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Al-Somairi MAA, Zheng B, Almaqrami BS, Al-Worafi NA, Alyafrusee ES, Al-Tayar B, Al-Rokhami RK, Al-Warafi LA, Alhashimi N, Xu H, Liu Y. Correlation between the three-dimensional hyoid bone parameters and pharyngeal airway dimensions in different sagittal and vertical malocclusions. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101994. [PMID: 39084559 DOI: 10.1016/j.jormas.2024.101994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/20/2024] [Accepted: 07/28/2024] [Indexed: 08/02/2024]
Abstract
OBJECTIVE This study aimed to explore the relationship between three-dimensional (3D) measurements of the hyoid bone (HB) and pharyngeal airway space (PAS) in relation to sagittal and vertical malocclusion. METHODS A total of 368 cone-beam computed tomography (CBCT) scans were classified into three skeletal groups (Class I, II, and III) and subdivided by vertical growth patterns (hypodivergent, normodivergent, and hyperdivergent). PAS dimensions, including nasopharyngeal, oropharyngeal, hypopharyngeal, and total airway spaces, were measured in surface area, volume, minimum constricted area (MCA), length, and width, HB position and dimension were analyzed in 3D using InVivo 6.0.3 and Dolphin 11.8 software. Data were analyzed using two-way ANOVA, and Bonferroni post-hoc tests, with P ≤ 0.05 considered significant. RESULTS The study found that patients with skeletal Class III and hypodivergent growth pattern had the highest sagittal position of the hyoid bone, while those with skeletal Class II and hyperdivergent pattern had the lowest hyoid length. Nasopharyngeal airway space width was significantly lower in skeletal Class III patients, while volume and area were lower in hyperdivergent patients. Oropharyngeal and hypopharyngeal dimensions were also affected by skeletal class and growth pattern, with hyperdivergent patients having the lowest values. Total pharyngeal volume, area, and minimum constricted area were also affected, with hyperdivergent patients having the lowest values and skeletal Class II patients having the lowest minimum constricted area. CONCLUSION Pharyngeal airway dimensions and hyoid bone parameters vary with malocclusions. The hyoid bone's position influences the airway, identifying patients at risk for airway obstruction and sleep-disordered breathing.
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Affiliation(s)
- Majedh Abdo Ali Al-Somairi
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Shenyang Clinical Medical Research Center of Orthodontic Disease, Shenyang 110002, PR China; Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, China; Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Ibb University, Republic of Yemen
| | - Bowen Zheng
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Shenyang Clinical Medical Research Center of Orthodontic Disease, Shenyang 110002, PR China
| | - Bushra Sufyan Almaqrami
- Department of Orthodontics, Ningbo Dental Hospital, Ningbo, Zhejiang, China; Orthodontics Division, Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen
| | - Naseem Ali Al-Worafi
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Shenyang Clinical Medical Research Center of Orthodontic Disease, Shenyang 110002, PR China
| | - Enas Senan Alyafrusee
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Shenyang Clinical Medical Research Center of Orthodontic Disease, Shenyang 110002, PR China; Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Ibb University, Republic of Yemen
| | - Barakat Al-Tayar
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Shenyang Clinical Medical Research Center of Orthodontic Disease, Shenyang 110002, PR China; Orthodontics Division, Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen
| | - Remsh K Al-Rokhami
- School of Stomatology, Nanchang University, The Key Laboratory of Oral Biomedicine, Jiangxi Province, Jiangxi Province Clinical Research Center for Oral Diseases, China
| | - Leena Ali Al-Warafi
- Department of Orthodontics, First Affiliated Hospital of Zhengzhou University, China
| | - Najah Alhashimi
- Unit and Divisional Chief Orthodontics at Hamad Medical Corporation, College of Dental Medicine, Qatar University, Doha, Qatar
| | - Hao Xu
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Shenyang Clinical Medical Research Center of Orthodontic Disease, Shenyang 110002, PR China
| | - Yi Liu
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Shenyang Clinical Medical Research Center of Orthodontic Disease, Shenyang 110002, PR China.
