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Ertugrul BY. Evaluation of effects of removable functional orthodontic apparatus on the upper airway size by cephalometric films. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e121-e125. [PMID: 34563728 DOI: 10.1016/j.jormas.2021.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 09/08/2021] [Accepted: 09/21/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Respiration is a vital functional process that has effects on normal craniofacial development. Since the upper airway formations and dentofacial structures are adjacent to each other, the interaction between them is possible. The aim of this study is to evaluate the effects of removable functional appliances used in the treatment of patients with mandibular and maxillary growth retardation-stenosis in Class I, Class II, and Class III malocclusion on the upper airway. MATERIALS AND METHODS Thirty two patients were studied in the study. The patients were divided into 4 groups according to treatment modalities. Maxillary expansion device group (Group A), Twinblock-Monoblock group (Group B), Face mask group (Group C), and Chincup group (Group D). The upper airway size in the lateral cephalometric images of the patients before orthodontic treatment with removable functional appliances (T0) and the upper airway size in the lateral cephalometric images taken after the end of the orthodontic treatment with the removable functional appliances (T1) were retrospectively compared. RESULT Most upper airway size increased after orthodontic treatment (T1) in the individuals who received orthodontic treatment with A, B, C, and D type removable functional appliances compared to pre-treatment (T0). When the changes in upper airway size pre-treatment (T0) and post-treatment (T1) were compared, the change in upper airway size according to treatment groups was found to be statistically different (p <0.05). CONCLUSION Since a large part of the upper airway is located in the craniofacial complex, orthodontists also examine the airway for diagnosis and planning and can regulate the airway in case of occlusion that has occurred or may occur. This puts orthodontists in an important place to intervene when complications occur or may develop in the upper airway. By determining the effects of removable functional appliances on the airways, airway problems that may be experienced at an early age can be prevented.
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Affiliation(s)
- Betul Yuzbasioglu Ertugrul
- Izmir Demokrasi University Faculty of Dentistry, Department of Orthodontics, Izmir, Turkey; Van Yüzüncü Yıl University Faculty of Dentistry, Department of Orthodontics, Van, Turkey.
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Yavan MA, Aycan M, Aksoyler D, Essiz A. Comparison of twin block appliance and Forsus Fatigue Resistant Device therapies on uvulo-glossopharyngeal dimensions: A retrospective study. APOS TRENDS IN ORTHODONTICS 2021. [DOI: 10.25259/apos_173_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives:
The aim of this study was to compare the effects of two different functional appliances on skeletal, dental, and uvulo-glossopharyngeal dimensions.
Materials and Methods:
Pre- and post-treatment lateral cephalograms of 50 adolescent Class II patients with a retrognathic mandible were obtained from an archive and divided into two groups according to functional therapy. Twenty-five patients (14 females, 11 males, mean age: 13.5 ± 2.8) who were treated with Forsus Fatigue Resistant Device (FFRD) and 25 patients (17 females, eight males, mean age: 12.5 ± 0.4) who had received functional therapy through the twin block (TWB) were enrolled. Skeletal, dentoalveolar, tongue, uvula, hyoid position, and oropharyngeal airway parameters were measured using the Dolphin software, and uvulo-glossopharyngeal area measurements were performed with the AutoCAD software.
Results:
The TWB group exhibited remarkable mandibular advancement compared to the FFRD group (P < 0.05). Both of the treatments proclined mandibular incisors, and tongue dimensions increased significantly in both groups (P < 0.05). While the hyoid point moved forward and the oropharyngeal area increased significantly in the TWB group, no significant changes were observed in the FFRD group. The comparison of the TWB and FFRD groups with regard to uvulo-glossopharyngeal dimensions showed no significant differences between the groups (P > 0.05).
Conclusion:
Changes in uvulo-glossopharyngeal dimensions did not significantly vary between the two different functional therapies.
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Affiliation(s)
- Mehmet Ali Yavan
- Department of Orthodontics, Adiyaman University, Adiyaman, Turkey
| | - Merve Aycan
- Department of Orthodontics, Private Orthodontist, Antalya, Turkey,
| | - Dicle Aksoyler
- Department of Plastic Surgery, Nicklaus Children’s Hospital, Miami, Florida, United States,
| | - Aysegul Essiz
- Department of Orthodontics, Adiyaman University, Adiyaman, Turkey
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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] [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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Gu M, Lin Y, McGrath CPJ, Hägg U, Wong RWK, Yang Y. Evaluation of the upper airway dimensions following Herbst appliance treatment in adolescents: A retrospective study. APOS TRENDS IN ORTHODONTICS 2020. [DOI: 10.25259/apos_83_2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives:
This retrospective study investigated dimensional changes in the upper airway following Herbst appliance therapy in adolescents with Class II malocclusion and compared those changes with growth data.
