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de Carvalho ARDRM, Pollmann MCF, Martins EJP. Upper airway dimensions and craniofacial morphology: A correlation study using cone beam computed tomography. Korean J Orthod 2024; 54:274-283. [PMID: 39128860 PMCID: PMC11422678 DOI: 10.4041/kjod23.206] [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: 10/17/2023] [Revised: 04/12/2024] [Accepted: 05/13/2024] [Indexed: 08/13/2024] Open
Abstract
Objective To determine the correlation between dentoskeletal parameters related to craniofacial morphology and the upper airway (UA) volume. Methods Cone-beam computed tomography images of 106 randomly selected orthodontic patients were analyzed using NemoFab Ortho software. The dentoskeletal variables assessed were anterior facial height (AFH), posterior facial height (PFH), PFH/AFH ratio, hyoid position, maxillary width (MW), and palatal depth. The UA volume (evaluation in anatomical regions and as a whole) was also assessed using the same software. We also evaluated potential differences in UA variables between age and sex groups. The correlation between the dentoskeletal parameters and UA volume was calculated using the Pearson correlation coefficient (R). Analysis of variance and Student's t test were performed to assess differences between age and sex for UA variables. Statistical analyses were performed using SPSS software (version 26 for Windows). Results This study found that PFH, AFH, and MW were the dentoskeletal parameters most strongly correlated with UA volume. However, the ANB angle did not show any significant correlation with UA volume. Additionally, differences in UA volumes were observed between age groups. Sex differences were found in both the "8-12" and "≥ 16" age groups for oropharyngeal and pharyngeal volumes. Conclusions In conclusion, our findings indicate a significant correlation between UA volume and dentoskeletal parameters, particularly those related to facial height and MW.
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Pop SI, Procopciuc A, Arsintescu B, Mițariu M, Mițariu L, Pop RV, Cerghizan D, Jánosi KM. Three-Dimensional Assessment of Upper Airway Volume and Morphology in Patients with Different Sagittal Skeletal Patterns. Diagnostics (Basel) 2024; 14:903. [PMID: 38732317 PMCID: PMC11083622 DOI: 10.3390/diagnostics14090903] [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: 03/24/2024] [Revised: 04/20/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND The relationship between respiratory function and craniofacial morphology has garnered significant attention due to its implications for upper airway and stomatognathic development. Nasal breathing plays a key role in craniofacial growth and dental positioning. This study investigated upper airway morphology and volume differences among individuals with class I, II, and III skeletal anomalies. METHODS Ninety orthodontic patients' CBCT scans were analyzed to assess the oropharynx and hypopharynx volumes. Skeletal diagnosis was established based on the cephalometric analysis. RESULTS A significant volume change in the oropharynx and pharynx was demonstrated when comparing class II with class III anomalies (p = 0.0414, p = 0.0313). The total volume of the pharynx was increased in class III anomalies. The area of the narrowest part of the pharynx (MIN-CSA) significantly decreased in classes I and II compared to class III (p = 0.0289, p = 0.0003). Patients with Angle class III anomalies exhibited higher values in the narrowest pharyngeal segment. Gender differences were significant in pharyngeal volumes and morphologies across malocclusion classes. CONCLUSIONS The narrowest segment of the pharynx had the highest values in patients with Angle class III. The volume of the oropharynx was found to be greater in patients with Angle class III versus patients with Angle class II.
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Affiliation(s)
- Silvia Izabella Pop
- Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 38 Gh. Marinescu Str., 540139 Târgu Mureș, Romania
| | - Ana Procopciuc
- Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 38 Gh. Marinescu Str., 540139 Târgu Mureș, Romania
| | - Bianca Arsintescu
- Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 38 Gh. Marinescu Str., 540139 Târgu Mureș, Romania
| | - Mihai Mițariu
- Faculty of Dental Medicine, Lucian Balga University, Bd-ul. Victoriei, 550024 Sibiu, Romania
| | - Loredana Mițariu
- Faculty of Dental Medicine, Lucian Balga University, Bd-ul. Victoriei, 550024 Sibiu, Romania
| | - Radu Vasile Pop
- Private Practice, Natural Smile Dental Clinic, 76 Gh Doja Str., 540232 Târgu Mureș, Romania
| | - Diana Cerghizan
- Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 38 Gh. Marinescu Str., 540139 Târgu Mureș, Romania
| | - Kinga Mária Jánosi
- Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 38 Gh. Marinescu Str., 540139 Târgu Mureș, Romania
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Benetti M, Montresor L, Cantarella D, Zerman N, Spinas E. Does Miniscrew-Assisted Rapid Palatal Expansion Influence Upper Airway in Adult Patients? A Scoping Review. Dent J (Basel) 2024; 12:60. [PMID: 38534284 DOI: 10.3390/dj12030060] [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: 12/19/2023] [Revised: 02/11/2024] [Accepted: 02/24/2024] [Indexed: 03/28/2024] Open
Abstract
(1) Objective: This scoping review evaluates the effects of miniscrew-assisted rapid palatal expansion (MARPE) on different regions of the upper airway in adult patients and investigates various methods of measurement. (2) Methods: The search encompassed Pubmed, Cochrane Library, Scopus and Web of Science. This review was conducted following the PRISMA_ScR guidelines, and the inclusion criteria for examined studies were chosen in accordance with the PICOS framework. (3) Results: Seven studies were included in this review, comprising four retrospective studies, one prospective and two case reports. All studies involved the use of Cone Beam Computed Tomography (CBCT) for measurements of the areas of interest. The percentage of increase in the volume of the nasal cavity varied between 31% and 9.9%, depending on the study. Volumetric variations in the nasopharynx were reported as increases between T0 (before expansion) and T1 (immediately after expansion) of 6.4%, 20.7% and 14.1%. All studies considered T0 before expansion and T1 immediately after expansion. Only one study evaluated remote follow-up to assess if the results were maintained after one year. (4) Conclusions: MARPE appears to lead to a statistically significant increase in the upper airway, especially in the nasal cavity and nasopharynx immediately after expansion. However, further prospective and retrospective trails with long-term controls are required to verify the effects of MARPE on the upper airway.
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Affiliation(s)
- Mariachiara Benetti
- Department of Surgical Science, Post Graduate School of Orthodontics, University of Cagliari, Via Ospedale, 01924 Cagliari, Italy
| | - Luca Montresor
- Department of Surgical Science, Post Graduate School of Orthodontics, University of Cagliari, Via Ospedale, 01924 Cagliari, Italy
| | - Daniele Cantarella
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Commenda 10, 20122 Milan, Italy
| | - Nicoletta Zerman
- Department of Pediatric Dentistry and Dental Hygiene, University of Verona, Via San Marco 121, 37138 Verona, Italy
| | - Enrico Spinas
- Department of Surgical Science, Post Graduate School of Orthodontics, University of Cagliari, Via Ospedale, 01924 Cagliari, Italy
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Sfondrini MF, Gallo S, Pascadopoli M, Gandini P, Roncoroni C, Scribante A. Upper Airway Dimensions among Different Skeletal Malocclusions: A Retrospective Observational Study by Cephalometric Analysis. Dent J (Basel) 2024; 12:12. [PMID: 38248220 PMCID: PMC10813941 DOI: 10.3390/dj12010012] [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: 09/17/2023] [Revised: 11/24/2023] [Accepted: 12/26/2023] [Indexed: 01/23/2024] Open
Abstract
The aim of the present work was to investigate the upper airway dimensions in adult non-orthodontic patients, equally divided according to their skeletal class. METHODS In this retrospective cross-sectional study, lateral cephalometric radiographs of adult patients referred for orthodontic consultation were collected. Cephalometric tracing was performed with dedicated software. For each measure, descriptive statistics were calculated. Cephalometric measurements between the different skeletal classes were compared. Linear regressions were performed between upper airway diameters and cephalometric measurements, sex and age. Significance was predetermined for p < 0.05. RESULTS Lateral cephalometric radiographs of 120 patients were reviewed. Nasopharynx length (NL) and depth (PD) measurements were significantly shorter in skeletal class III patients (p < 0.05). The superior pharyngeal airway space (SPAS) was found to be significantly shorter in class III patients as compared to class II patients (p < 0.05), and the mean airway space (MAS) of class I patients was found to be significantly shorter compared to class II patients (p < 0.05). Palate length (PL) values were found to be significantly longer in class I (p < 0.05). Linear regressions showed that the sella-nasion-A point angle (SNA) and Riedel's angle between point A, the nasion and point B (ANB) significantly influenced NL and PD (p < 0.05). CONCLUSIONS Class III patients show significantly shorter nasopharynx measurements; clinicians should consider that this sagittal discrepancy could be related to an altered anatomy of the upper respiratory tract.
