaluated the pharyngeal airway space changes up to 1 year after bilateral sagittal split osteotomy mandibular setback surgery and bimaxillary surgery with maxillary posterior impaction through three-dimensional computed tomography analysis. Methods A total of 37 patients diagnosed with skeletal class III malocclusion underwent bilateral sagittal split osteotomy setback surgery only (group 1, n = 23) or bimaxillary surgery with posterior impaction (group 2, n = 14). Cone-beam computed tomography scans were taken before surgery (T0), 2 months after surgery (T1), 6 months after surgery (T2), and 1 year after surgery (T3). The nasopharynx (Nph), oropharynx (Oph), hypopharynx (Hph) volume, and anteroposterior distance were measured through the InVivo Dental Application version 5. Results In group 1, Oph AP, Oph volume, Hph volume, and whole pharynx volume were significantly decreased after the surgery (T1) and maintained. In group 2, Oph volume and whole pharynx volume were decreased (T2) and relapsed at 1 year postoperatively (T3). Conclusion In class III malocclusion patients, mandibular setback surgery only showed a greater reduction in pharyngeal airway than bimaxillary surgery at 1 year postoperatively, and bimaxillary surgery was more stable in terms of airway. Therefore, it is important to evaluate the airway before surgery and include it in the surgical plan.
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Affiliation(s)
- No Eul Kang
- Department of Oral and Maxillofacial Surgery, Institute of Oral Health Science, Ajou University School of Medicine, 164, Worldcup-ro, Yengto-gu, Suwon-si, Gyeonggi-do, 16499, Republic of Korea
| | - Dae Hun Lee
- Department of Oral and Maxillofacial Surgery, Institute of Oral Health Science, Ajou University School of Medicine, 164, Worldcup-ro, Yengto-gu, Suwon-si, Gyeonggi-do, 16499, Republic of Korea
| | - Ja In Seo
- Department of Oral and Maxillofacial Surgery, Institute of Oral Health Science, Ajou University School of Medicine, 164, Worldcup-ro, Yengto-gu, Suwon-si, Gyeonggi-do, 16499, Republic of Korea
| | - Jeong Keun Lee
- Department of Oral and Maxillofacial Surgery, Institute of Oral Health Science, Ajou University School of Medicine, 164, Worldcup-ro, Yengto-gu, Suwon-si, Gyeonggi-do, 16499, Republic of Korea
| | - Seung Il Song
- Department of Oral and Maxillofacial Surgery, Institute of Oral Health Science, Ajou University School of Medicine, 164, Worldcup-ro, Yengto-gu, Suwon-si, Gyeonggi-do, 16499, Republic of Korea.
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Tekin U, Akdeniz BS, Keller EE. Pharyngeal airway space changes and stability following an extended LeFort-I osteotomy advancement in cleft lip and palate and non-cleft lip and palate patients: A long term comparison study. J Stomatol Oral Maxillofac Surg 2021; 123:121-127. [PMID: 34157445 DOI: 10.1016/j.jormas.2021.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 04/16/2021] [Accepted: 04/29/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of this study was to evaluate effects of extended maxillary advancement osteotomy on pharyngeal airway space (PAS) in mid-facial deficient cleft lip and palate (CLP) patients and mid-facial deficient non-CLP patients. METHODS Pharyngeal airway space (PAS) of 10 CLP and 10 non-CLP patients with the mean age of 19 years 10 months was measured on digitized lateral cephalograms taken shortly before maxillary advancement operation with Quadrangular Le Fort I osteotomy (QLF-I) (T0), early post-operative, (T1) and long term post-operative (T2). Two way repeated analysis of variance, independent samples t-test and correlations tests were used for statistical analysis of airway and skeletal changes. RESULTS Total PAS depth and area was significantly increased after the advancement and was stable in long term post-operative period for CLP and non-CLP patients. Nasopharyngeal and velopharyngeal airway space depth and area was statistically increased at T1 and T2 for both groups. Oropharyngeal airway depth and area showed no significant statistical difference at any of the time points. The effect of QLF-I osteotomy on (PAS) was similar in both CLP and non-CLP patients. CONCLUSIONS Nasopharyngeal, velopharyngeal, and total pharyngeal airway space depth and area increased after maxillary advancement with the QLF-I osteotomy; this increase was stable in long term follow up. Maxillary advancement with the QLF-I technique had no significant effect on oropharyngeal airway space depth and area in both CLP and non-cleft patients.
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Affiliation(s)
- Umut Tekin
- Department of Oral and Maxillofacial Surgery Division of Oral and Maxillofacial Surgery, Mayo Clinic College of Medicine, Rochester, MN, United States
| | - Berat Serdar Akdeniz
- Department of Orthodontics, Kirikkale University Dentistry Faculty, Kirikkale, Turkey.
| | - Eugene E Keller
- Division of Oral and Maxillofacial Surgery, Mayo Clinic, Rochester, MN, United States
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Mehta S, Wang D, Kuo CL, Mu J, Vich ML, Allareddy V, Tadinada A, Yadav S. Long-term effects of mini-screw-assisted rapid palatal expansion on airway. Angle Orthod 2021; 91:195-205. [PMID: 33315060 DOI: 10.2319/062520-586.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 09/01/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To evaluate the long-term effects on airway in patients with mini-screw-assisted rapid palatal expansion (MARPE), rapid palatal expansion (RPE), and controls with three-dimensional cone-beam computed tomography (CBCT) analysis. MATERIALS AND METHODS A total of 180 CBCTs of 60 patients were analyzed at different time points, such as pretreatment, postexpansion, and posttreatment. Patients were divided into three groups: mini-screw assisted rapid palatal expansion (MARPE), rapid palatal expansion (RPE), and controls. The nasal cavity, nasopharyngeal, oropharyngeal, and laryngopharyngeal airway volume and area were measured. Changes in total airway volume, total airway area, minimal cross-sectional area, maxillary intermolar width, external maxillary width, and palatal width were also evaluated. RESULTS Both MARPE and RPE caused a statistically significant increase in the airway after expansion as compared with the control group, but there was no statistically significant difference in the change in airway between MARPE, RPE, and the control group at posttreatment, except for nasopharyngeal volume, which was significantly increased in the MARPE group. There was no correlation between the amount of expansion and increase in total airway volume. CONCLUSIONS There was a significant increase in total airway volume, total airway area, and minimal cross-sectional area with MARPE and RPE immediately after expansion, but at posttreatment, the changes in the MARPE and RPE groups were similar to the change in the control group. However, MARPE led to a significant long-term increase in nasopharyngeal volume. The amount of expansion did not correlate with the increase in pharyngeal airway volume.