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Savoldi F, Dagassan-Berndt D, Patcas R, Mak WS, Kanavakis G, Verna C, Gu M, Bornstein MM. The use of CBCT in orthodontics with special focus on upper airway analysis in patients with sleep-disordered breathing. Dentomaxillofac Radiol 2024; 53:178-188. [PMID: 38265247 PMCID: PMC11003665 DOI: 10.1093/dmfr/twae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/14/2023] [Accepted: 12/29/2023] [Indexed: 01/25/2024] Open
Abstract
Applications of cone-beam CT (CBCT) in orthodontics have been increasingly discussed and evaluated in science and practice over the last two decades. The present work provides a comprehensive summary of current consolidated practice guidelines, cutting-edge innovative applications, and future outlooks about potential use of CBCT in orthodontics with a special focus on upper airway analysis in patients with sleep-disordered breathing. The present scoping review reveals that clinical applications of CBCT in orthodontics are broadly supported by evidence for the diagnosis of dental anomalies, temporomandibular joint disorders, and craniofacial malformations. On the other hand, CBCT imaging for upper airway analysis-including soft tissue diagnosis and airway morphology-needs further validation in order to provide better understanding regarding which diagnostic questions it can be expected to answer. Internationally recognized guidelines for CBCT use in orthodontics are existent, and similar ones should be developed to provide clear indications about the appropriate use of CBCT for upper airway assessment, including a list of specific clinical questions justifying its prescription.
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Affiliation(s)
- Fabio Savoldi
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Dorothea Dagassan-Berndt
- Center for Dental Imaging, University Center for Dental Medicine Basel UZB, University of Basel, Basel, 4058, Switzerland
| | - Raphael Patcas
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, 8032, Switzerland
| | - Wing-Sze Mak
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong SAR
| | - Georgios Kanavakis
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine Basel UZB, University of Basel, Basel, 4058, Switzerland
| | - Carlalberta Verna
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine Basel UZB, University of Basel, Basel, 4058, Switzerland
| | - Min Gu
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, 4058, Switzerland
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Al-Somairi MAA, Liu Y, Almashraq AA, Almaqrami BS, Alshoaibi LH, Alyafrusee ES, Al-Tayar B, An X, Alhammadi MS. Correlation between the three-dimensional maxillomandibular complex parameters and pharyngeal airway dimensions in different sagittal and vertical malocclusions. Dentomaxillofac Radiol 2023; 52:20220346. [PMID: 36695712 PMCID: PMC9944012 DOI: 10.1259/dmfr.20220346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES This study aimed to determine the three-dimensional (3D) correlation between maxillomandibular complex parameters and pharyngeal airway dimensions in different sagittal and vertical malocclusions. METHODS This retrospective cross-sectional study included the CBCT scans of 368 patients with a mean age of 23.81 ± 3.01 years. The patients were classified into three groups (skeletal Class I, II, and III). Each class group was divided into three subgroups based on vertical growth patterns (hypo-, normo-, and hyperdivergent). The maxillomandibular complex was evaluated in the three planes using 16 skeletal measurements. Naso-, oro-, hypo-, and total pharyngeal airway spaces were assessed in terms of width, volume, surface area, and minimum constricted area (MCA). Two-way ANOVA followed by the Bonferroni post-hoc test were used. RESULTS The nasopharyngeal airway space was significantly lowest regarding sagittal and lateral widths in the skeletal Class III patients, the lowest volume and surface area were in hyperdivergent patients, and MCA was the highest in Class II and hypodivergent patients. The oro- and hypopharyngeal sagittal width, volume, surface area, and MCA were the lowest in the hyperdivergent patients, and oropharyngeal lateral width and hypopharyngeal sagittal width were the highest in skeletal Class III. The total pharyngeal volume, surface area, and MCA were the lowest in the hyperdivergent patients, and skeletal Class II patients had the lowest MCA. CONCLUSIONS The pharyngeal airway dimensions differ with various sagittal and vertical malocclusions. These differences could apply to diagnosis, treatment planning, and possible changes following orthodontic/orthopedic or surgical treatment.