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Affiliation(s)
- Maria Francesca Sfondrini
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Simone Gallo
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Maurizio Pascadopoli
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Paola Gandini
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Caterina Roncoroni
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Andrea Scribante
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
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Šidlauskienė M, Šidlauskas M, Šidlauskas A, Juzėnas S, Lopatienė K. Heritability of cephalometric variables of airway morphology in twins with completed active growth. BMC Oral Health 2023; 23:244. [PMID: 37106360 PMCID: PMC10134508 DOI: 10.1186/s12903-023-02919-x] [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: 12/16/2022] [Accepted: 03/28/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The interplay between genetic and environmental impacts on dental and facial morphology has been widely analyzed, but little is known about their relative contributions to airway morphology. The aim of this study was to evaluate the genetic and environmental influences on the cephalometric variables of airway morphology in a group of postpubertal twins with completed craniofacial growth. MATERIALS AND METHODS The materials comprised lateral head cephalograms of 94 pairs of twins (50 monozygotic, 44 dizygotic) with completed craniofacial growth. Zygosity was determined using 15 specific DNA markers. The computerized cephalometric analysis included 22 craniofacial, hyoideal, pharyngeal structural linear and angular variables. Genetic analysis and heritability estimation were performed using maximum likelihood genetic structural equation modeling (GSEM). Principal component analysis (PCA) was used to assess the correlations between cephalometric measurement variables. RESULTS Upper airway dimensions showed moderate to high genetic determination (SPPW-SPP and U-MPW: a2 = 0.64 and 0.5, respectively). Lower airway parameters showed only common and specific environmental determination (PPW-TPP a2 = 0.24, e2 = 0.38; LPW-V c2 = 0.2, e2 = 0.63; PCV-AH c2 = 0.47, e2 = 0.28). The relationship between the maxilla and the hyoid bone (for variables PNS-AH, ANS-AH d2 = 0.9, 0.92, respectively) showed very strong additive genetic determination. The size of the soft palate was affected by additive and dominant genes. Its length (SPL) was strongly influenced by dominant genes, while its width (SPW) showed a moderate additive genetic influence. Owing to correlations in the behavior of variables, the data could be expressed in 5 principal components that jointly explained 36.8% of the total variance. CONCLUSIONS The dimensions of the upper airway are strongly determined by genes, while the parameters of the lower airway depend mainly on environmental factors. TRIAL REGISTRATION The protocol has been approved by the Kaunas Regional Ethical Committee (No. BE - 2-41., May 13, 2020).
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Affiliation(s)
- Monika Šidlauskienė
- Department of Orthodontics, Faculty of Medicine, Lithuanian University of Health Sciences, Eivenių 2, Kaunas, LT-50161, Lithuania.
- Clinic of Orthodontics, Medical Academy, Lithuanian University of Health Sciences, J. Lukšos-Daumanto str. 6, Kaunas, LT-50106, Lithuania.
| | - Mantas Šidlauskas
- Department of Orthodontics, Faculty of Medicine, Lithuanian University of Health Sciences, Eivenių 2, Kaunas, LT-50161, Lithuania
| | - Antanas Šidlauskas
- Department of Orthodontics, Faculty of Medicine, Lithuanian University of Health Sciences, Eivenių 2, Kaunas, LT-50161, Lithuania
| | - Simonas Juzėnas
- Institute of Digestive Research, Faculty of Medicine, Lithuanian University of Health Sciences, Eivenių 2, Kaunas, LT-50161, Lithuania
| | - Kristina Lopatienė
- Department of Orthodontics, Faculty of Medicine, Lithuanian University of Health Sciences, Eivenių 2, Kaunas, LT-50161, Lithuania
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Florez BM, Tagawa DT, Inoue DP, Yamashita HK, Aidar LADA, Dominguez GC. Associations between skeletal discrepancies, breathing pattern, and upper airway obstruction in Class III malocclusions. Int J Pediatr Otorhinolaryngol 2023; 166:111471. [PMID: 36764078 DOI: 10.1016/j.ijporl.2023.111471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 01/25/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To verify the associations between sagittal and vertical skeletal discrepancies, changes in upper airways, and breathing pattern in children and adolescents with Angle Class III and Class III subdivision malocclusions. METHODS Eighty-five children and adolescents with a mean age of 9.5 ± 1.74 years were selected. Cephalometry assessed the sagittal relationship (AO-BO measurement), facial types (Ricketts VERT index), nasopharynx, and oropharynx. An otorhinolaryngologist analyzed the breathing pattern and upper airway obstruction during anamnesis, physical examination, anterior rhinoscopy, and nasofibroscopy. Medical records were also reviewed. For statistical analysis, ordinary one-way ANOVA, Kruskal-Wallis (Tukey's post-hoc), unpaired t-test, Pearson's correlation, chi-square, and Fisher's exact tests (p < 0.05) were used. RESULTS The nasopharyngeal cephalometric dimension and pharyngeal tonsil hypertrophy were associated, whereas the oropharyngeal cephalometric dimension and palatine tonsils hypertrophy were not. Sagittal discrepancies were associated with septum deviation, while facial type was associated with inferior turbinate and palatine tonsils hypertrophy. However, facial type was not associated with breathing pattern, septum deviation, and pharyngeal tonsils hypertrophy. CONCLUSIONS Sagittal discrepancies and type of malocclusion were not associated with breathing pattern and changes in upper airways, except for the severity of septum deviation and Class III malocclusions, which were associated with large sagittal discrepancies. Although the facial types analyzed presented signs of airway obstruction, the highest prevalence of inferior turbinate and palatine tonsils hypertrophy were found in patients with dolichofacial type.