Materials and Methods:
Lateral cephalograms from 44 Herbst-treated adolescents (23 boys, mean age = 13.3 ± 1.1 years, and 21 girls, mean age = 12.6 ± 1.1 years) were analyzed for the changes in the upper airway and craniofacial variables. Longitudinal cephalometric data of 34 untreated adolescents (15 boys, mean age = 12.6 ± 0.3 years, and 19 girls, mean age = 12.9 ± 0.4 years) were used as growth data for comparison.
Results:
Following treatment, significant changes were noted in most of the variables. Boys displayed greater downward movement of the hyoid bone than girls did (P = 0.021). Compared with the growth data, a greater increase in retroglossal oropharyngeal depth and hypopharyngeal depth was observed in boys and girls, respectively. Both displayed a decrease in the inclination of the soft palate and a smaller change in nasopharyngeal depth.
Conclusion:
Herbst appliance therapy enlarges the upper airway dimensions at two dissimilar sites in girls (oropharynx) and boys (hypopharynx). Boys display a greater increase in anterior and posterior facial heights than girls do, potentially accounting for the site dissimilarities. Moreover, a Herbst appliance improves the inclination of the soft palate and restricts the growth of the nasopharynx in both boys and girls.
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Affiliation(s)
- Min Gu
- Department of Paediatric Dentistry and Orthodontics, The University of Hong Kong, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
| | - Yifan Lin
- Department of Paediatric Dentistry and Orthodontics, The University of Hong Kong, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
| | - Colman Patrick Joseph McGrath
- Department of Public Health, The University of Hong Kong, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
| | - Urban Hägg
- Department of Paediatric Dentistry and Orthodontics, The University of Hong Kong, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
| | - Ricky Wing Kit Wong
- Department of Dentistry and Maxillofacial Surgery Cleft Center (Craniofacial Orthodontics), United Christian Hospital, Hong Kong, China,
| | - Yanqi Yang
- Department of Paediatric Dentistry and Orthodontics, The University of Hong Kong, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
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V A, Jena AK, Sharan J. Effects of functional appliance treatment on pharyngeal airway passage dimensions in Class II malocclusion subjects with retrognathic mandibles: A systematic review. APOS TRENDS IN ORTHODONTICS 2019. [DOI: 10.25259/apos_59_2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objective:The objective of this study was to assess the pharyngeal airway passage (PAP) dimension changes following functional appliance treatment in Class II malocclusion subjects with retrognathic mandibles.Materials and Methods:Two authors independently searched various electronic databases such as PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Scopus, NCBI, and Google Scholar for the available literature within the period from January 1, 2001, to December 31, 2018. On the basis of population, intervention, comparison, and outcome, “changes in PAP dimensions following functional appliance therapy in skeletal Class II malocclusion subjects associated with mandibular retrusion” was considered as search question of the study. After the selection and removal of duplicate articles, assessment for risk of bias was calculated and the data from the included articles were extracted by two authors independently.Results:From six databases and additional hand searching, a total of 5784 articles were extracted. Of 5784 articles, 3754 articles were screened after removal of 2030 duplicates. After going through the title and abstract, 3197 articles were excluded and 40 articles were assessed for full text. From these 40 articles, eight articles fulfilled our inclusion and exclusion criteria for the qualitative synthesis review.Conclusions:The correction of mandibular deficiency by functional appliances has minimum effect on the nasopharynx. Functional appliance treatment has a significant effect on the improvement of the oropharyngeal airway. Changes of hypopharyngeal airway passage need to be studied further among Class II malocclusion subjects with retrognathic mandibles.