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Affiliation(s)
| | - Yi Liu
- Department of Orthodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Abeer A. Almashraq
- Department of Pre-Clinical Oral Health Sciences, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | | | - Lina H. Alshoaibi
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, China
| | | | - Barakat Al-Tayar
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, China
| | - Xiaoli An
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, China
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Cheng B, Mohamed AS, Habumugisha J, Guo Y, Zou R, Wang F. A Study of the Facial Soft Tissue Morphology in Nasal- and Mouth-Breathing Patients. Int Dent J 2022; 73:403-409. [DOI: 10.1016/j.identj.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/03/2022] [Accepted: 09/10/2022] [Indexed: 11/05/2022] Open
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Evaluation and Correlation Between Pharyngeal Space, Mandible, and Tongue in Two Different Facial Patterns. JOURNAL OF INDIAN ORTHODONTIC SOCIETY 2022. [DOI: 10.1177/03015742221083065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: Respiratory function has a direct relationship with the pharyngeal airway dimension and mandibular morphology. The objective of the present study was to compare and correlate pharyngeal airway, mandibular morphology, and tongue position in hyperdivergent and normodivergent patterns using standard cephalometric radiographs. Materials and Methods: A total of 130 individuals with age 13 to 19 years, with no craniofacial skeletal abnormalities, were taken. The individuals were divided into 2 groups based on their Frankfort mandibular angle (FMA). Group I consist of 65 hyperdivergent individuals (34 males, 31 females) with FMA >28. Group II consisted of 65 normodivergent individuals (28 males, 37 females) with FMA >25 to <28. For statistical analysis, variables were analyzed by unpaired t-test, with P value <.05. Correlation between the pharyngeal space and the other variables was analyzed with the Pearson correlation test. Results: Upper pharyngeal airway space in hyperdivergent growth pattern exhibited a significant negative correlation with ramus width (r = −0.02 and P = .028). Gonial angle showed a statistically significant inverse correlation with lower pharyngeal airway space (r = −0.398 and P = .029). A-point-nasion-B-point (ANB), saddle angle, posterior tongue space, tongue gap, and pharyngeal airway among normodivergent subjects, showed a statistically significant negative correlation. Conclusion: The present study showed a significant relationship between pharyngeal airway space, craniofacial morphology, and tongue position suggesting that narrower airway space may be a causative factor for altered dentofacial skeletal patterns. Reduced ramus width, lowered tongue, and narrower posterior pharyngeal wall might be a balancing mechanism set for morphological imbalance in hyperdivergent pattern.
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Miranda-Viana M, Freitas DQ, Machado AH, Gomes AF, Nejaim Y. Do the dimensions of the hard palate have a relationship with the volumes of the upper airways and maxillary sinuses? A CBCT study. BMC Oral Health 2021; 21:356. [PMID: 34284755 PMCID: PMC8290584 DOI: 10.1186/s12903-021-01724-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/14/2021] [Indexed: 11/30/2022] Open
Abstract
Background As the hard palate is a central structure of the skull, and its close relationship with the nasal cavity, oral cavity, and maxillary sinuses, it would be of interest to study if there is a relationship between this bone and other structures of the stomatognathic system. Thus, this study aimed to assess the dimensions of the hard palate and associate them with sex, and skeletal and breathing patterns. Also, to investigate if there is a relationship between these dimensions and the volumes of the upper airways and maxillary sinuses.