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Kochhar AS, Sidhu MS, Bhasin R, Kochhar GK, Dadlani H, Sandhu J, Virk B. Cone beam computed tomographic evaluation of pharyngeal airway in North Indian children with different skeletal patterns. World J Radiol 2021; 13:40-52. [PMID: 33728030 PMCID: PMC7941671 DOI: 10.4329/wjr.v13.i2.40] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/27/2020] [Accepted: 01/28/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In growing patients with skeletal discrepancies, early assessment of functional factors can be vital for the restoration of normal craniofacial growth.
AIM To compare airway volumes in patients with mandibular retrognathism with the normal anteroposterior skeletal relationship, thereby assessing the association between cephalometric variables and airway morphology.
METHODS Cone-beam computed tomography volume scans, and lateral cephalograms, 3-dimensional airway volume and cross-sectional areas of 120 healthy children (54 boys and 66 girls mean age 15.19 ± 1.28) which were done for orthodontic assessment were evaluated. The subjects were divided into 2 groups based on the angle formed between point A, Nasion and point B (ANB) values and cephalometric variables (such as anterior and posterior facial height, gonial angle etc.) airway volumes, and cross-sectional measurements were compared using independent t tests. Pearson’s correlation coefficient test was used to detect any relationship of different parts of the airway and between airway volume and 2-dimensional cephalometric variables.
RESULTS Means and standard deviations for cephalometric, cross-sectional, and volumetric variables were compared. ANB, mandibular body length and facial convexity were statistically highly significant (P < 0.01) whereas condylion to point A, nasal airway and total airway volume (P < 0.05) were statistically significant. The nasal airway volume and the superior pharyngeal airway volume had a positive correlation (P < 0.01), nasal airway was correlated to middle (P < 0.05) and total airway superior had a relation with middle (P < 0.05), inferior and total airway (P < 0.05), middle was related to all other airways; inferior was also related to all the airways except nasal. Lateral cephalometric values were positively correlated with the airway volume with Frankfurt Mandibular Plane Angle and facial convexity showed significant correlations with total airway volume (P < 0.05). Additionally, ANB angle was significantly correlated with total airway volume and superior airway (P < 0.05).
CONCLUSION The mean total airway volume in patients with retrognathic mandible was significantly smaller than that of patients with a normal mandible.
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Affiliation(s)
| | - Maninder Singh Sidhu
- Department of Orthodontics, Faculty of Dental Sciences, SGT University, Gurugram 122001, India
| | - Ritasha Bhasin
- Faculty of Dentistry, University of Toronto, Toronto M5G 1G6, Canada
| | - Gulsheen Kaur Kochhar
- Department of Pediatric and Preventive Dentistry, National Dental College and Hospital, Derabassi 140507, Punjab, India
| | - Himanshu Dadlani
- Department of Periodontology, Kalka Dental College, Uttar Pradesh 210507, India
- Senior Consultant, Department of Dental Surgery, Max Hospital, Gurgaon 122001, India
| | - Jagpreet Sandhu
- Formerly at Department of Orthodontics, Genesis Institute of Dental Sciences, Punjab 152001, India
| | - Bobby Virk
- Chief Orthodontist, Smile With Braces, Puyallup, WA 98371, United States
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Abstract
Objectives Obstructive sleep apnea (OSA) is associated with anatomical restrictions of pharyngeal airway, but the mechanism of airflow dynamics in OSA is largely unknown. This study utilized computational flow dynamics (CFD) to build a 3D model of the pharynx and to test the hypothesis that an increased restriction in the pharynx in OSA/obese minipigs leads to higher resistance, which in turn creates turbulence to induce temporary blockage of pharyngeal airway patency. Design Of five 9-11-months-old Yucatan minipigs, 3 were non-obese (BMI<35) and two obese (BMI>51). After natural sleep monitoring using BioRadio system, pigs were sedated to collect MRI images and airflow parameters. The MRI images were processed to create 3D configurations of pharynx. These 3D configurations were meshed to create finite element models (FEM) of CFD. The obtained airflow parameters were input into the configurations to identify turbulent airflow and its location. Results Heavy snoring and multiple >5s hypopnea/apnea episodes (AHI = 32-35) were identified in both obese minipigs during sleep. Compared to the non-obese/non-OSA controls, obese/OSA minipigs showed much lower respiratory tidal volumes and inspiratory airflow speed. FEM simulation found that turbulence was not present in the pharynx in either model. However, a 25% increase of airflow velocity was observed at the narrowest part of the nasal pharynx in the obese/OSA minipig model. Conclusions Despite the narrower pharyngeal airway and the higher velocity of airflow, FEM simulation indicated that turbulence was not produced in the obese/OSA minipigs.
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Affiliation(s)
- Zi-Jun Liu
- Depts. Orthodontics & Oral Health Sciences, School of Dentistry
| | - Tiffany Do
- Depts. Orthodontics & Oral Health Sciences, School of Dentistry
| | - Hanson Fong
- Dept. Material Sciences and Engineering, College of Engineering, University of Washington, Seattle, WA, 98195, USA
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İnce-Bingöl S, Kaya B. Pharyngeal airway and hyoid bone position changes of skeletal anchored Forsus Fatigue Resistant Device and activator appliances. Clin Oral Investig 2021; 25:4841-4850. [PMID: 33449194 DOI: 10.1007/s00784-021-03789-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To evaluate the effects of miniplate anchored Forsus Fatigue Resistant Device (MAF) and activator treatments in the pharyngeal airway dimensions and hyoid bone position. MATERIALS AND METHODS Thirty-eight patients with mandibular retrusion who were treated with either MAF or activator were selected retrospectively and compared with an untreated control group. The data of 114 lateral cephalograms, comprising those taken before treatment (T1) and at the end of functional treatment (T2), were evaluated with regard to their linear, angular, and area measurements. RESULTS The mandibular length increased and the hyoid bone moved forward with both treatments (P < 0.05). The horizontal change in the hyoid bone position with MAF treatment was correlated with changes in the point B and ANB angle. Increases of 1.8 mm, 1.4 mm, and 1.8 mm in the pharyngeal airway dimensions were obtained at the levels of the second, third, and fourth cervical vertebra, respectively, with the MAF treatment. On the other hand, an increase of 1.9 mm was found at the level of the fourth cervical vertebra with the activator treatment. The greatest vertical movement in the Menton and the highest increase in the oropharyngeal area were observed in the MAF group (P < 0.05). CONCLUSION Both the MAF and activator treatments caused favorable maxillomandibular changes; however, the MAF treatment provided a greater increase in the oropharyngeal area according to both the increase in mandibular length and the change in the vertical position of the mandible. CLINICAL RELEVANCE Functional appliances were found to be useful in increasing the pharyngeal airway dimensions in the short-term. The skeletal anchored fixed functional appliance caused a greater increase in the oropharyngeal airway area that may be beneficial for Class II patients who carry a risk of having respiratory problems.