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Ali B, Shaikh A, Fida M. Effect of Clark's twin-block appliance (CTB) and non-extraction fixed mechano-therapy on the pharyngeal dimensions of growing children. Dental Press J Orthod 2017; 20:82-8. [PMID: 26691974 PMCID: PMC4686749 DOI: 10.1590/2177-6709.20.6.082-088.oar] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Accepted: 06/29/2015] [Indexed: 12/02/2022] Open
Abstract
Introduction: Narrow airway dimensions due to mandibular deficiency can predispose an individual
to severe respiratory distress. Hence, treatment with mandibular advancement
devices at an early age might help improving the pharyngeal passage and reduce the
risk of respiratory difficulties. Therefore, the aim of the current study was to
evaluate the mean changes in the pharyngeal dimensions of children with mandibular
deficiency treated with Clark's twin-block appliance (CTB) followed by fixed
orthodontic treatment. Methods: Orthodontic records of 42 children with mandibular deficiency were selected.
Records comprised three lateral cephalograms taken at the start of CTB treatment,
after CTB removal and at the end of fixed appliance treatment, and were compared
with 32 controls from the Bolton-Brush study. Friedman test was used to compare
pre-treatment, mid-treatment and post-treatment pharyngeal dimensions. Wilcoxon
signed rank test was used to compare the airway between pre-treatment and post
follow-up controls. Mann-Whitney U test was applied to compare the mean changes in
pharyngeal dimensions between treatment group and controls from T2 to
T0. Post-hoc Dunnet T3 test was used for multiple comparisons of
treatment outcomes after CTB and fixed appliances, taking a
p-value of ≤ 0.05 as statistically significant. Results: Superior pharyngeal space (p < 0.001) and upper airway
thickness (p = 0.035) were significantly increased after CTB, and
the change in superior pharyngeal space remained stable after fixed
mechano-therapy. Conclusion: CTB can have a positive effect in improving pharyngeal space and the resultant
increase in airway remains stable on an average of two and a half years.
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Affiliation(s)
- Batool Ali
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Attiya Shaikh
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Mubassar Fida
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
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Xiang M, Hu B, Liu Y, Sun J, Song J. Changes in airway dimensions following functional appliances in growing patients with skeletal class II malocclusion: A systematic review and meta-analysis. Int J Pediatr Otorhinolaryngol 2017; 97:170-180. [PMID: 28483230 DOI: 10.1016/j.ijporl.2017.04.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 04/05/2017] [Accepted: 04/06/2017] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The purpose of the study was to evaluate the treatment effects of functional appliances (FAs) on upper airway dimensions in growing Class II patients with mandibular retrognathism. METHODS Five databases and the references of identified articles were electronically searched for relevant studies that met our eligibility criteria. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. The effects of FAs on airway dimensions were combined by meta-analysis using the RevMan and STATA software. RESULTS Seven studies (177 treated patients with mean age: 11.48 years and 153 untreated controls with mean age: 11.20 years) were included in this review. Compared to the control group, the oropharyngeal dimensions in the treatment group subjects were significantly increased at the superior pharyngeal space (MD = 1.73 mm/year, 95% CI, 1.13-2.32 mm, P < 0.00001), middle pharyngeal space (MD = 1.68 mm/year, 95% CI, 1.13-2.23 mm, P < 0.00001) and inferior pharyngeal space (MD = 1.21 mm/year, 95% CI, 0.48-1.95 mm, P = 0.001). No significant differences were found in nasopharyngeal and hypopharyngeal dimensions and the position of hyoid bone (P > 0.05). Soft palate length and soft palate inclination were improved significantly in the treatment group (P < 0.05). CONCLUSIONS The results showed that FAs can enlarge the upper airway dimensions, specifically in the oropharyngeal region, in growing subjects with skeletal Class II malocclusion. The early intervention for mandibular retrognathism with FAs may help enlarge the airway dimensions and decrease potential risk of obstructive sleep apnea syndrome for growing patients in the future.