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Affiliation(s)
- Bruna Maluza Florez
- Department of Diagnostic Imaging, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil; Department of Orthodontics, Universidade Santa Cecília, Santos, SP, Brazil.
| | | | - Daniel Paganini Inoue
- Department of Otorhinolaryngology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | - Helio Kiitiro Yamashita
- Department of Diagnostic Imaging, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | | | - Gladys Cristina Dominguez
- Department of Orthodontics, School of Dentistry, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
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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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CATTANEO PM, CORNELIS MA. Digital workflows in Orthodontic postgraduate training. Semin Orthod 2022. [DOI: 10.1053/j.sodo.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Artificial Intelligence as an Aid in CBCT Airway Analysis: A Systematic Review. LIFE (BASEL, SWITZERLAND) 2022; 12:life12111894. [PMID: 36431029 PMCID: PMC9696726 DOI: 10.3390/life12111894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND The use of artificial intelligence (AI) in health sciences is becoming increasingly popular among doctors nowadays. This study evaluated the literature regarding the use of AI for CBCT airway analysis. To our knowledge, this is the first systematic review that examines the performance of artificial intelligence in CBCT airway analysis. METHODS Electronic databases and the reference lists of the relevant research papers were searched for published and unpublished literature. Study selection, data extraction, and risk of bias evaluation were all carried out independently and twice. Finally, five articles were chosen. RESULTS The results suggested a high correlation between the automatic and manual airway measurements indicating that the airway measurements may be automatically and accurately calculated from CBCT images. CONCLUSIONS According to the present literature, automatic airway segmentation can be used for clinical purposes. The main key findings of this systematic review are that the automatic airway segmentation is accurate in the measurement of the airway and, at the same time, appears to be fast and easy to use. However, the present literature is really limited, and more studies in the future providing high-quality evidence are needed.
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Balasubramanian S, Kalaskar R, Kalaskar A. Rapid Maxillary Expansion and Upper Airway Volume: Systematic Review and Meta-analysis on the Role of Rapid Maxillary Expansion in Mouth Breathing. Int J Clin Pediatr Dent 2022; 15:617-630. [PMID: 36865716 PMCID: PMC9973120 DOI: 10.5005/jp-journals-10005-2421] [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] [Indexed: 02/05/2023] Open
Abstract
Objective Rapid maxillary expansion (RME) has been extensively used in orthodontic practice for over a century, and it is claimed to benefit upper airway morphology. However, its effect in actually alleviating mouth breathing has remained unexplored. This systematic review was planned with an objective to provide a comprehensive synthesis of the effects of RME on upper airway volume and most importantly, its role in alleviating mouth breathing. Methods A literature search of electronic databases were done for the time period of 2000-2018. Randomized controlled trials (RCTs) and non-RCTs conducted on 8-15-year-old children who received bonded or banded RME and upper airway measured using three-dimensional (3D) imaging were included. Results Twelve studies (two RCTs, nine nonrandomized clinical trials, and one non-RCT) were included in this systematic review, and nine studies were included for meta-analysis. Among the evaluated parameters, nasal cavity volume showed a significant increase which was maintained even after the retention phase, whereas nasopharyngeal and oropharyngeal volume did not report a significant change. Conclusion Based on this systematic review, it can be concluded that RME causes a significant increase in nasal cavity volume, but its effect on nasopharyngeal and oropharyngeal volume is not statistically significant in majority of studies. This increase in volume may not be considered as an equivalent for enhancement of airway and function unless proven so. In order to establish its significance in the improvement of breathing, it is necessary to conduct more well-designed RCTs with samples actually comprising mouth breathers. How to cite this article Balasubramanian S, Kalaskar R, Kalaskar A. Rapid Maxillary Expansion and Upper Airway Volume: Systematic Review and Meta-analysis on the Role of Rapid Maxillary Expansion in Mouth Breathing. Int J Clin Pediatr Dent 2022;15(5):617-630.
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Affiliation(s)
- Shruti Balasubramanian
- Department of Pediatric & Preventive Dentistry, Government Dental College & Hospital, Nagpur, Maharashtra, India
| | - Ritesh Kalaskar
- Department of Pediatric & Preventive Dentistry, Government Dental College & Hospital, Nagpur, Maharashtra, India
| | - Ashita Kalaskar
- Department of Oral Medicine and Radiology, Government Dental College & Hospital, Nagpur, Maharashtra, India
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Mohamed AS, Habumugisha J, Cheng B, Zhao M, Guo Y, Zou R, Wang F. Three-dimensional evaluation of hyoid bone position in nasal and mouth breathing subjects with skeletal Class I, and Class II. BMC Oral Health 2022; 22:228. [PMID: 35681197 PMCID: PMC9185978 DOI: 10.1186/s12903-022-02257-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This retrospective study investigated the effect of breathing pattern, skeletal class (Class I, Class II), and age on the hyoid bone position (HBP) in normodivergent subjects. METHODS A total of 126 subjects (61 males, 65 females) aged 7-9 years and 10-12 years were scanned using cone-beam computed tomography (CBCT). All participants were classified according to the anteroposterior skeletal pattern into (Class I, Class II). Each skeletal group was further divided according to the breathing mode into mouth breathers (MB) and nasal breathers (NB). The HBP was measured accordingly. Independent sample t-test and Mann Whitney U test were used to detect significant differences between the groups, and binary logistic regression was used to identify MB predictive indicators. RESULTS The breathing mode and skeletal class affected the vertical HBP in subjects with 7-9 years, while they affected the anteroposterior HBP in subjects with 10-12 years. Regarding the age effect, hyoid bone was located more anteriorly in the older NB subjects, and hyoid bone was more inferiorly in the older age group. A regression equation of the significant variables was formulated, C3-Me (P: 001, OR: 2.27), and H-EB (P: 0.046, OR: 1.16) were positively correlated with occurrence of MB. CONCLUSION There were significantly different HBPs among subjects with different anteroposterior skeletal classes, breathing modes, and age cohorts. Moreover, C3-Me, and H-EB were significant predictors and correlated with increased likelihood of being MB subject.
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Affiliation(s)
- Amin S Mohamed
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, People's Republic of China.,Department of Orthodontics, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Janvier Habumugisha
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, People's Republic of China.,Department of Orthodontics, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Bo Cheng
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, People's Republic of China.,Department of Orthodontics, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Minyue Zhao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, People's Republic of China.,Department of Orthodontics, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Yucheng Guo
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, People's Republic of China.,Department of Orthodontics, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Rui Zou
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, People's Republic of China. .,Department of Orthodontics, Xi'an Jiaotong University, Xi'an, People's Republic of China.
| | - Fei Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, People's Republic of China. .,Department of Orthodontics, Xi'an Jiaotong University, Xi'an, People's Republic of China.