Methods Two hundred and ninety-eight CBCT scans of patients were classified according to sex, and skeletal and breathing patterns. Then, the linear dimensions of width and height of the hard palate at the regions of the first premolars and first molars, and the volumes of the upper airways and maxillary sinuses were measured using the CS 3D Imaging and ITK-SNAP software, respectively. Data were submitted to multi-way analysis of variance and linear regression, with a significance level of 5% (α = 0.05). Results Sex and facial type influenced the hard palate dimensions (p < 0.05). Males had greater width and height of the hard palate than females (p < 0.0001). It was observed greater width for brachycephalics at the first premolars region (p = 0.0032), and greater height for dolichocephalics at the first premolars (p = 0.0154) and first molars (p = 0.0038) regions. Skeletal malocclusion and breathing pattern did not influence the measurements of the hard palate (p > 0.05). There was a significant relationship between the width and height of the hard palate at the premolar’s region and the total volume of the upper airways (p = 0.018, and p = 0.038), and between both dimensions of the hard palate at the molar’s region and the total volume of the maxillary sinuses (p < 0.0001). Conclusions The hard palate dimensions are influenced by sex and facial type, but not by skeletal malocclusion or breathing pattern. Also, there is an association between these dimensions and the volumes of the upper airways and maxillary sinuses.
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Affiliation(s)
- Murilo Miranda-Viana
- Department of Oral Diagnosis - Oral Radiology Area, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil.
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis - Oral Radiology Area, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Alessiana Helena Machado
- Department of Oral Diagnosis - Oral Radiology Area, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Amanda Farias Gomes
- Department of Oral Diagnosis - Oral Radiology Area, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Yuri Nejaim
- Oral Radiology Area, Dental School, Federal University of Mato Grosso Do Sul, Campo Grande, MS, Brazil
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Haskell BS, Voor MJ, Roberts AM. A consideration of factors affecting palliative oral appliance effectiveness for obstructive sleep apnea: a scoping review. J Clin Sleep Med 2021; 17:833-848. [PMID: 33196434 PMCID: PMC8020709 DOI: 10.5664/jcsm.9018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES This scoping review allows physicians, researchers, and others interested in obstructive sleep apnea to consider effectiveness of oral appliances (OAs). The intent is to improve understanding of OA effectiveness by considering morphologic interaction in patients with obstructive sleep apnea. METHODS Morphologic and biomechanical criteria for positional alterations of the mandible assessed success rates of OA appliances. Searches of databases (Medline, PubMed, The Cochrane Library, EBSCO) using terms: OA treatment effectiveness and positive and/or negative outcome predictors. Craniofacial predictors of OAs and obstructive sleep apnea biomechanical factors of anatomical traits associated with OA effectiveness were included. Databases searched radiographic cephalometric imaging for morphology/phenotypes and apnea-hypopnea index responses. Articles were excluded if title or abstract was not relevant or a case report. If the analysis did not report mean or standard deviation for apnea-hypoxia index, it was excluded. No language, age, or sex restrictions were applied. RESULTS Analysis of 135 articles included in searched literature indicated alterations in musculature and pharyngeal airway structure through OA use. These alterations were individually unpredictable with wide variability 61.81% ± 12.29 (apnea-hypoxia index mean ± standard deviation). Morphologic variations as predictors were typically weak and idiosyncratic. Biomechanical factors and wide variations in the metrics of appliance application were unclear, identifying gaps in knowledge and practice of OAs. CONCLUSIONS An integrated basis to identify morphologic and biomechanical elements of phenotypic expressions of sleep-disordered breathing in the design and application of OAs is needed. Current knowledge is heterogeneous and shows high variability. Identification of subgroups of patients with obstructive sleep apnea responding to OAs is needed.