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Affiliation(s)
- Sinem İnce-Bingöl
- Department of Orthodontics, Faculty of Dentistry, Baskent University, 1. Cad No: 107 Bahcelievler, Ankara, Turkey.
| | - Burçak Kaya
- Department of Orthodontics, Faculty of Dentistry, Baskent University, 1. Cad No: 107 Bahcelievler, Ankara, Turkey
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Hsu KJ, Hsiao SY, Chen YA, Chen HS, Chen CM. The investigation of pharyngeal airway space by cephalogram landmarks in primary school children in Taiwan. J Dent Sci 2020; 16:922-928. [PMID: 34141106 PMCID: PMC8189871 DOI: 10.1016/j.jds.2020.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/06/2020] [Indexed: 11/18/2022] Open
Abstract
Background/purpose Proper breathing is essential to healthy growth and development of children. The present study aimed to investigate changes in the pharyngeal airway space in primary-school children. Materials and methods Cephalometric radiographs were obtained from 93 primary-school children, who were divided into three age groups (Group I, aged 7–8 years; Group II, aged 9–10 years; and Group III, aged 11–12 years). Landmarks identified on each cephalogram included the tip of the uvula (U), hyoid bone (H), and epiglottis (E). Linear and angular measurements comprised nasopharyngeal airway (NP); PS (shortest distance from the soft palate to the pharyngeal wall); UP (distance from the tip of the uvula to the pharyngeal wall); TS (shortest distance from the posterior tongue to the pharyngeal wall); EP (distance, parallel to the X-axis, from the epiglottis to the pharyngeal wall). Statistical analysis was performed using one-way analysis of variance and Pearson correlation tests. Results Group III had the highest values for all the variables. The three groups exhibited significant differences for all pharyngeal airway variables, except for EP. The three groups had significantly different vertical U, H, and E. There were positive correlations between age and NP, PS, UP, and TS; however, no significant correlation was observed between age and EP. Age significantly correlated with the vertical U, E, and H. Correlations between age and the horizontal U, E, and H were nonsignificant. Conclusion Among primary-school children from various grades, age significantly correlated with all pharyngeal airway variables, except with EP.
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Affiliation(s)
- Kun-Jung Hsu
- School of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Dental Department, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Szu-Yu Hsiao
- Department of Dentistry for Child and Special Needs, Kaohsiung Medical University, Hospital, Kaohsiung, Taiwan
| | - Ying-An Chen
- Dental Department, Zhongxiao Branch of Taipei City Hospital, Taipei, Taiwan
| | - Han-Sheng Chen
- Dental Department, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
- Corresponding author. Dental Department, Kaohsiung Municipal Siaogang Hospital, No. 482, Shanming Road, Siaogang District, Kaohsiung, 812, Taiwan.
| | - Chun-Ming Chen
- School of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan
- Corresponding author. Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, San-Ming District, Kaohsiung, 807, Taiwan.
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Cheng JH, Hsiao SY, Chen CM, Hsu KJ. Relationship between hyoid bone and pharyngeal airway in different skeletal patterns. J Dent Sci 2020; 15:286-293. [PMID: 32952886 PMCID: PMC7486506 DOI: 10.1016/j.jds.2020.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 05/17/2020] [Indexed: 11/26/2022] Open
Abstract
Background/purpose The hyoid bone and its attached muscles play an important role in the maintenance of the pharyngeal airway space. The aim of the present study was to investigate the correlations between hyoid bone and pharyngeal airway spaces among three skeletal patterns. Materials and methods Cephalograms of 90 male and 90 female were divided into skeletal patterns: Class I, Class II, and Class III. The following pharyngeal airway spaces were measured: SP, soft palate related pharyngeal airway; BP, B point related pharyngeal airway; C2P, second cervical vertebra related pharyngeal airway; and LP, laryngopharyngeal airway. The paired t-test, one-way analysis of variance, and Pearson correlation analysis were used in the statistical analyses. Results SP was significantly longer in Class III (12.4 mm) than in Class I (10.7 mm) and Class II (9.5 mm), and BP was significantly greater in Class III (16.3 mm) than in Class II (12.4 mm). The hyoid bone had a significantly anterior location in Class III compared to Class II, whereas vertical positions of the hyoid bone showed no significant differences among the three skeletal patterns. Among female with a Class III skeletal pattern, the horizontal position of the hyoid bone had a positive moderate, significant correlation with the C2P, whereas among male, this was not observed. Conclusion The location of the maxilla (SNA) was not significantly correlated with the pharyngeal airway space. However, the more protruding the mandible (SNB) is, the more anterior the hyoid bone and the longer the pharyngeal airway will be.