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Affiliation(s)
- MingLi Xiang
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Bo Hu
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yang Liu
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jicheng Sun
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jinlin Song
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
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Hourfar J, Kinzinger GSM, Meißner LK, Lisson JA. Effects of two different removable functional appliances on depth of the posterior airway space : A retrospective cephalometric study. J Orofac Orthop 2016; 78:166-175. [PMID: 27896418 DOI: 10.1007/s00056-016-0071-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 10/24/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Aim of the study was the comparison of treatment effects upon pharyngeal depth in patients treated with either (1) S-II-appliance or (2) Activator. METHODS Pre- and posttreatment lateral cephalograms of 73 patients were analyzed using a customized set of measurements. According to predefined criteria, patients were either treated with S-II-appliance or Activator. Pharyngeal depth was assessed from cranial to caudal at six levels (P1 to P6). Paired t tests were used for intragroup and t tests for independent samples for intergroup comparisons. Results were considered statistically significant at p ≤ 0.05. RESULTS 37 (22 female, 15 male) patients were treated with the S-II-appliance (mean pretreatment age 11.1 ± 1.07 years), and 36 (20 female, 16 male) patients with an Activator (mean pretreatment age 11.3 ± 1.12 years). Mean treatment time was 14 months for the S-II-appliance and 12 months for the Activator. Most measurements at the different levels showed an average increase ranging from approximately 0.5 mm to almost 2 mm. Changes were more pronounced in S-II patients. In contrast to intergroup comparisons, some intragroup comparisons revealed statistically significant differences at levels P5 (p = 0.0062) and P6 (p = 0.0155) in S-II patients and at P1-level (p = 0.0197) in Activator patients. CONCLUSIONS Both appliances similarly led to an increase of the pharyngeal depth. The sites of statistically significant changes differed.
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Affiliation(s)
- Jan Hourfar
- Orthodontic Practice, Reinheim, Germany.,Department of Orthodontics, University of Heidelberg, Heidelberg, Germany
| | - Gero Stefan Michael Kinzinger
- Orthodontic Practice, Tönisvorst, Germany.,Department of Orthodontics, Saarland University, Kirrberger Strasse 100, 66424, Homburg/Saar, Germany
| | - Luisa Katharina Meißner
- Department of Orthodontics, Saarland University, Kirrberger Strasse 100, 66424, Homburg/Saar, Germany
| | - Jörg Alexander Lisson
- Department of Orthodontics, Saarland University, Kirrberger Strasse 100, 66424, Homburg/Saar, Germany.
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Upper airway changes following single-step or stepwise advancement using the Functional Mandibular Advancer. J Orofac Orthop 2016; 77:454-462. [PMID: 27770150 DOI: 10.1007/s00056-016-0062-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 08/11/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Purpose of the present study was to determine and compare possible changes in the dimensions of the pharyngeal airway, morphology of the soft palate, and position of the tongue and hyoid bone after single-step or stepwise mandibular advancement using the Functional Mandibular Advancer (FMA). PATIENTS AND METHODS The sample included 51 peak-pubertal Class II subjects. In all, 34 patients were allocated to two groups using matched randomization: a single-step mandibular advancement group (SSG) and a stepwise mandibular advancement group (SWG). Both groups were treated with FMA followed by fixed appliance therapy; the remaining 17 subjects who underwent only fixed appliance therapy constituted the control group (CG). The study was conducted using pre- and posttreatment lateral cephalometric radiographs. Data were analyzed by paired t test, one-way analysis of variance, and Pearson's correlation coefficient. RESULT In the SWG and SSG, although increases in nasopharyngeal airway dimensions were not significant compared with those in the CG, enlargements in the oropharyngeal airway dimensions at the level of the soft palate tip and behind the tongue, and decreases in soft palate angulation, were significant. Tongue height increased significantly only in the SWG. Compared with the CG, while forward movement of the hyoid was more prominent in SSG and SWG, the change in the vertical movement of the hyoid was not significant. No significant difference between SWG and SSG was observed in pharyngeal airway, soft palate, tongue or hyoid measurements. CONCLUSIONS The mode of mandibular advancement in FMA treatment did not significantly affect changes in the pharyngeal airway, soft palate, tongue, and hyoid bone.
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Kim KB. How has our interest in the airway changed over 100 years? Am J Orthod Dentofacial Orthop 2016; 148:740-7. [PMID: 26522033 DOI: 10.1016/j.ajodo.2015.08.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 08/01/2015] [Accepted: 08/01/2015] [Indexed: 12/01/2022]
Abstract
Since the beginning of our specialty, our understanding of the link between function and facial growth and development has progressively improved. Today, we know that children with sleep-related breathing problems will often develop distinctive facial characteristics. In adults, sleep apnea can result in serious morbidity and mortality. Orthodontists can ask sleep-related questions in the health history to help identify sleep breathing disorders. Treating these patients presents unique opportunities for orthodontists to collaborate with other medical specialties to improve a patient's health and treatment outcome. Research presented in our Journal in the next century may shed new light that will help us better identify the problem and aid the specialty in developing more effective evidence-based treatment. Additional efforts are needed to understand the physiology, neurology, and genetics of sleep breathing disorders.