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Affiliation(s)
- Bruce S. Haskell
- Division of Orthodontics, University of Kentucky College of Dentistry, Lexington Kentucky
- Department of Physiology, School of Medicine, University of Louisville, Louisville, Kentucky
- Comprehensive Dentistry, School of Dentistry, University of Louisville, Louisville, Kentucky
| | - Michael J. Voor
- Department of Orthopedics, School of Medicine, University of Louisville, Louisville, Kentucky
- Department of Biomedical Engineering, School of Medicine, University of Louisville, Louisville, Kentucky
| | - Andrew M. Roberts
- Department of Physiology, School of Medicine, University of Louisville, Louisville, Kentucky
- Department of Pediatrics, School of Medicine, University of Louisville, Louisville, Kentucky
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Pradhan R, Rajbhandari A, Bajracharya M, Manandhar P, Maharjan S, Pant BD. Study of Upper Pharyngeal Airway Dimension in Young Adults Visiting Orthodontic Department of a Dental College: A Descriptive Cross-sectional Study. ACTA ACUST UNITED AC 2021; 59:271-275. [PMID: 34506436 PMCID: PMC8369541 DOI: 10.31729/jnma.6293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Indexed: 11/24/2022]
Abstract
Introduction: Orthodontic treatment may affect the size and position of oropharyngeal structures altering the airway dimension. Airway dimension is considered as one of the parameter of orthodontic diagnosis and treatment planning. Narrow airway passage is associated with sleep disordered breathing. This aims to study about the measurement of upper pharyngeal airway dimension of young Nepalese adults visiting orthodontic department of a dental college. Methods: This descriptive cross-sectional study conducted at Department of Orthodontics, People's Dental College and Hospital, Kathmandu. Data was collected from 8th December 2020 to 28th February 2021. Ethical clearance (Reference number. 1, CH100 06, 2077/2076) was taken from Institutional Review Committee of Peoples Dental College and Hospital, Kathmandu, Nepal. Convenient Sampling technique was done. Data was collected and analysis was done using Statistical Package of Social Sciences 16. Results: Mean upper pharyngeal airway dimension was 11.40±1.84mm and 11.68±1.96mm for male and female respectively. Upper pharyngeal airway dimension was found to be almost similar for male and female. Conclusions: Gender diversity regarding upper pharyngeal airway dimesnion was not observed in this study while other studies also revealed similarities in upper pharyngeal airway dimension between male and female, inspite of larger craniofacial dimension in males than females.
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Affiliation(s)
- Resina Pradhan
- Department of Orthodontics, People's Dental College and Hospital, Kathmandu, Nepal
| | - Anjana Rajbhandari
- Department of Orthodontics, People's Dental College and Hospital, Kathmandu, Nepal
| | - Manju Bajracharya
- Department of Orthodontics, People's Dental College and Hospital, Kathmandu, Nepal
| | - Pushkar Manandhar
- Department of Orthodontics, People's Dental College and Hospital, Kathmandu, Nepal
| | - Surendra Maharjan
- Department of Orthodontics, People's Dental College and Hospital, Kathmandu, Nepal
| | - Bashu Dev Pant
- Department of Orthodontics, People's Dental College and Hospital, Kathmandu, Nepal
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Chan L, Kaczynski R, Kang HK. A cross-sectional retrospective study of normal changes in the pharyngeal airway volume in white children with 3 different skeletal patterns from age 9 to 15 years: Part 1. Am J Orthod Dentofacial Orthop 2020; 158:710-721. [PMID: 32828607 DOI: 10.1016/j.ajodo.2019.10.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 01/06/2023]
Abstract
INTRODUCTION This study investigated correlations between airway size and age, sex, and skeletal patterns; identified airway change trends; and measured volumetric norms in children via cone-beam computed tomography. METHODS Four hundred twenty nontreated white patients were stratified by age, sex, and anteroposterior skeletal pattern. The nasopharyngeal airway (NPA), oropharyngeal airway (OPA), and total pharyngeal airway (TPA) volumes were delineated on 3-dimensional digital cephalograms. SPSS (SPSS, Chicago, Ill) was used to run an analysis of variance and post-hoc analyses. RESULTS The Class III group had significantly larger OPA volumes than Class I and II groups. Male subjects had considerably larger NPA volumes than female subjects. Age was significantly associated with all 3 airway volumes (P <0.05). The young cohort (ages, 9-10 years) had a mean TPA of 11,435.34 ± 484.45 mm3, the middle cohort (ages, 11-13 years) had a mean TPA of 14,152.07 ± 395.46 mm3, and the older cohort (ages, 14-15 years) had a mean TPA of 18,057.99 ± 484.25 mm3. CONCLUSIONS An effect of skeletal classification on OPA and a sex effect on NPA were observed. The annual change in the mean of TPA volume decreased in subjects aged 10-12 years, then rebounded until 14 years. TPA change peaked in female subjects 1 year before male subjects.