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Affiliation(s)
- Jung-Hsuan Cheng
- Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Szu-Yu Hsiao
- Department of Dentistry for Child and Special Needs, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chun-Ming Chen
- Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan.,Graduate Institute of Dental Sciences, School of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kun-Jung Hsu
- Graduate Institute of Dental Sciences, School of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Dentistry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
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Yi X, Yao L, Zhao P, Yuan X, Wang Z. Three-dimensional assessment of pharyngeal volume and cross-sectional area in Chinese infants and preschool children. Int J Pediatr Otorhinolaryngol 2020; 136:110253. [PMID: 32797809 DOI: 10.1016/j.ijporl.2020.110253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/26/2020] [Accepted: 07/04/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The cross-sectional area (CSA) and the volume of the pharyngeal airway normative reference data aren't established, although they are closely associated with the pathogenesis of obstructive sleep apnea syndrome (OSAS) in infants and preschool children. Our objective is to measure the cross-sectional area (CSA) and volume of pharyngeal airway subregions and investigate the effects of age and sex in infants and preschool children using computerized tomography (CT). METHODS After applying strict inclusion criteria, 57 infants and preschool children (27 females, 30 males) aged from 1 day to 72 months who underwent maxillofacial CT scans due to trauma were selected. The sample was stratified into three age groups (1 day-24 months, 25-48 months, and 49-72 months). The CSA and the volume of the naso-, palato-, glosso-, and laryngopharyngeal airway were calculated using a 3-dimensional image processing software. Linear regression analysis was performed to express the effect of age, height, and weight. One-way analysis of covariance with height as a covariate was used to analyze the statistical significance of the difference between males and females within each age group. RESULTS The CSA and volume of all pharyngeal airway subregions increased with age, height, and weight (P < 0.05) in children under 6 years old. Multiple linear regression analysis showed an age effect, identified in all measurements (P < 0.001), whereas no height or weight effect were found. There were no differences in any measurements between males and females within each age group. CONCLUSION The normative reference data of CSA and volume of pharyngeal airway subregions were established after applying strict inclusion and exclusion criteria in infants and preschool children. Results may be useful in screening and assist in the timely diagnosis and management of pediatric OSAS.
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Affiliation(s)
- Xiaoli Yi
- Department of Radiology, The Affiliated Children's Hospital, Capital Institute of Pediatrics, Beijing, China
| | - Linyin Yao
- Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xinyu Yuan
- Department of Radiology, The Affiliated Children's Hospital, Capital Institute of Pediatrics, Beijing, China.
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
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25
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Abstract
OBJECTIVE To compare pharyngeal airway dimensions and hyoid bone position in different craniofacial growth patterns. METHODS In total, 611 patients divided into 9 subgroups were compared according to malocclusion classification and vertical growth pattern, and these subgroups were compared in terms of pharyngeal airway and hyoid measurements. A two-way ANOVA test was used to compare the findings of the subgroups. RESULTS No significant difference was found for the pharyngeal measurements between the groups (p>0.05). The vertical airway length (PNS-Ep) was significantly shorter in the Class III malocclusion group (p<0.05) and in the hypodivergent group (p<0.05). No statistically significant difference was found between any subgroups in any measurements of the position of the hyoid bone (p>0.05). CONCLUSION The pharyngeal airway dimensions and hyoid bone position are similar among individuals in the sagittal direction. The vertical airway length is significantly shorter in Class III and hypodivergent individuals.
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Affiliation(s)
- Gönül Kocakara
- Department of Orthodontics, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
| | | | - Hikmet Orhan
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
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Chauhan R, Bagga DK, Agrawal P, Kalra H, Kumar P, Singh A. Radiographic Evaluation of the Hyoid Bone Position and Pharyngeal Airway Depth in Anteroposterior Dysplasia. Int J Clin Pediatr Dent 2019; 12:101-106. [PMID: 31571780 PMCID: PMC6749869 DOI: 10.5005/jp-journals-10005-1601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction The pharyngeal airway, tongue, and hyoid bone are correlated. The hyoid bone is connected to the pharynx, mandible, and cranium through muscles and ligaments and its position with respect to them determines the tongue posture and function. It also plays an important role in maintaining the airway and upright natural head position. Different skeletal patterns have different morphologies and shapes of the mandible, which might be affected by the position of the hyoid bone and the pharyngeal airway depth. This cephalometric study was conducted to relate the pharyngeal airway depth and the hyoid bone position of different skeletal patterns in sagittal dimension, and it determines and compares the linear parameters of the pharyngeal airway depth in Class I, II, and III malocclusion groups and anteroposterior, vertical, and angular positions of the hyoid bone positions in Class I, II, and III malocclusion groups. Materials and methods Lateral cephalometric radiographs selected for study were divided into three groups of 30 samples each based on ANB angle and β angle into skeletal Class I, Class II, and Class III, respectively. Five linear measurements for the pharyngeal airway depth, four linear measurements for anteroposterior position, two linear measurements for vertical position, and one angular measurement for angular hyoid bone position were made. Results The pharyngeal airway depth was found to show no statistically significant difference between Class I and Class III malocclusions. The pharyngeal airway depth in Class II malocclusion was found to be statistically smaller at D1 as compared to that in Class I and Class III malocclusions, whereas it remained the same at the rest of the locations measured, i.e., D2, D3, D4, and D5. The Class III malocclusion group showed a significant statistical difference in the anteroposterior hyoid bone position at all levels (i.e., H1, H2, H3, and H4) as compared to the Class II malocclusion group, whereas it showed a statistically significant difference as compared to the Class I malocclusion group at H1 and H3. The angular inclination of the hyoid bone in the Class II malocclusion group showed a statistically significant difference with the Class I and Class III malocclusion group but the Class III malocclusion group showed no significant difference statistically when compared to the Class I malocclusion group. Conclusion The pharyngeal airway depth in the Class II malocclusion group was also found to be narrower at the superiormost level measured at the posterior nasal spine from the posterior pharyngeal wall. The hyoid bone position was variable in angular and anteroposterior dimensions among different malocclusion groups. How to cite this article Chauhan R, Bagga DK, et al. Radiographic Evaluation of the Hyoid Bone Position and Pharyngeal Airway Depth in Anteroposterior Dysplasia. Int J Clin Pediatr Dent 2019;12(2):101–106.