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Alagoz E, Unver T, Seker ED, Kurt G, Senturk E, Ozdem A, Dolanmaz D. EVALUATING CHANGES IN NASAL AIRWAY VOLUME AND NASAL AIRFLOW AFTER SURGICALLY ASSISTED RAPID MAXILLARY EXPANSION. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:533-542. [DOI: 10.1016/j.oooo.2022.04.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/10/2022] [Accepted: 04/23/2022] [Indexed: 11/28/2022]
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13
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Niu X, Moland J, Pedersen TK, Bilgrau AE, Cattaneo PM, Glerup M, Stoustrup P. Restricted upper airway dimensions in patients with dentofacial deformity from juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2022; 20:32. [PMID: 35477405 PMCID: PMC9044879 DOI: 10.1186/s12969-022-00691-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/09/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This retrospective, cross-sectional study aimed to assess the pharyngeal airway dimensions of patients with juvenile idiopathic arthritis (JIA) and moderate/severe JIA-related dentofacial deformity (mandibular retrognathia/micrognathia), and compare the results with JIA patients with a normal mandibular appearance and a group of non-JIA patients. METHODS Seventy-eight patients were retrospectively included in a 1:1:1 manner as specified below. All patients had previously been treated at the Section of Orthodontics, Aarhus University, Denmark. All had a pretreatment cone beam computed tomography (CBCT). Group 1 (JIA+); 26 JIA patients with severe arthritis-related dentofacial deformity and mandibular retrognathia/micrognathia. Group 2 (JIA-); 26 JIA patients with normal mandibular morphology/position. Group 3 (Controls); 26 non-JIA subjects. Dentofacial morphology and upper airway dimensions, excluding the nasal cavity, were assessed in a validated three-dimensional (3D) fashion. Assessment of dentofacial deformity comprised six morphometric measures. Assessment of airway dimensions comprised nine measures. RESULTS Five morphometric measures of dentofacial deformity were significantly deviating in the JIA+ group compared with the JIA- and control groups: Posterior mandibular height, anterior facial height, mandibular inclination, mandibular occlusal inclination, and mandibular sagittal position. Five of the airway measurements showed significant inter-group differences: JIA+ had a significantly smaller nasopharyngeal airway dimension (ad2-PNS), a smaller velopharyngeal volume, a smaller minimal cross-sectional area and a smaller minimal hydraulic diameter than JIA- and controls. No significant differences in upper airway dimensions were seen between JIA- and controls. CONCLUSION JIA patients with severe arthritis-related dentofacial deformity and mandibular micrognathia had significantly restricted upper airway dimensions compared with JIA patients without dentofacial deformity and controls. The restrictions of upper airway dimension seen in the JIA+ group herein were previously associated with sleep-disordered breathing in the non-JIA background population. Further studies are needed to elucidate the role of dentofacial deformity and restricted airways in the development of sleep-disordered breathing in JIA.
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Affiliation(s)
- Xiaowen Niu
- grid.7048.b0000 0001 1956 2722Section of Orthodontics, Aarhus University, Aarhus, Denmark
| | - Julianne Moland
- grid.7048.b0000 0001 1956 2722Section of Orthodontics, Aarhus University, Aarhus, Denmark
| | - Thomas Klit Pedersen
- grid.7048.b0000 0001 1956 2722Section of Orthodontics, Aarhus University, Aarhus, Denmark ,grid.154185.c0000 0004 0512 597XDepartment of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Anders Ellern Bilgrau
- grid.5117.20000 0001 0742 471XDepartment of Mathematical Sciences, Aalborg University, Aalborg, Denmark
| | - Paolo M. Cattaneo
- grid.7048.b0000 0001 1956 2722Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia, Formerly, Section of Orthodontics, Aarhus University, Denmark, Aarhus, Denmark
| | - Mia Glerup
- grid.154185.c0000 0004 0512 597XDepartment of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Peter Stoustrup
- Section of Orthodontics, Aarhus University, Aarhus, Denmark.
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Shams N, Razavi M, Zabihzadeh M, Shokuhifar M, Rakhshan V. Associations between the severity of nasal septal deviation and nasopharynx volume in different ages and sexes: a cone-beam computed tomography study. Maxillofac Plast Reconstr Surg 2022; 44:13. [PMID: 35362901 PMCID: PMC8975893 DOI: 10.1186/s40902-022-00343-9] [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: 02/11/2022] [Accepted: 03/16/2022] [Indexed: 11/22/2022] Open
Abstract
Background Nasal septum deviation (NSD) can cause serious anatomical and clinical complications. It can change the breathing pattern and thus alter the anatomy of the airway structures. Despite its importance, the association between NSD with the nasopharynx volume (NPV) has not been assessed before. Therefore, we aimed to investigate it for the first time. Methods Archival CBCTs of 202 patients older than 17 years and without any history of trauma or pathology of the nasopharynx and without any orthodontic/orthognathic treatments were evaluated (129 women, 73 men, mean age: 36.24 ± 14.61 years). All included CBCTs must have been taken with a 12 × 8 field of view and fully covered the nasopharynx areas. The extent of NSD (°) and NPV (mm3) were measured. NSDs were categorized as mild (NSD ˂ 9°), moderate (9 ≤ NSD ≤ 15°), and severe (NSD ˃ 15°). Associations between sex, age, NSD, and nasopharynx volume were assessed using independent-samples t test, chi-square, one-way ANOVA, Tamhane post hoc test, Pearson and point-biserial correlation coefficients, and multiple linear regressions (α = 0.05). Results Mean NSDs were 11.27 ± 4.69° (range 1–19.5), 11.58 ± 4.63°, and 10.70 ± 4.76° in the sample, females, and males, respectively (P > 0.05). Of females, 27.9%, 40.3%, and 31.8% had mild, moderate, and severe NSDs. These were 35.6%, 39.7%, and 24.7% in males (P > 0.05). Mean NPVs were 4.88 ± 1.49, 4.80 ± 1.43, and 5.04 ± 1.60 mm3 in the sample, females, and males, respectively (P > 0.05). Mean NPVs were 6.41 ± 1.21, 4.87 ± 0.73, and 3.30 ± 0.65 mm3 in mild, moderate, and severe NSD groups (all P values = 0.000). Mean ages were 27.06 ± 6.49, 29.80 ± 9.64, and 54.73 ± 8.45 years in mild, moderate, and severe NSD groups (severe group being older than the other two groups, P = 0.000). NSD was strongly, negatively correlated with NPV (R = − 0.793, P = 0.000). Sex was not correlated with NPV or NSD (P ≥ 0.189). Age was negatively and positively correlated with NPV and NSD, respectively (P = 0.000). Modeling NSD (β = −0.776, P = 0.000) as a predictor for NPV rendered age effect insignificant (P > 0.05). Conclusions It was found, for the first time, that the more deviated the nasal septum, the smaller the nasopharynx volume. Aging might increase NSD and through it, reduce the nasopharynx volume. Sex might not affect NSD or NPV.
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Affiliation(s)
- Nasim Shams
- Department of Oral and Maxillofacial Radiology, Dental School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahshid Razavi
- Department of Oral and Maxillofacial Radiology, Dental School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mansour Zabihzadeh
- Department of Medical Physics, Medicine School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammadreza Shokuhifar
- Department of Oral and Maxillofacial Radiology, Dental School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Vahid Rakhshan
- Department of Anatomy, School of Dentistry, Azad University of Medical Sciences, Tehran, Iran
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Ferlias N, Gjørup H, Doherty MA, Haagerup A, Pedersen TK. Obstructive Sleep Apnoea in pycnodysostosis; a three-dimensional upper airway analysis. Orthod Craniofac Res 2021; 25:494-501. [PMID: 34963019 DOI: 10.1111/ocr.12561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/04/2021] [Accepted: 12/20/2021] [Indexed: 11/30/2022]
Abstract
AIM To assess the upper airway (UA) morphology in patients with pycnodysostosis with a 3D analysis, compare results with normative data and investigate correlation of the total volume (TV) to other UA morphology variables. MATERIALS AND METHODS Cone beam computed tomography (CBCT) images of eight Danish patients with pycnodysostosis (4 males, 4 females with a mean age of 31.8 years, SD:16.3 years), were analysed using Mimics® (Materialise®, Belgium) and compared with a sex- and age-matched control group (6 males, 8 females with a mean age of 33.6 years, SD:18.6 years). RESULTS The distance from the tip of the epiglottis (E) to the Frankfurt horizontal plane (Fp) was significantly shorter in the pycnodysostosis group (p < 0.042). Regarding the cross-sectional measurements, at the "maximum constriction" (p < 0.005), the "upper airway limit" (p < 0.001) and the "lower airway limit" (p < 0.035) cross-sections were significantly smaller in the pycnodysostosis group. The volumes "nasopharynx" (p < 0.002) and "total airway" (TV) (p < 0.01) were also significantly smaller. CONCLUSION Patients with pycnodysostosis have a reduced total airway as well as nasopharyngeal volume compared with matched controls. Additionally, they have a reduced cross-sectional area in the upper and lower borders of the UA, and the area of maximum constriction is also reduced. These factors might explain the high prevalence of obstructive sleep apnoea in pycnodysostosis. TV is positively correlated to total length and cross-sections at all levels including the maximum constriction area as well as the anteroposterior dimension at the upper and lower airway borders.