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Affiliation(s)
- Loren Chan
- Department of Orthodontics, School of Dentistry, University of Detroit Mercy, Detroit, Mich
| | - Richard Kaczynski
- Department of Orthodontics, School of Dentistry, University of Detroit Mercy, Detroit, Mich, and Department of Psychiatry, School of Medicine, Yale University, New Haven, Conn
| | - He-Kyong Kang
- Department of Orthodontics, School of Dentistry, University of Detroit Mercy, Detroit, Mich.
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Kocakara G, Buyukcavus MH, Orhan H. Evaluation of pharyngeal airway dimensions and hyoid bone position according to craniofacial growth pattern. Cranio 2020; 40:313-323. [PMID: 32692620 DOI: 10.1080/08869634.2020.1796060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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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Shokri A, Mollabashi V, Zahedi F, Tapak L. Position of the hyoid bone and its correlation with airway dimensions in different classes of skeletal malocclusion using cone-beam computed tomography. Imaging Sci Dent 2020; 50:105-115. [PMID: 32601585 PMCID: PMC7314608 DOI: 10.5624/isd.2020.50.2.105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 02/13/2020] [Accepted: 03/14/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose This study investigated the position of the hyoid bone and its relationship with airway dimensions in different skeletal malocclusion classes using cone-beam computed tomography (CBCT). Materials and Methods CBCT scans of 180 participants were categorized based on the A point-nasion-B point angle into class I, class II, and class III malocclusions. Eight linear and 2 angular hyoid parameters (H-C3, H-EB, H-PNS, H-Me, H-X, H-Y, H-[C3-Me], C3-Me, H-S-Ba, and H-N-S) were measured. A 3-dimensional airway model was designed to measure the minimum cross-sectional area, volume, and total and upper airway length. The mean cross-sectional area, morphology, and location of the airway were also evaluated. Data were analyzed using analysis of variance and the Pearson correlation test, with P values <0.05 indicating statistical significance. Results The mean airway volume differed significantly among the malocclusion classes (P<0.05). The smallest and largest volumes were noted in class II (2107.8±844.7 mm3) and class III (2826.6±2505.3 mm3), respectively. The means of most hyoid parameters (C3-Me, C3-H, H-Eb, H-Me, H-S-Ba, H-N-S, and H-PNS) differed significantly among the malocclusion classes. In all classes, H-Eb was correlated with the minimum cross-sectional area and airway morphology, and H-PNS was correlated with total airway length. A significant correlation was also noted between H-Y and total airway length in class II and III malocclusions and between H-Y and upper airway length in class I malocclusions. Conclusion The position of the hyoid bone was associated with airway dimensions and should be considered during orthognathic surgery due to the risk of airway obstruction.