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Affiliation(s)
- Rajat Chauhan
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Dinesh Kumar Bagga
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Poonam Agrawal
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Hiten Kalra
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Prafful Kumar
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Anoop Singh
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
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Xu J, Sun R, Wang L, Hu X. Cone-beam evaluation of pharyngeal airway space in adult skeletal Class II patients with different condylar positions. Angle Orthod 2018; 89:312-316. [PMID: 30457352 DOI: 10.2319/040518-253.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To test the null hypothesis that there is no significant difference in pharyngeal airway space among adult skeletal Class II patients with different condylar positions using cone-beam computed tomography (CBCT). MATERIALS AND METHODS The CBCT records of 60 patients with skeletal Class II malocclusion (ANB angle ≥ 4°, Wits ≥ 0) were selected from the CBCT database. According to the condyle position, the patients were divided in three groups: anterior group (CD ≤ -12%), centric group (-12% ≤ CD ≤ +12%), and posterior group (CD ≥ +12%). Three-dimensional (3D) pharyngeal airway models were reconstructed using InvivoDental software 5.1.3. The volume and area of the pharyngeal airway space were measured in the 3D airway model. RESULTS The volume and area of the pharyngeal airway space in the centric group were significantly smaller than those in the posterior group ( P < .01). The volume and area of the pharyngeal airway space were smallest in the anterior group and significantly increased in the centric and posterior groups ( P < .001). CONCLUSIONS The null hypothesis was rejected. Significant differences were noted in pharyngeal airway space among adult skeletal Class II patients with different condylar positions.
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Tan SK, Tang ATH, Leung WK, Zwahlen RA. Three-dimensional pharyngeal airway changes in dento-skeletal class II patients after two-jaw orthognathic surgery with segmentation - a pilot study. J Stomatol Oral Maxillofac Surg 2018; 119:461-468. [PMID: 30099221 DOI: 10.1016/j.jormas.2018.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 06/12/2018] [Accepted: 07/29/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To investigate short- and long-term post-surgical three-dimensional changes of pharyngeal airway morphology and hyoid bone position in dento-skeletal class II deformity patients after two-jaw surgery with segmentation. METHODS Relations between skeletal movement, hyoid bone position and three-dimensional pharyngeal airway changes were retrospectively analyzed on pre- and post-surgical CBCTs in dento-skeletal class II patients who underwent orthognathic two-jaw surgery with segmentation. RESULTS While long-term significant reductions in length (P= 0.003), surface area (P= 0.042) and volume (P= 0.004) were found in the nasopharynx, the highly significant increases in oropharyngeal airway length, surface area, volume and the minimal cross-sectional area (P < 0.05) prevailed only in the short-term. Although a significant antero-superior movement of the hyoid bone was detected both in short- and long-term follow-up CBCTs (P < 0.05), only its superior, but not the anterior movement was found to be associated with an increased lateral width of the oropharyngeal minimal cross-sectional area. CONCLUSION Two-jaw orthognathic surgery with segmentations in dento-skeletal class II patients improved oropharyngeal airway parameters significantly in the short-, but not long-term.
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Affiliation(s)
- S K Tan
- Center of Oral and Maxillofacial Surgery Studies, Faculty of Dentistry, Universiti Teknologi MARA Sungai Buloh Campus, Jalan Hospital, 47000 Selangor Darul Ehsan, Malaysia; Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, 34, Hospital Road, Sai Ying Pun, Hong Kong SAR, PR China
| | - A T H Tang
- 503 Tak Shing house, 20, Des Voeux road, Central, Hong Kong SAR, PR China
| | - W K Leung
- Discipline of Periodontology, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong SAR, PR China
| | - R A Zwahlen
- Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, 34, Hospital Road, Sai Ying Pun, Hong Kong SAR, PR China.
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Tan SK, Leung WK, Tang ATH, Zwahlen RA. Letter to the editor on the article "Impact on the upper airway space of different types of orthognathic surgery for the correction of skeletal class III malocclusion: A systematic review and meta-analysis". Int J Surg 2017; 45:156-157. [PMID: 28433756 DOI: 10.1016/j.ijsu.2017.03.083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 03/29/2017] [Indexed: 11/25/2022]
Affiliation(s)
- S K Tan
- Center of Oral & Maxillofacial Surgery Studies, Faculty of Dentistry, Universiti Teknologi MARA Sungai Buloh Campus, Jalan Hospital, Selangor Darul Ehsan, Malaysia; Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, China
| | - W K Leung
- Discipline of Periodontology, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong, China
| | - A T H Tang
- Private Practice, 503 Tak Shing House, 20 Des Voeux Road, Central, Hong Kong, China
| | - R A Zwahlen
- Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, China.
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Celikoglu M, Buyukcavus MH. Changes in pharyngeal airway dimensions and hyoid bone position after maxillary protraction with different alternate rapid maxillary expansion and construction protocols: A prospective clinical study. Angle Orthod 2017; 87:519-525. [PMID: 28139938 DOI: 10.2319/082316-632.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the changes in pharyngeal airway dimensions and the position of the hyoid bone after maxillary protraction with different alternate rapid maxillary expansion and construction (Alt-RAMEC) protocols in patients with skeletal class III malocclusion as a result of maxillary retrusion. MATERIAL AND METHODS The patients with skeletal class III malocclusions were consecutively divided into two groups. Group 1 consisted of 17 patients (11 boys and 6 girls, mean age 11.31 ± 1.71 years) who had the Alt-RAMEC protocol for 5 weeks, and group 2 consisted of 17 patients (10 boys and 7 girls, mean age 11.64 ± 1.24 years) who had the Alt-RAMEC procedure for 9 weeks. In this study, 4 angular and 13 linear measurements were performed to evaluate the skeletal and pharyngeal airway changes that occurred after maxillary protraction. RESULTS A significant increase in the maxillary growth, inhabitation of mandibular growth, and clockwise rotation of the mandible caused the improvement of the maxillo-mandibular relationship in both groups. Those changes caused a significant increase in the upper pharyngeal airway dimension (P < .01) and affected the vertical position of the hyoid bone in both groups (P < .05 and P < .01, respectively). However, changes that occurred in both groups were found to be similar for all airway variables (P > .05). CONCLUSION Upper pharyngeal dimension and vertical position of the hyoid bone were affected by the maxillary protraction with different Alt-RAMEC protocols. There were no statistically significant differences between the groups.