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Affiliation(s)
- Nikolaos Ferlias
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Denmark
| | - Hans Gjørup
- Department of Oral and Maxillofacial Surgery, Center for, Oral Health in Rare Diseases, Aarhus University Hospital, Aarhus, Denmark
| | | | - Annette Haagerup
- NIDO Denmark, Hospital Unit West and Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Thomas Klit Pedersen
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Denmark.,Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
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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] [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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Chen W, Mou H, Qian Y, Qian L. Evaluation of the position and morphology of tongue and hyoid bone in skeletal Class II malocclusion based on cone beam computed tomography. BMC Oral Health 2021; 21:475. [PMID: 34579690 PMCID: PMC8474784 DOI: 10.1186/s12903-021-01839-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 09/20/2021] [Indexed: 11/10/2022] Open
Abstract
Background The aim of the study was to analyze the morphology and position of the tongue and hyoid bone in skeletal Class II patients with different vertical growth patterns by cone beam computed tomography in comparison to skeletal Class I patients. Methods Ninety subjects with malocclusion were divided into skeletal Class II and Class I groups by ANB angles. Based on different vertical growth patterns, subjects in each group were divided into 3 subgroups: high-angle group (MP-FH ≥ 32.0°), average-angle group (22.0° ≤ MP-FH < 32°) and low-angle group (MP-FH < 22°). The position and morphology of the tongue and hyoid bone were evaluated in the cone beam computed tomography images. The independent Student’s t‐test was used to compare the position and morphology of the tongue and hyoid bone between skeletal Class I and Class II groups. One-way analysis of variance (ANOVA) was used to compare the measurement indexes of different vertical facial patterns in each group. Results Patients in skeletal Class II group had lower tongue posture, and the tongue body was smaller than that of those in the Class I group (P < 0.05). The position of the hyoid bone was lower in the skeletal Class II group than in Class I group (P < 0.05). The tongue length and H-Me in the skeletal Class I group with a low angle were significantly larger than those with an average angle and high angle (P < 0.05). There was no significant difference in the position or morphology of the tongue and hyoid bone in the skeletal Class II group with different vertical facial patterns (P > 0.05). Conclusion Patients with skeletal Class II malocclusion have lower tongue posture, a smaller tongue body, and greater occurrence of posterior inferior hyoid bone position than skeletal Class I patients. The length of the mandibular body in skeletal Class I patients with a horizontal growth type is longer. The position and morphology of the tongue and hyoid bone were not greatly affected by vertical facial development in skeletal Class II patients.
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Affiliation(s)
- Wener Chen
- Department of Orthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medical, Shanghai, 200011, China
| | - HungEn Mou
- Department of Orthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medical, Shanghai, 200011, China
| | - Yufen Qian
- Department of Orthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medical, Shanghai, 200011, China
| | - Liwen Qian
- Department of Orthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medical, Shanghai, 200011, China.
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18
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Hasanin M, ElNaghy R, Olson D, Al-Jewair T. Three-dimensional analysis of upper airway and craniofacial morphology in orthodontic adolescents with Attention Deficit Hyperactivity Disorder (ADHD): A comparative retrospective study. Int Orthod 2021; 19:622-632. [PMID: 34507915 DOI: 10.1016/j.ortho.2021.08.005] [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: 05/24/2021] [Revised: 08/23/2021] [Accepted: 08/23/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The aim of this study is to evaluate craniofacial characteristics and upper airway morphology in adolescents with Attention Deficit Disorder with Hyperactivity (ADHD) compared to controls (CON). MATERIALS AND METHODS Records from July 2014 to May 2018 of patients who were seeking orthodontic treatment at a single institute and had full pre-treatment orthodontic records including cone-beam computed tomography (CBCT) were reviewed. Comprehensive cephalometric variables were measured to determine craniofacial morphology. Upper airway volume (UAV), minimum cross-sectional area (MCA), and linear measurements were calculated at multiple planes. RESULTS A total of 87 adolescents (ADHD, 29; CON, 58) were included in the study. Overall, UAV and MCA in ADHA group were smaller than CON. Statistical significance was evident in airway widths at planes A (P=0.002), C (P=0.042), and D (P<0.001), and airway area at plane D (lower hypopharynx) (P<0.001), with the ADHD group showing narrower widths and area compared to CON. The most common skeletal classification in the ADHD group was sequenced as Class II, Class I then Class III, with percentages of (58.6%), (31%) and (10.3%), respectively. No significant differences were found between the groups for any of the skeletal, dental, and soft tissue cephalometric variables. CONCLUSIONS ADHD affected adolescents have similar craniofacial characteristics, but narrower upper airway dimensions compared to controls. Further investigations with larger samples are warranted to further elucidate the relationship between SDB and ADHD.
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Affiliation(s)
- Majd Hasanin
- Department of Graduate Orthodontics, School of Dentistry, University of Detroit Mercy, Detroit, Michigan, USA
| | - Rahma ElNaghy
- Department of Graduate Orthodontics, School of Dentistry, University of Detroit Mercy, Detroit, Michigan, USA; Nahda University in Beni-Suef (NUB), Beni-Suef City, Egypt.
| | - Douglas Olson
- CHOC Children's Cleft and Craniofacial Center, Orange County, California, USA
| | - Thikriat Al-Jewair
- Department of Orthodontics, School of Dental Medicine, University at Buffalo, New York, USA
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Orabi N, Flores-Mir C, Elshebiny T, Elkordy S, Palomo JM. Pharyngeal airway dimensional changes after orthodontic treatment with premolar extractions: A systematic review with meta-analysis. Am J Orthod Dentofacial Orthop 2021; 160:503-515.e3. [PMID: 34479766 DOI: 10.1016/j.ajodo.2021.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The objective of this research was to evaluate the effect of orthodontic extraction on the pharyngeal airway volume and Minimum cross-sectional area (MCA) in growing and adult patients. METHODS Seven databases, unpublished gray literature, and the references list of the identified articles were electronically searched for relevant studies that met our eligibility criteria. Included studies assessed the effect of dental extraction or sagittal dental movements on pharyngeal airway dimensions. The quality of the included studies was assessed using the methodological index for nonrandomized studies. In addition, a meta-analysis was conducted using the RevMan 5 (Nordic Cochrane Centre, Cochrane Collaboration, Copenhagen, Denmark). RESULTS In 7 studies, 268 treated patients with a mean age of 19.1 ± 7.6 years and 342 nonextraction control group subjects with a mean age of 19.3 ± 7.2 years were included. Compared with the control group, no statistically significant difference was found in total, nasopharyngeal, glossopharyngeal, oropharyngeal volume, or MCA (P >0.05) in the extraction group except in oropharyngeal volume in which a statistically significant increase in the volume 0.41 cm3 (95% CI, 0.05-0.80; P = 0.03) was detected. The clinical significance of this increase is questionable. Included studies showed a moderate to high risk of bias. CONCLUSIONS There is no strong evidence to support the concept that premolar extractions in bimaxillary protrusion or crowded growing and adult patients reduce either pharyngeal airway volume or MCA. Moreover, as the level of evidence was considered very low for all variables, the magnitude, and direction of the summaries have to be interpreted with caution. Future studies with better quality could significantly affect the direction and strength of the results. TRIAL REGISTRATION NUMBER PROSPERO CRD42018089924.