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Affiliation(s)
- Ki Beom Kim
- Associate professor, Department of Orthodontics, Center for Advanced Dental Education, Saint Louis University, St Louis, Mo.
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Rizk S, Kulbersh VP, Al-Qawasmi R. Changes in the oropharyngeal airway of Class II patients treated with the mandibular anterior repositioning appliance. Angle Orthod 2015; 86:955-961. [PMID: 26649978 DOI: 10.2319/042915-295.1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the effects of functional appliance treatment on the oropharyngeal airway volume, airway dimensions, and anteroposterior hyoid bone position of growing Class II patients. MATERIALS AND METHODS Twenty Class II white patients (mean age, 11.7 ± 1.75 years) treated with the MARA followed by fixed appliances were matched to an untreated control sample by cervical vertebrae maturation stage at pretreatment (T1) and posttreatment (T2) time points. Cone beam computed tomography scans were taken at T1 and T2. Dolphin3D imaging software was used to determine oropharyngeal airway volume, dimensions, and anteroposterior hyoid bone position. RESULTS Multivariate ANOVA was used to evaluate changes between T1 and T2. Oropharyngeal airway volume, airway dimensions, and A-P position of the hyoid bone increased significantly with functional appliance treatment. SNA and ANB decreased significantly in the experimental group (P ≤ .05). Changes in SNB and Sn-GoGn failed to reach statistical significance. CONCLUSIONS Functional appliance therapy increases oropharyngeal airway volume, airway dimensions, and anteroposterior hyoid bone position in growing patients.
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Affiliation(s)
- Susan Rizk
- a Private Practice, Lathrup Village, Mich
| | | | - Riyad Al-Qawasmi
- c Associate Professor, Department of Orthodontics, University of Detroit Mercy, Detroit, Mich
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Jiang YY, Xu X, Su HL, Liu DX. Gender-related difference in the upper airway dimensions and hyoid bone position in Chinese Han children and adolescents aged 6-18 years using cone beam computed tomography. Acta Odontol Scand 2015; 73:391-400. [PMID: 25630980 DOI: 10.3109/00016357.2014.978366] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate the gender-related differences in upper airway dimensions and hyoid bone position in Chinese Han children and adolescents (6-18 years) using cone-beam computed tomography (CBCT). MATERIALS AND METHODS CBCT-scans of 119 boys and 135 girls were selected and divided into four groups (group 1: 6-9 years; group 2: 10-12 years; group 3: 13-15 years; group 4: 16-18 years). The airway dimensions including the cross-sectional area (CSA), anteroposterior (AP) and lateral (LAT) width, length (L), mean CSA and volume (VOL) of upper airway segmentations and hyoid bone position including 11 linear and three angular measurements were investigated using Materialism's interactive medical image control system (MIMICS) 16.01 software. Gender-related differences were analyzed by two independent sample t-tests. RESULTS No gender-related difference was found in values of the facial morphology, airway dimensions and hyoid bone position for group 1 (p > 0.05). The children and adolescents in groups 2, 3 and 4 showed significant gender-related differences in the measurement results of facial morphology, airway dimensions and hyoid bone positions (p < 0.05). What's more, the measurement values of boys were obviously larger than those of girls except some measurements in group 2. CONCLUSIONS The measurements of airway dimensions and hyoid bone positions have gender-related differences in children and adolescents aged 10-18 years. These results could be taken into consideration during orthodontic diagnosis and treatment.