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Iwasaki T, Sato H, Suga H, Minami A, Yamamoto Y, Takemoto Y, Inada E, Saitoh I, Kakuno E, Kanomi R, Yamasaki Y. Herbst appliance effects on pharyngeal airway ventilation evaluated using computational fluid dynamics. Angle Orthod 2017; 87:397-403. [PMID: 28121164 DOI: 10.2319/080616-603.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the effect of a Herbst appliance on ventilation of the pharyngeal airway (PA) using computational fluid dynamics (CFD). MATERIALS AND METHODS Twenty-one Class II patients (10 boys; mean age, 11.7 years) who required Herbst therapy with edgewise treatment underwent cone-beam computed tomography (CBCT) before and after treatment. Nineteen Class I control patients (8 boys; mean age, 11.9 years) received edgewise treatment alone. The pressure and velocity of the PA were compared between the groups using CFD based on three-dimensional CBCT images of the PA. RESULTS The change in oropharyngeal airway velocity in the Herbst group (1.95 m/s) was significantly larger than that in the control group (0.67 m/s). Similarly, the decrease in laryngopharyngeal airway velocity in the Herbst group (1.37 m/s) was significantly larger than that in the control group (0.57 m/s). CONCLUSION The Herbst appliance improves ventilation of the oropharyngeal and laryngopharyngeal airways. These results may provide a useful assessment of obstructive sleep apnea treatment during growth.
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Li X, Zhao Q, Zhao R, Gao M, Gao X, Lai W. Effect of occlusal plane control procedure on hyoid bone position and pharyngeal airway of hyperdivergent skeletal Class II patients. Angle Orthod 2016; 87:293-299. [PMID: 27715137 DOI: 10.2319/041416-308.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the effect of occlusal plane control on the hyoid bone position and pharyngeal airway of hyperdivergent skeletal Class II patients during orthodontic treatment. MATERIALS AND METHODS Cephalograms of 47 hyperdivergent skeletal Class II subjects with occlusal plane control (OPC), and another 50 subjects without occlusal plane control (NOPC) were selected to compare the effects of the occlusal plane control procedure. Lateral cephalograms before treatment (T1), immediately after treatment (T2), and an average of 12 months after treatment (T3) were obtained, and 17 measurements were analyzed in each group and compared between groups. RESULTS With respect to the T2-T1 changes, the sagittal discrepancies in both groups were alleviated. In the OPC group, both the occlusal and mandibular plane angles decreased, accompanied by anterior and superior movement and counterclockwise rotation of the hyoid bone. The overall changes from T3 to T1 in each group exhibited trends similar to that induced by treatment. As for pharyngeal airway space alterations, no significant difference in OPC group was presented throughout treatment or retention periods. CONCLUSIONS The customized occlusal plane control procedure was effective for hyperdivergent skeletal Class II patients: The occlusal plane rotated counterclockwise, followed by a counterclockwise rotation of the mandibular plane. The hyoid bone moved anteriorly and superiorly, accompanied by its counterclockwise rotation. However, this procedure did not induce significant alteration of the pharyngeal airway space.
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Celikoglu M, Buyuk SK, Ekizer A, Unal T. Pharyngeal airway effects of Herbst and skeletal anchored Forsus FRD EZ appliances. Int J Pediatr Otorhinolaryngol 2016; 90:23-28. [PMID: 27729139 DOI: 10.1016/j.ijporl.2016.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 08/25/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVE To evaluate the skeletal and pharyngeal airway effects of skeletal anchored Forsus FRD EZ appliance using bilateral miniplates inserted on mandibular symphyses and to compare the findings with a well matched control group treated using a Herbst appliance. METHODS Thirty patients with skeletal Class II malocclusion due to mandibular retrusion were divided into two groups. Group 1 consisted of 15 patients (8 females and 7 males; mean age: 13.11 ± 1.29 years) treated using the Herbst appliance and Group 2 consisted of 15 patients (9 females and 7 males; 12.84 ± 1.27 years) treated using the skeletal anchored Forsus FRD EZ appliance. Treatment changes were assessed by means of linear, angular, and area measurements. RESULTS The groups were well matched regarding to the chronological ages, gender distribution and initial cephalometric values (P > 0.05). In both groups, skeletal Class II malocclusion was corrected by decrease in SNA and increase in SNB, Co-Gn, VRL-B and VRL-Pog measurements. Those changes caused a significant correction in the maxillo-mandibular relationship. Upper and lower pharyngeal airway dimensions were increased in both group, while the increase in the lower pharyngeal dimension was found to be statistically significant in the skeletal anchored Forsus FRD EZ group (P < 0.05). Oropharyngeal area measurements significantly increased in both groups (P < 0.001 and P < 0.01, respectively). Comparison of the groups showed that both groups had similar changes with no statistically significant differences (P > 0.05). CONCLUSION Skeletal changes produced by both appliances caused significant pharyngeal airway changes.
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Affiliation(s)
- Mevlut Celikoglu
- Department of Orthodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey.
| | | | - Abdullah Ekizer
- Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Tuba Unal
- Privite Practice, İskenderun, Hatay, Turkey
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Bhatia S, Jayan B, Chopra SS. Effect of retraction of anterior teeth on pharyngeal airway and hyoid bone position in Class I bimaxillary dentoalveolar protrusion. Med J Armed Forces India 2016; 72:S17-S23. [PMID: 28050064 DOI: 10.1016/j.mjafi.2016.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 06/21/2016] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND To test the hypothesis that the retraction of anterior teeth has no effect on the dimensions of pharyngeal airway and to evaluate the retraction of anterior teeth on each parameter of pharyngeal airway. METHODS Twenty-two adult patients of Class I bimaxillary protrusion requiring first premolar extractions with maximum anchorage requirements were selected. The pharyngeal airway and dentofacial parameters of the patients were compared using pre- and post-treatment lateral cephalograms with the help of Student's paired t-test (P < 0.05). The relationship between airway size and dentofacial parameters was also evaluated using Pearson correlation coefficient. RESULTS The upper and lower lips were retracted by 2.25 and 5.4 mm after retraction of the incisors. The tips of upper and lower incisors were retracted by 7.75 and 7.15 mm, respectively. There was a statistically significant decrease in SPP-SPPW (P < 0.05), U-MPW (P < 0.001), TB-TPPW (P < 0.001), and change in HRGN (P < 0.01). A significant correlation was observed between the amount of retraction of lower incisor and decrease in the pharyngeal airway posterior to soft palate (r = 0.102), tongue (r = 0.322), and change in HRGN (r = 0.265). CONCLUSIONS The size of the pharyngeal (velopharyngeal and glossopharyngeal) airway reduced and hyoid bone position changed after retraction of the incisors in extraction space in bimaxillary protrusive adult patients.