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Affiliation(s)
- Noha Orabi
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio; School of Dental Medicine, Cairo University, Cairo, Egypt; Department of Orthodontics, School of Dentistry, Cairo University, Cairo, Egypt; Private Practice at Wenger Orthodontics, Mayfield Heights, Ohio.
| | - Carlos Flores-Mir
- Department of Orthodontics, Faculty of Medicine and Dentistry, Univesity of Alberta, Edmonton, Alberta, Canada
| | - Tarek Elshebiny
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Sherif Elkordy
- Department of Orthodontics, School of Dentistry, Cairo University, Cairo, Egypt
| | - Juan Martin Palomo
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio
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Niu X, Motro M, Will LA, Cornelis MA, Cattaneo PM. Does rapid maxillary expansion enlarge the nasal cavity and pharyngeal airway? A three-dimensional assessment based on validated analyses. Orthod Craniofac Res 2021; 24 Suppl 2:124-133. [PMID: 34352162 DOI: 10.1111/ocr.12526] [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: 03/31/2021] [Accepted: 07/14/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To evaluate the three-dimensional changes following rapid maxillary expansion (RME) of the nasal cavity (NC) and pharyngeal airway (PA) in growing patients, using innovative and validated evaluation methods and to investigate whether a correlation between skeletal expansion and increase in airway volume exists. SETTINGS AND SAMPLE POPULATION Records of patients who had cone beam computed tomography taken before and after orthodontic treatment with or without RME were retrospectively collected and divided into two groups: (a) RME, 39 patients (mean age 10.40 ± 1.74 years); and (b) control, 29 patients, matched for age (mean age 11.07 ± 1.45 years) and follow-up period. MATERIAL AND METHODS Total and partial volumes of the NC and the PA were calculated. The PA centerline was determined to assess the minimal cross-sectional area and hydraulic diameter. Paired and unpaired t test were applied to compare the difference between time points and between groups. One-way ANOVA and post hoc Tukey's tests were used to compare subgroups with respect to changes in palatal width and lacrimal ducts distance. RESULTS All of the NC, PA and skeletal parameters were significantly enlarged after RME. The NC volume and inter-molar distance in the RME were significantly larger compared to the control group. The initially lower mean values of minimal cross-sectional area and hydraulic diameter in the RME group when compared to the control group normalized after RME treatment. CONCLUSIONS Based on validated analyses, the NC volume increase was evident after RME in the long term after controlling for growth.
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Affiliation(s)
- Xiaowen Niu
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Melih Motro
- Department of Orthodontics and Dentofacial Orthopedics, Boston University, Boston, MA, USA
| | - Leslie A Will
- Department of Orthodontics and Dentofacial Orthopedics, Boston University, Boston, MA, USA
| | - Marie A Cornelis
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Carlton, Vic., Australia
| | - Paolo M Cattaneo
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Carlton, Vic., Australia
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The Airway Volume Related to the Maxillo-Mandibular Position Using 3D Analysis. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6670191. [PMID: 34239931 PMCID: PMC8241511 DOI: 10.1155/2021/6670191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 05/15/2021] [Accepted: 06/11/2021] [Indexed: 11/18/2022]
Abstract
Objective The aim of this research was to compare three cephalometric analyses and their correlation with the airway volume in subjects with different skeletal classes using 2D and 3D images. Study Design. Cross-sectional descriptive study. Material and Method. Steiner, McNamara, and Ricketts analyses and the airway volume were compared in 115 subjects who were candidates for orthognathic surgery under diagnosis using cone beam computed tomography (CBCT); 46 males (40%) and 69 females (60%) were included. The sagittal positions of the maxilla and mandible, the angulation of the mandibular plane, the sagittal positions of the upper and lower incisors, measurements of the largest or shortest airway area, and the volume were compared using Spearman's test considering a p value < 0.05. Results Differences were observed between the Steiner and McNamara techniques for the sagittal position of the maxilla (p = 0.01). For mandibular angulation, there was a greater difference between values for Steiner and Ricketts techniques (p = 0.001). In the upper incisor, the results for McNamara and Ricketts techniques were significantly different (p = 0.004). Analysing the airway, subjects with a class II skeletal pattern had a smaller volume than those with a class III pattern (p = 0.034). Conclusion It may be concluded that skeletal class II patients have a significantly smaller airway volume than class III patients. The skeletal parameter does not always relate to the airway volume; however, the high mandibular angle could be related to the airway conditions.
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22
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Shujaat S, Jazil O, Willems H, Van Gerven A, Shaheen E, Politis C, Jacobs R. Automatic segmentation of the pharyngeal airway space with convolutional neural network. J Dent 2021; 111:103705. [PMID: 34077802 DOI: 10.1016/j.jdent.2021.103705] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/30/2021] [Accepted: 05/24/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES This study proposed and investigated the performance of a deep learning based three-dimensional (3D) convolutional neural network (CNN) model for automatic segmentation of the pharyngeal airway space (PAS). METHODS A dataset of 103 computed tomography (CT) and cone-beam CT (CBCT) scans was acquired from an orthognathic surgery patients database. The acquisition devices consisted of 1 CT (128-slice multi-slice spiral CT, Siemens Somatom Definition Flash, Siemens AG, Erlangen, Germany) and 2 CBCT devices (Promax 3D Max, Planmeca, Helsinki, Finland and Newtom VGi evo, Cefla, Imola, Italy) with different scanning parameters. A 3D CNN-based model (3D U-Net) was built for automatic segmentation of the PAS. The complete CT/CBCT dataset was split into three sets, training set (n = 48) for training the model based on the ground-truth observer-based manual segmentation, test set (n = 25) for getting the final performance of the model and validation set (n = 30) for evaluating the model's performance versus observer-based segmentation. RESULTS The CNN model was able to identify the segmented region with optimal precision (0.97±0.01) and recall (0.96±0.03). The maximal difference between the automatic segmentation and ground truth based on 95% hausdorff distance score was 0.98±0.74mm. The dice score of 0.97±0.02 confirmed the high similarity of the segmented region to the ground truth. The Intersection over union (IoU) metric was also found to be high (0.93±0.03). Based on the acquisition devices, Newtom VGi evo CBCT showed improved performance compared to the Promax 3D Max and CT device. CONCLUSION The proposed 3D U-Net model offered an accurate and time-efficient method for the segmentation of PAS from CT/CBCT images. CLINICAL SIGNIFICANCE The proposed method can allow clinicians to accurately and efficiently diagnose, plan treatment and follow-up patients with dento-skeletal deformities and obstructive sleep apnea which might influence the upper airway space, thereby further improving patient care.