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Affiliation(s)
- Ying-Ying Jiang
- Department of Orthodontics, Shangdong Provincial Key Laboratory of Oral Biomedicine, School of Dentistry, Shandong University , Jinan City , PR China
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Ghodke S, Utreja AK, Singh SP, Jena AK. Effects of twin-block appliance on the anatomy of pharyngeal airway passage (PAP) in class II malocclusion subjects. Prog Orthod 2014; 15:68. [PMID: 25534004 PMCID: PMC4274348 DOI: 10.1186/s40510-014-0068-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 12/01/2014] [Indexed: 12/24/2022] Open
Abstract
Background The use of functional appliances for the correction of retrognathic mandible is very common in orthodontics. Similar appliances known as oral appliances are also frequently used in adults for the treatment of mild to moderate obstructive sleep apnea (OSA). Many studies have reported improvement of pharyngeal airway passage (PAP) dimensions following functional appliance therapy in children and oral appliance therapy in adults. There is only one study in the literature that discussed the effect of oral appliance therapy on posterior pharyngeal wall thickness (PPWT) among subjects with OSA. The effect of functional appliance therapy on PPWT has never been investigated. Thus the present study was conducted to evaluate the effects of twin-block appliance on pharyngeal airway passage (PAP) dimensions and posterior pharyngeal wall thickness (PPWT) in class II malocclusion subjects with retrognathic mandibles. Methods Thirty-eight class II malocclusion subjects in the age range of 8 to 14 years with mandibular retrusion were divided into a treatment (n = 20) and control (n = 18) group. Mandibular retrusion in the treatment group subjects was corrected by twin-block appliance. The effect of twin-block appliance on PAP and PPWT dimensions were evaluated from lateral cephalograms recorded prior-to and after 6 months of appliance therapy in the treatment group subjects and the changes were compared with the changes in the control group subjects. Student’s t-test was used for statistical analysis; P-value of 0.05 was considered a statistically significant level. Results The depth of the oropharynx was increased significantly in the treatment group subjects (P < 0.001) as compared to the control group subjects (P < 0.05). The depth of the hypopharynx increased significantly in treatment group subjects (P < 0.01). The PPWT at the level of the nasopharynx, oropharynx, and hypopharynx were maintained in the treatment group subjects; whereas in control group subjects, the PPWT was further reduced although the changes were not statistically significant. Conclusions Correction of mandibular retrusion by twin-block appliance in class II malocclusion subjects increased the PAP dimensions and maintained the pre-treatment thickness of posterior pharyngeal wall.
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Affiliation(s)
| | | | | | - Ashok Kumar Jena
- Unit of Orthodontics, Department of Dental Surgery, All India Institute of Medical Sciences, Sijua, Dumduma, Bhubaneswar, India.
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Follow-up study of dental implants with bioactive oxide films on bone tissue healing and osseointegration: clinical radiography and bone quality analysis. IMPLANT DENT 2014; 23:659-64. [PMID: 25379663 DOI: 10.1097/id.0000000000000181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate osseointegration and bone stress resulted during the first 3 months after the installation of functional implants modified with bioactive oxide. METHODS Several studies have investigated finite element models for dental implants; however, only a few have examined a model for the implants during different stages of osseointegration. In this study, mandible models were reconstructed using computer tomographic data, and bone qualities and stress distributions were investigated as well. RESULTS Bone quality increased rapidly within the 3-month bone healing time. Data analysis indicated that the bone stresses increased with the progress of osseointegration, and the maximum stresses were obtained at the position around the first screw. CONCLUSION The results confirmed that functional films could improve the biomechanical properties of the implants and promote the initial bone stability. Furthermore, potential clinical benefit can be obtained due to the inducing superior biomechanical behavior in dental implants.
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Li L, Liu H, Cheng H, Han Y, Wang C, Chen Y, Song J, Liu D. CBCT evaluation of the upper airway morphological changes in growing patients of class II division 1 malocclusion with mandibular retrusion using twin block appliance: a comparative research. PLoS One 2014; 9:e94378. [PMID: 24705466 PMCID: PMC3976395 DOI: 10.1371/journal.pone.0094378] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 03/14/2014] [Indexed: 11/23/2022] Open
Abstract
Objective The purpose of this study was to evaluate the morphological changes of upper airway after Twin Block (TB) treatment in growing patients with Class II division 1 malocclusion and mandibular retrusion compared with untreated Class II patients by cone beam computed tomography (CBCT). Materials and Methods Thirty growing patients who have completed TB treatment were recruited into TB group. The control group (n = 30) was selected from the patients with the same diagnosis and without TB treatment. CBCT scans of the pre-treatment (T1) and post-treatment (T2) data of TB group and control data were collected. After three-dimensional (3D) reconstruction and registration of T1 and T2 data, the morphological changes of upper airway during TB treatment were measured. The statistical differences between T1 and T2 data of TB group as well as T2 and control data were accessed by t-test. Results During the TB treatment, the mandible moved advanced by 3.52±2.14 mm in the horizontal direction and 3.77±2.10 mm in the vertical direction. The hyoid bone was in a more forward and inferior place. The upper airway showed a significant enlargement in nasopharynx, oropharynx and hypopharynx. In addition, the nasopharynx turned more circular, and the oropharynx became more elliptic in transverse shape. However, the transverse shape of the hypopharynx showed no significant difference. After comparison between T2 and control data, only the horizontal movement of the hyoid bone, the volumetric expansion of the oropharynx and hypopharynx, and changes of the oropharyngeal transverse shape showed significant difference. Conclusion Compared to the untreated Class II patients, the upper airway of growing patients with Class II division 1 malocclusion and mandibular retrusion showed a significant enlargement in the oropharynx and hypopharynx as well as a more elliptic transverse shape in the oropharynx, and the hyoid bone moved to an anterior position after TB treatment.