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Affiliation(s)
- S Bhatia
- Classified Specialist (Orthodontics), 33 Corps Dental Unit, C/O 99 APO, India
| | - B Jayan
- Consultant (Orthodontics & Dentofacial Orthopedics), Army Dental Centre (R&R), Delhi Cantt 10, India
| | - S S Chopra
- Commanding Officer & Corps Dental Adviser, 3 Corps Dental Unit, C/O 99 APO, India
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Anandarajah S, Dudhia R, Sandham A, Sonnesen L. Risk factors for small pharyngeal airway dimensions in preorthodontic children: A three-dimensional study. Angle Orthod 2016; 87:138-146. [PMID: 27304232 DOI: 10.2319/012616-71.1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To analyze which parameters, gathered from standard orthodontic diagnostic material, were most relevant for identifying small pharyngeal airway dimensions in preorthodontic children. MATERIALS AND METHODS The sample was composed of 105 cone beam computed tomography scans of healthy preorthodontic children (44 boys, 61 girls; mean age, 10.7 ± 2.4 years). Airway volume and minimal cross-sectional area were three-dimensionally assessed. Cephalometric features and skeletal maturity were assessed on generated two-dimensional cephalograms. Associations were analyzed and adjusted for age, gender, and skeletal maturity by multiple regression analyses. RESULTS Airway volume and minimal cross-sectional area were significantly smaller in prepubertal children (P < .001, P < .05, respectively) and positively associated with age (P < .001, P < .01, respectively). After adjustment of age, skeletal maturity and gender significant associations were found between pharyngeal airway dimensions and craniofacial morphology. Airway volume was positively associated with maxillary and mandibular width (P < .01; P < .001, respectively) and anterior face height (P < .05; P < .05, respectively). Minimal cross-sectional area was positively associated with maxillary and mandibular width (P < .01; P < .001, respectively) and negatively associated with sagittal jaw relationship (AnPg, P < .05). Mandibular width and age were the most relevant factors for airway volume (r2 = 0.36). Mandibular width and sagittal jaw relationship were the most relevant factors for minimal cross-sectional area (r2 = 0.16). CONCLUSION Pharyngeal airway dimensions were significantly associated with age, skeletal maturity, and craniofacial morphology in all three planes. Children with a reduced mandibular width and increased sagittal jaw relationship are particularly at risk of having small pharyngeal airway dimensions.
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Hatab NA, Konstantinović VS, Mudrak JKH. Pharyngeal airway changes after mono- and bimaxillary surgery in skeletal class III patients: Cone-beam computed tomography evaluation. J Craniomaxillofac Surg 2015; 43:491-6. [PMID: 25794643 DOI: 10.1016/j.jcms.2015.02.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 12/19/2014] [Accepted: 02/10/2015] [Indexed: 11/25/2022] Open
Abstract
The aim of this study was to evaluate the two-dimensional (2D) and three-dimensional (3D) changes in the pharyngeal airway space (PAS) in 20 class III patients who underwent mono- or bimaxillary surgery using cone-beam computed tomography (CBCT). CBCT examination was obtained before surgery (T1) and at least 3 months after surgery (T2). The pharyngeal airway of each patient was studied at three levels: the level of the posterior nasal spine, the level of the most inferior point of the soft palate, and the level of the top of the epiglottis. At each of these levels, the anteroposterior and lateral dimension as well as cross-sectional area were measured. The volume of the whole PAS and volume between each cross section were also measured. The area and anteroposterior dimensions at the level of the most inferior point of the soft palate significantly decreased in patients who underwent monomaxillary surgery. The volume of the PAS decreased in both groups, but decreased significantly only in the monomaxillary group. The upper volume decreased in the mono- and increased in the bimaxillary group. The lower volume significantly decreased in the monomaxillary group. However, results showed that PAS decreased more after mono-than after bimaxillary surgery.
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Affiliation(s)
- N A Hatab
- Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Dr Subotića 4, 11000 Belgrade, Serbia.
| | - V S Konstantinović
- Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Dr Subotića 4, 11000 Belgrade, Serbia
| | - J K H Mudrak
- Private Dental Clinic, Am Stetenrain 8, 36251 Ludwigsau, Germany
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Celikoglu M, Bayram M, Sekerci AE, Buyuk SK, Toy E. Comparison of pharyngeal airway volume among different vertical skeletal patterns: a cone-beam computed tomography study. Angle Orthod 2014; 84:782-787. [PMID: 24592903 PMCID: PMC8641273 DOI: 10.2319/101013-748.1] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 12/01/2013] [Indexed: 10/05/2023] Open
Abstract
OBJECTIVE To test the null hypothesis that there are no significant differences in pharyngeal airway volumes among adult patients with different vertical skeletal patterns and a clinically normal sagittal skeletal pattern using cone-beam computed tomography (CBCT). MATERIAL AND METHODS The study sample consisted of 100 adult patients (45 men and 55 women; mean age = 24.0 ± 5.3 years) with a normal sagittal skeletal pattern divided into three groups according to the vertical skeletal patterns: high angle (32 patients: 15 women and 17 men), low angle (34 patients: 14 women and 20 men), and normal angle (34 patients: 16 women and 18 men) groups. Nasopharyngeal, oropharyngeal, and total airway volumes of patients in all vertical groups were calculated. Group differences were analyzed using one-way analysis of variance and post hoc Tukey tests. RESULTS Nasopharyngeal airway volume in the high-angle group (mean = 6067.9 ± 1693.9 mm(3)) was significantly lower than that of the low- and normal-angle groups (P < .01). Oropharyngeal airway volume was highest in the low-angle group (mean = 15,957.6 ± 6817.2 mm(3)) and significantly decreased in the control (mean = 11,826.1 ± 4831.9 mm(3); P = .008) and high angle (mean = 10,869.1 ± 4084.1 mm(3); P = .001) groups. Total airway volume was highest in the low-angle group (mean = 24,261.6 ± 8470.1 mm(3)) and lowest in the high-angle group (mean = 16,937.0 ± 5027.4 mm(3); P < .001). CONCLUSION The null hypothesis was rejected. Significant differences were found in pharyngeal airway volumes among different skeletal vertical patterns.