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Affiliation(s)
- Sohaib Shujaat
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, Leuven, Belgium.
| | - Omid Jazil
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, Leuven, Belgium
| | | | | | - Eman Shaheen
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, Leuven, Belgium
| | - Constantinus Politis
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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Niu X, Madhan S, Cornelis MA, Cattaneo PM. Novel three-dimensional methods to analyze the morphology of the nasal cavity and pharyngeal airway. Angle Orthod 2021; 91:320-328. [PMID: 33523094 DOI: 10.2319/070620-610.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 11/01/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES To assess the intraexaminer and interexaminer reliabilities of novel semiautomatic methods to segment the nasal cavity (NC) and pharyngeal airway (PA) and to determine the minimal cross-sectional area (CS) and hydraulic diameter (HD) of the PA. MATERIALS AND METHODS To test reproducibility, two examiners analyzed the NC and PA independently in 10 retrospectively selected cone beam computed tomography (CBCT) images using semiautomatic segmentation. The PA centerline was determined to assess the minimal CS and HD. The intraclass correlation coefficient (ICC) was used to calculate intraexaminer and interexaminer reliabilities. Measurement errors were assessed by Dahlberg's formula and paired t-tests. The level of agreement was assessed using the Bland-Altman method. RESULTS Intraexaminer and interexaminer reliabilities were excellent (minimal ICC, 0.960). The error of the method was good except for interexaminer values for the oropharynx (P = .016). The minimal CS and HD measurements were reliable (minimal ICC, 0.993; narrow limits of agreement). CONCLUSIONS The novel methods for analysis of the NC and PA are reliable. The minimal CS and HD demonstrated excellent reliabilities, which are critical to detect the most constricted part of the PA. Separation of the oropharynx from the voids close to the retroglossal area is not trivial and should be considered with caution.
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Di Carlo G, Gili T, Caldarelli G, Polimeni A, Cattaneo PM. A community detection analysis of malocclusion classes from orthodontics and upper airway data. Orthod Craniofac Res 2021; 24 Suppl 2:172-180. [PMID: 33966341 DOI: 10.1111/ocr.12490] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/19/2021] [Accepted: 05/03/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The interaction between skeletal class and upper airway has been extensively studied. Nevertheless, this relationship has not been clearly elucidated, with the heterogeneity of results suggesting the existence of different patterns for patients' classification, which has been elusive so far, probably due to oversimplified approaches. Hence, a network analysis was applied to test whether different patterns in patients' grouping exist. SETTINGS AND SAMPLE POPULATION Ninety young adult patients with no obvious signs of respiratory diseases and no previous adeno-tonsillectomy procedures, with thirty patients characterized as Class I (0 < ANB < 4); 30 Class II (ANB > 4); and 30 as Class III (ANB < 0). MATERIALS AND METHODS A community detection approach was applied on a graph obtained from a previously analysed sample: thirty-two measurements (nineteen cephalometric and thirteen upper airways data) were considered. RESULTS An airway-orthodontic complex network has been obtained by cross-correlating patients. Before entering the correlation, data were controlled for age and gender using linear regression and standardized. By including or not the upper airway measurements as independent variables, two different community structures were obtained. Each contained five modules, though with different patients' assignments. CONCLUSION The community detection algorithm found the existence of more than the three classical skeletal classifications. These results support the development of alternative tools to classify subjects according to their craniofacial morphology. This approach could offer a powerful tool for implementing novel strategies for clinical and research in orthodontics.
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Affiliation(s)
- Gabriele Di Carlo
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Rome, Italy
| | - Tommaso Gili
- Networks Unit, IMT School for Advanced Studies Lucca, Lucca, Italy.,Department of Molecular Sciences and Nanosystems, Ca'Foscari University of Venice, Venezia Mestre, Italy
| | - Guido Caldarelli
- Department of Molecular Sciences and Nanosystems, Ca'Foscari University of Venice, Venezia Mestre, Italy.,CNR-ISC Unità Sapienza, Rome, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Rome, Italy
| | - Paolo M Cattaneo
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Vic., Australia
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Parizotto JDOL, Peixoto AP, Borsato KT, Bianchi J, Vendramini Pittoli S, Tonello C, Gonçalves JR. Craniofacial and airway morphology of individuals with oculoauriculovertebral spectrum. Orthod Craniofac Res 2021; 24:575-584. [PMID: 33713375 DOI: 10.1111/ocr.12483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 02/03/2021] [Accepted: 02/19/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The objectives of this study were to characterize the craniofacial and airway morphology of oculo-auriculo-vertebral spectrum (OAVS) individuals using computed tomography (CT) examination. SETTING AND SAMPLE POPULATION This sample included individuals in the age range from 5 to 14 years, consisted of a group of 18 OAVS individuals (12 females and 6 males), Pruzansky-Kaban1 IIB and III and by a paired control group matched by age and sex for comparison of morphometric and airway variables. MATERIALS AND METHODS Through the CT examination, airway analysis was performed using Dolphin Imaging® Software, and seven morphometric measurements were performed to evaluate craniofacial morphology by Materialize Mimics® Software. To compare airway and morphometric variables, the control group was used. Student's t test and Mann-Whitney U test were performed to compare differences between the groups. RESULTS Statistically significant differences were showed between the control and OAVS groups for the variables: total airway (TA) area, volume and MAA, RP area, RP volume, RP MAA, RG volume, RG MAA, total posterior height diff, Md incl and y-axis asymmetry. Pearson and Spearman's correlation showed mostly moderate correlations between Mand Occlusal canting AS with TA area and RP volume, Ax-Gn with TA area and Hy-C3 with TA volume. CONCLUSIONS The OAVS's airway was altered and worse than the control group. Our results suggest that the contralateral side of OAVS individuals is unaffected; however, longitudinal assessments are needed to confirm it. Hyoid bone and postural measures play an important role in interpreting airway features of individuals with and without OAVS.
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Affiliation(s)
| | - Adriano Porto Peixoto
- Department of Orthodontics, University of São Paulo (USP), Hospital for Rehabilitation of Craniofacial Anomalies, Bauru, Brazil
| | - Karina Tostes Borsato
- Department of Pediatric Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Jonas Bianchi
- Department of Pediatric Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil.,Department of Orthodontics Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, United States.,Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, United States
| | - Siulan Vendramini Pittoli
- Department of Clinical Genetics, University of São Paulo (USP), Hospital for Rehabilitation of Craniofacial Anomalies, Bauru, Brazil
| | - Cristiano Tonello
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (USP), São Paulo, Brazil
| | - João Roberto Gonçalves
- Department of Pediatric Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
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Saati S, Ramezani K, Ramezani N, Alafchi B. Evaluation of pharyngeal airway volume and nasal septum deviation relation in different sagittal and vertical craniofacial patterns through cone beam computed tomography. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2021. [DOI: 10.1016/j.ajoms.2020.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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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] [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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Hourfar J, Lisson JA, Kinzinger GSM. Changes of epiglottis and hyoid bone position after orthodontic treatment with cast splint fixed functional appliances. Clin Oral Investig 2021; 25:1525-1534. [PMID: 33409688 DOI: 10.1007/s00784-020-03460-9] [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: 04/20/2020] [Accepted: 07/10/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Angle Class II malocclusions including a retrognathic mandible are the most frequent orthodontic problems. Both removable and fixed functional appliances can be used for mandibular advancement. Mandibular advancement after treatment with any fixed functional appliance has numerous therapeutic effects, such as stretching of masticatory muscles, ligaments, membranes and surrounding soft tissues, thus causing positional changes of the hyoid bone and epiglottis. This retrospective study investigates and compares treatment effects upon epiglottis- and hyoid bone position and posterior airway space in class II patients who received mandibular advancement through two different cast splint fixed functional appliances. MATERIAL AND METHODS Two groups of 21 patients each ('Functional Mandibular Advancer' (FMA) and Herbst appliance) were investigated. The same experienced orthodontist performed the treatment in all patients, employing a single-step advancement protocol. The mandible always received initial protrusion into an edge-to-edge position. Conventional lateral cephalograms were available pre-treatment (T1) and immediately after appliance removal (T2) for all patients. The measurements comprised (I) hyoid bone, (II) epiglottis or (III) posterior airway space. Treatment-related changes were analysed with one-sample Student's t tests for intragroup comparisons and independent Student's t tests for intergroup comparisons. Statistical significance was set at p < 0.05. RESULTS Measurements of the hyoid bone showed mostly increases for both appliances after treatment. Intergroup comparisons were not significant for FMA patients but significant for selected measurements in Herbst appliance patients. Intergroup comparisons showed insignificant changes. The posterior airway space was always insignificantly increased after treatment. The greatest increase was found caudally. Intergroup comparisons showed insignificant changes. CONCLUSIONS Both fixed functional appliances cause an anterior and caudal displacement of epiglottis and hyoid bone and enlarge the posterior airway space. The therapeutic effects of the Herbst appliance are slightly larger, although not significantly. CLINICAL RELEVANCE Treatment with either Herbst appliance of FMA alters the hyoid bone position and enlarges the posterior airway space. Still, long-term data are as yet unavailable; it remains unknown if the effects upon posterior airway space remain stable, and if a resulting posterior airway space enlargement may have clinical influence upon obstructive sleep apnoea syndrome.