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Affiliation(s)
- Liang Li
- Department of Orthodontics, Shandong Provincial Key Laboratory of Oral Biomedicine, School of Dentistry, Shandong University, Jinan, China
| | - Hong Liu
- Department of Orthodontics, School of Dentistry, Shandong University, Jinan, China
| | - Huijuan Cheng
- Department of Orthodontics, Shandong Provincial Key Laboratory of Oral Biomedicine, School of Dentistry, Shandong University, Jinan, China
| | - Yanzhao Han
- Department of Orthodontics, Shandong Provincial Key Laboratory of Oral Biomedicine, School of Dentistry, Shandong University, Jinan, China
| | - Chunling Wang
- Department of Orthodontics, Shandong Provincial Key Laboratory of Oral Biomedicine, School of Dentistry, Shandong University, Jinan, China
| | - Yu Chen
- Department of Orthodontics, Shandong Provincial Key Laboratory of Oral Biomedicine, School of Dentistry, Shandong University, Jinan, China
| | - Jinlin Song
- Department of Orthodontics, Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, the Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing, China
- * E-mail: (DL); (JS)
| | - Dongxu Liu
- Department of Orthodontics, Shandong Provincial Key Laboratory of Oral Biomedicine, School of Dentistry, Shandong University, Jinan, China
- * E-mail: (DL); (JS)
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Jena AK, Singh SP, Utreja AK. Effectiveness of twin-block and Mandibular Protraction Appliance-IV in the improvement of pharyngeal airway passage dimensions in Class II malocclusion subjects with a retrognathic mandible. Angle Orthod 2013; 83:728-34. [PMID: 23241007 PMCID: PMC8754040 DOI: 10.2319/083112-702.1] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Accepted: 11/01/2012] [Indexed: 10/02/2023] Open
Abstract
OBJECTIVE To test the hypothesis that twin-block and Mandibular Protraction Appliance-IV (MPA-IV) are not effective in improving the pharyngeal airway passage (PAP) dimensions among Class II malocclusion subjects with a retrognathic mandible. MATERIALS AND METHODS Eighty-three subjects ranging in age from 8 to 14 years were divided into four groups. Group I included 30 Class I malocclusion subjects (healthy controls); group II consisted of 16 Class II malocclusion subjects (Class II controls); group III had 16 subjects in whom Class II malocclusion was treated by MPA-IV; and the remaining 21 subjects formed group IV, whose Class II malocclusions were corrected by twin-block appliance. Lateral cephalograms recorded at the beginning of orthodontic treatment in group I subjects and at the beginning and end of follow-up/treatment with functional appliance in group II, III, and IV subjects were analyzed to determine the PAP dimensions. Paired t-test, one-way analysis of variance, and Tukey tests were applied for statistical analysis, and a P-value .05 was considered statistically significant. RESULTS Soft palate length was decreased significantly in group III (P < .05) and group IV (P < .001) subjects. Soft palate thickness in group IV subjects was increased significantly as compared to group II (P < .05) and group III (P < .01) subjects. The improvement in soft palate inclination in group III and group IV subjects was significant (P < .01). The oropharynx depth was increased significantly in group III (P < .05) and group IV (P < .001) subjects. The depth of the hypopharynx was increased significantly (P < .01) in group IV subjects. CONCLUSIONS The twin-block appliance was more efficient than the MPA-IV in the improvement of PAP dimensions among Class II malocclusion subjects with retrognathic mandible.
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Affiliation(s)
- Ashok Kumar Jena
- Unit of Orthodontics, Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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