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Affiliation(s)
- Mevlut Celikoglu
- Associate Professor, Department of Orthodontics, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| | - Mehmet Bayram
- Associate Professor, Department of Orthodontics, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| | - Ahmet E. Sekerci
- Assistant Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Suleyman K. Buyuk
- Research Assistant, Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Ebubekir Toy
- Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Inonu University, Malatya, Turkey
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Celikoglu M, Ucar FI, Sekerci AE, Buyuk SK, Ersoz M, Sisman Y. Assessment of pharyngeal airway volume in adolescent patients affected by bilateral cleft lip and palate using cone beam computed tomography. Angle Orthod 2014; 84:995-1001. [PMID: 24665888 DOI: 10.2319/121913-930.1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To test the null hypothesis that there were no significant differences for pharyngeal airway volumes between the adolescent patients affected by bilateral cleft lip and palate (BCLP) and well-matched controls using cone beam computed tomography. MATERIALS AND METHODS The study sample consisted of 16 patients (11 female and 5 male; mean [SD] age 14.1 [2.1] years) affected by BCLP and 16 patients (10 female and 6 male; mean [SD] age 13.4 [2.0] years) as age- and sex-matched control group. Craniofacial measurements and pharyngeal airway dimension, area, and volume measurements of patients in both groups were calculated and statistically examined using Student's t-test and multiple linear regression analyses. RESULTS Statistically significant differences were found between the BCLP and control groups for SNB (P < .05), SN-GoGn (P < .05), Co-A (P < .05), PAS (P < .01), minAx (P < .01), and oropharyngeal airway volume (P < .05). The most predictive variables for oropharyngeal airway volume were found as PAS (r = .655 and P = .000) and minAx (r = .787 and P = .000). CONCLUSIONS The null hypothesis was rejected. Oropharyngeal (P < .05) and total (P > .05) airway volumes were found to be less in the BCLP group, and thus the treatment choice in these patients should have positive effects on the pharyngeal airway.
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Affiliation(s)
- Mevlut Celikoglu
- a Associate Professor, Department of Orthodontics, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
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Han S, Choi YJ, Chung CJ, Kim JY, Kim KH. Long-term pharyngeal airway changes after bionator treatment in adolescents with skeletal Class II malocclusions. Korean J Orthod 2014; 44:13-9. [PMID: 24511511 PMCID: PMC3915171 DOI: 10.4041/kjod.2014.44.1.13] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 07/19/2013] [Accepted: 07/29/2013] [Indexed: 11/16/2022] Open
Abstract
Objective The aim of this study was to evaluate long-term changes in the pharyngeal airway dimensions after functional appliance treatment in adolescents with skeletal Class II malocclusions. Methods Pharyngeal airway dimensions were compared between subjects with skeletal Class II malocclusions (n = 24; mean age: 11.6 ± 1.29 years) treated with a Class II bionator and age-matched control subjects with skeletal Class I occlusions (n = 24; mean age: 11.0 ± 1.21 years) using a series of lateral cephalograms obtained at the initial visit (T0), after treatment (T1), and at the completion of growth (T2). Results The length of the nasopharyngeal region was similar between adolescents with skeletal Class I and Class II malocclusions at all time points, while the lengths of the upper and lower oropharyngeal regions and the pharyngeal airway areas were significantly smaller in the skeletal Class II adolescents before treatment when compared to the control adolescents (p < 0.05). However, following treatment with a functional appliance, the skeletal Class II adolescents had increased pharyngeal airway dimensions, which became similar to those of the control subjects. Conclusions Functional appliance therapy can increase the pharyngeal airway dimensions in growing adolescents with skeletal Class II malocclusions, and this effect is maintained until the completion of growth.
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Affiliation(s)
- Seimin Han
- Department of Orthodontics, College of Dentistry, Yonsei University, Seoul, Korea
| | - Yoon Jeong Choi
- Department of Orthodontics, College of Dentistry, Yonsei University, Seoul, Korea. ; Department of Orthodontics, Gangnam Severance Dental Hospital, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Chooryung J Chung
- Department of Orthodontics, College of Dentistry, Yonsei University, Seoul, Korea. ; Department of Orthodontics, Gangnam Severance Dental Hospital, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Ji Young Kim
- Department of Orthodontics, College of Dentistry, Yonsei University, Seoul, Korea
| | - Kyung-Ho Kim
- Department of Orthodontics, College of Dentistry, Yonsei University, Seoul, Korea. ; Department of Orthodontics, Gangnam Severance Dental Hospital, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
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Kim MA, Kim BR, Youn JK, Kim YJR, Park YH. Head posture and pharyngeal airway volume changes after bimaxillary surgery for mandibular prognathism. J Craniomaxillofac Surg 2013; 42:531-5. [PMID: 24080139 DOI: 10.1016/j.jcms.2013.07.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 05/29/2013] [Accepted: 07/31/2013] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate head posture and the pharyngeal airway volume changes using 3D imaging after bimaxillary surgery in mandibular prognathism patients by null hypothesis. MATERIALS AND METHODS Cone-beam computed tomography (CBCT) scans were obtained for 25 mandibular prognathism patients before bimaxillary surgery (T1) and 6 months after surgery (T2). The head posture of each patient was assessed by measuring cranio-cervical angle on a midsagittal plane passing through the anterior nasal spine at T1 and T2. Additionally, the volume of each subject's pharyngeal airway was measured using InVivoDental 3D imaging software. RESULTS The cranio-cervical angle increased significantly 6 months after bimaxillary surgery (p < 0.01). The total volume of the pharyngeal airway slightly decreased (p > 0.05) at the same timepoints, while naso- and oro-pharyngeal airway volume decreased significantly (p < 0.05, p < 0.05). There was significant relationship between the changes of head posture and those of total airway volume (p < 0.05). CONCLUSION The null hypothesis was rejected. Bimaxillary surgery resulted in significant head flexion and a slight decrease in total pharyngeal airway volume.
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Affiliation(s)
- Min-Ah Kim
- Department of Orthodontics, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Gil-dong 445, Gangdong-gu, Seoul 134-701, Republic of Korea
| | - Bo-Ram Kim
- Department of Orthodontics, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Gil-dong 445, Gangdong-gu, Seoul 134-701, Republic of Korea
| | - Jong-Kuk Youn
- Graduate School of Hallym University, Seoul, Republic of Korea
| | - Yoon-Ji R Kim
- Department of Orthodontics, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Gil-dong 445, Gangdong-gu, Seoul 134-701, Republic of Korea
| | - Yang-Ho Park
- Department of Orthodontics, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Gil-dong 445, Gangdong-gu, Seoul 134-701, Republic of Korea.
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