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Affiliation(s)
- Abbas Shokri
- Dental Implant Research Center, Department of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Vahid Mollabashi
- Department of Orthodontics, Dental School, Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Foozie Zahedi
- Dental Implant Research Center, Department of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Leili Tapak
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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Farias Gomes A, Sousa Melo SL, Nejaim Y, Groppo FC, Teixeira FB, Freitas DQ. Variations in pulp volume between normotensive and hypertensive individuals on CBCT imaging. Clin Oral Investig 2020; 24:4069-4076. [PMID: 32333179 DOI: 10.1007/s00784-020-03279-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 04/08/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To compare the pulp volume of individuals with altered and normal systemic blood pressure (BP) in order to verify if high BP promotes dimensional modifications in the pulp space. MATERIALS AND METHODS Cone beam computed tomography scans of 91 patients (49 females and 42 males, mean age 31.7 ± 6.38 years) who had a healthy maxillary canine were selected. Values of arterial BP measured at two dental visits were used to classify the sample as normal BP (< 130 × 80 mmHg) and altered BP (≥ 130 × 80 mmHg); 49 patients had normal BP and 42 had altered BP. One oral radiologist evaluated each patient's pulp and tooth volumes, using semi-automatic segmentation, and the tooth length. Data were submitted to Student's t test and logistic regression, with a significance level of 5% (p < 0.05). RESULTS Pulp volume (p = 0.0027), pulp volume/tooth volume (p = 0.0013), and pulp volume/tooth length (p = 0.0007) ratios were greater in the altered BP group. Conversely, there was no difference in tooth volume between the groups (p = 0.0697). A logistic regression model (p = 0.0002) using pulp volume and age enabled the development of a formula for predicting altered BP, with 68% accuracy. CONCLUSIONS Individuals with altered systemic BP have greater pulp volumes than those with normal BP. The formula developed in this study may indicate the presence of altered BP. CLINICAL RELEVANCE As arterial hypertension is a silent disease that produces no warning signs or symptoms, identification of modifications in the pulp volume in cone beam computed tomography scans may be an adjuvant sign of the diagnosis of this disease.
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Affiliation(s)
- Amanda Farias Gomes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil.
| | - Saulo L Sousa Melo
- Department of Integrative Biomedical and Diagnostic Sciences, Oregon Health and Science University, Portland, OR, USA
| | - Yuri Nejaim
- Oral Radiology Area, Dental School, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Francisco Carlos Groppo
- Department of Physiological Sciences, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Fabrício B Teixeira
- Department of Endodontics, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, IA, USA
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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Three-Dimensional Assessment of Pharyngeal Volume on Computed Tomography Scans: Applications to Anesthesiology and Endoscopy. J Craniofac Surg 2020; 31:755-758. [PMID: 31985592 DOI: 10.1097/scs.0000000000006094] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Pharyngeal volume is important in anesthesiology for correctly assessing intubation procedures. However, most of studies are based on patients in upright position and do not assess possible relationships between pharyngeal volume and cranial size. This study aims at measuring pharyngeal volume in CT-scans and to assess possible statistically significant differences according to sex.Eighty healthy subjects (40 males and 40 females) aged between 21 and 86 years were retrospectively chosen from a hospital database of maxillofacial CT-scans; 3D segmentation was performed separately for naso-, oro- and laryngopharyngeal portion through ITK-SNAP software, and their volume was calculated. Three cranial measurements were obtained: distance between anterior and posterior nasal spine, upper facial height (nasion-prosthion) and biorbital breadth (ectoconchion-ectoconchion distance).The effect of sex on volume for each pharyngeal portion was assessed through one-way ANCOVA test using each of the 3 cranial measurements as covariate (P < 0.05).On average, the volume of nasopharynx, oropharynx and laryngopharynx was 7.2 ± 2.7 cm, 7.5 ± 4.2 cm, 3.5 ± 2.2 cm respectively in males, and 6.4 ± 2.9 cm, 5.2 ± 2.1 cm, 3.0 ± 1.8 cm in females. Statistically significant differences according to sex were found only for oropharyngeal volume, independently from cranial measurements (P < 0.05).This study provides data concerning volume of pharyngeal air space in supine subjects: these reference standards can be useful for anaesthesiologic procedures.
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Cagna DR, Donovan TE, McKee JR, Eichmiller F, Metz JE, Albouy JP, Marzola R, Murphy KR, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2019; 122:198-269. [PMID: 31405523 DOI: 10.1016/j.prosdent.2019.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 12/13/2022]
Abstract
This comprehensive review of the 2018 dental literature is provided to inform busy dentists about progress in the profession. Developed by the Committee on Scientific Investigation of the American Academy of Restorative Dentistry, each author brings discipline-specific expertise to one of the 8 sections of the report including (1) prosthodontics; (2) periodontics, alveolar bone, and peri-implant tissues; (3) implant dentistry; (4) dental materials and therapeutics; (5) occlusion and temporomandibular disorders; (6) sleep-related breathing disorders; (7) oral medicine and oral and maxillofacial surgery; and (8) dental caries and cariology. The report targets important information that will likely influence day-to-day treatment decisions. Each review is not intended to stand alone but to update interested readers so that they may visit source materials if greater detail is desired. As the profession continues its march toward evidence-based clinical decision-making, an already voluminous library of potentially valuable dental literature continues to grow. It is the intention of this review and its authors to provide assistance in navigating the extensive dental literature published in 2018. It is our hope that readers find this work useful in the clinical management of patients moving forward.
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Affiliation(s)
- David R Cagna
- Professor, Associate Dean, and Residency Director, Department of Prosthodontics, University of Tennessee Health Sciences Center, College of Dentistry, Memphis, Tenn.
| | - Terence E Donovan
- Professor and Head of Biomaterials, Department of Restorative Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC
| | - James R McKee
- Private practice, Restorative Dentistry, Downers Grove, Ill
| | | | - James E Metz
- Private practice, Restorative Dentistry, Columbus, Ohio
| | - Jean-Pierre Albouy
- Assistant Professor, Department of Restorative Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC
| | | | - Kevin R Murphy
- Associate Clinical Professor, Department of Periodontics, University of Maryland College of Dentistry, Baltimore, MD; Private practice, Periodontics and Prosthodontics, Baltimore, MD
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15
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Gomes AF, Brasil DM, Silva AIV, Freitas DQ, Haiter-Neto F, Groppo FC. Accuracy of ITK-SNAP software for 3D analysis of a non-regular topography structure. Oral Radiol 2019; 36:183-189. [PMID: 31267257 DOI: 10.1007/s11282-019-00397-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/27/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the accuracy of ITK-SNAP software for measuring volumes of a non-regular shape structure, using cone beam computed tomography (CBCT) scans, besides for developing a mathematical model to correct the software measurement error in case it existed. METHODS A phantom made by moulding a rubber duck's head was filled with total (38,000 mm3) and partial volumes of water (7000 mm3, 14,000 mm3, 21,000 mm3, 28,000 mm3 and 35,000 mm3), which constituted the gold standards. The sound phantom and the phantom filled with different volumes of water were scanned in a Picasso Trio CBCT unit set at 80 kVp, 3.7 mA, 0.2 mm3 voxel and 12 × 8.5 cm field of view. Semi-automatic segmentation was performed with ITK-SNAP 3.0 software by two trained oral radiologists. Linear regression analyzed the relation between ITK-SNAP calculated volumes and the gold standard. Intraclass correlation coefficient was applied to analyze the reproducibility of the method. Significance level was set at 5%. RESULTS Linear regression analysis showed a significant relationship between ITK-SNAP volumes and the gold standard (F = 22,537.3, p < 0.0001), with an R2 of 0.9993. The average error found was 4.7 (± 4.3) %. To minimize this error, a mathematical model was developed and provided a reduction of it. ICC revealed excellent intra-examiner agreements for both examiners 1 (ICC = 0.9991, p < 0.0001) and 2 (ICC = 0.9989, p < 0.0001). Likewise, inter-examiner agreement was excellent (ICC = 0.9991, p < 0.0001). CONCLUSION The software showed to be accurate for evaluating non-regular shape structures. The mathematical model developed reduced an already small error on the software's measurements.
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Affiliation(s)
- Amanda Farias Gomes
- Department of Oral Diagnosis-Oral Radiology, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, Piracicaba, 13414-903, SP, Brazil
| | - Danieli Moura Brasil
- Department of Oral Diagnosis-Oral Radiology, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, Piracicaba, 13414-903, SP, Brazil.
| | - Amaro Ilídio Vespasiano Silva
- Department of Oral Radiology, School of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis-Oral Radiology, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, Piracicaba, 13414-903, SP, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis-Oral Radiology, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, Piracicaba, 13414-903, SP, Brazil
| | - Francisco Carlos Groppo
- Department of Physiological Sciences-Pharmacology, Anesthesiology and Therapeutics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
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