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Affiliation(s)
- Jan Hourfar
- Department of Orthodontics, Saarland University, Homburg/Saar, Germany.
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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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Kuang W, Zheng J, Li S, Yuan S, He H, Yuan W. Three-Dimensional Analysis of the Pharyngeal Airway Volume and Craniofacial Morphology in Patients With Bilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2020; 58:332-339. [PMID: 32812438 DOI: 10.1177/1055665620946982] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE This study aimed to determine the correlations between the craniofacial morphology and pharyngeal airway volume in patients with complete bilateral cleft lip and palate (BCLP). DESIGN Retrospective study. SETTING Tertiary hospital. PARTICIPANTS Twenty-seven patients with complete BCLP and 27 class I control patients, aged 10 to 14 years. MAIN OUTCOME MEASURE The pharyngeal airway volume and craniofacial morphology were evaluated using cone-beam computed tomography. Measurements were compared between groups and any correlations were identified. RESULTS A significantly smaller total pharyngeal airway volume (TPV), oropharyngeal airway volume, and upper (UOPV) and lower (LOPV) oropharyngeal airway volume were found in patients with BCLP than in class I control patients, with no difference in the nasopharyngeal volume between groups. Furthermore, the craniofacial morphology measurements of N-Me, S-Go, Or-C, Ptm-C, Me-C, Co-Go, Go-Me, Ptm-Or, N-S-Ar, and Ar-Go-Me significantly differed between the BCLP and control groups (all P < .05). Multiple regression analysis indicated that Ptm-C and Me-C; Ptm-C, Or-C, and Me-C; and Me-C explained 20.3%, 38.9%, and 17.1% of the variations in TPV (P = .025), UOPV (P = .002), and LOPV (P = .018), respectively. CONCLUSIONS Total pharyngeal airway volume, TPV, OPV, UOPV, and LOPV were significantly smaller in patients with BCLP than in class I controls. In patients with BCLP, the maxilla showed inhibited sagittal development and a retrograde position; moreover, the pharyngeal airway volume was weakly associated with the position of the maxilla and mandible relative to the coronal plane.
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Affiliation(s)
- Wenying Kuang
- Department of Orthodontics, School and 499766Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jie Zheng
- Department of Orthodontics, School and 499766Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Shaolin Li
- Changjiang Institute of Survey, Planning, Design and Research, Wuhan, China
| | - Shiyu Yuan
- 66365Clinical Medicine department, Zhengzhou University, Zhengzhou, China
| | - Hong He
- Department of Orthodontics, School and 499766Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wenjun Yuan
- Department of Orthodontics, School and 499766Hospital of Stomatology, Wuhan University, Wuhan, China
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Abstract
BACKGROUND Crouzon syndrome is associated with severe respiratory impairment of the upper airway due in part to midfacial dysmorphology. We calculated the distinctive nasal diameter and pharyngeal airway volume in patients with Crouzon syndrome and compared them with age-matched control subjects. METHODS Children with computed tomography scans in the absence of surgical intervention were included. Computed tomography scans were digitized and manipulated using Surgicase CMF (Materialise). Craniometric data relating to the midface and airway were collected. For all linear measurements, mean percent increases or decreases were calculated relative to the size of control subjects, and volumetric assessment of the airway was tabulated. Statistical analysis was performed using t test. RESULTS Twenty-six computed tomography scans were included (control n = 17, Crouzon n = 9). All children were in early mixed dentition. Pharyngeal airway volume was decreased in patients with Crouzon syndrome relative to control subjects by 46% (P = 0.003). The distance from the posterior tongue to the posterior pharyngeal wall decreased 31% when comparing the Crouzon group versus the control (P = 0.04). CONCLUSIONS Three-dimensional analysis revealed notably decreased pharyngeal and nasal airway volumes in patients with Crouzon syndrome, but nasal bone tissue and soft tissue measurements showed very little change between patients and control subjects.
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Gokce G, Veli I, Yuce YK, Isler Y. Efficiency evaluation of rapid maxillary expansion treatment on nasal septal deviation using tortuosity ratio from cone-beam computer tomography images. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 188:105260. [PMID: 31862681 DOI: 10.1016/j.cmpb.2019.105260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/12/2019] [Accepted: 12/02/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVE This study aims to assess the effect of Rapid Maxillary Expansion (RME) on Nasal Septal Deviation (NSD) changes from three-dimensional (3D) images. METHODS In this study, cone-beam computed tomography (CBCT) images from 15 patients with maxillary constriction (mean age 12 ± 1.6 years) were included. RME treatment with Hyrax appliance was performed in all patients. CBCT scans were taken at three different times; before appliance insertion (T0), after active expansion (T1) and 3 months after appliance insertion (T2). We developed a novel Matlab-based application to quantify NSD based on the tortuosity ratio by dividing the actual length of the septum by the ideal length in the mid-sagittal plane by using this application. RESULTS Tortuosity ratio (TR) values were found as 1.03 ± 0.03 (T0), 1.02 ± 0.02 (T1), and 1.02 ± 0.02 (T2). Differences of TR values among these groups were evaluated using the statistical method of ANOVA (ANalysis Of VAriance) for repeated measures with the significance level of p ≤ .05. Results showed significant reductions in TR values between T0-T1 (p ≤ .05) and between T0-T2 (p ≤ .05). Nonetheless, a significant difference between T1-T2 was not determined (p > .05). CONCLUSIONS As a result, we can conclude that the NSD degree is affected by the RME treatment. The developed application can be used for both educational and research purposes.
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Affiliation(s)
- Gokcenur Gokce
- Faculty of Dentistry, Department of Orthodontics, Izmir Katip Celebi University, Cigli, Izmir, Turkey
| | - Ilknur Veli
- Faculty of Dentistry, Department of Orthodontics, Izmir Katip Celebi University, Cigli, Izmir, Turkey
| | - Yilmaz Kemal Yuce
- Rafet Kayis Faculty of Engineering, Department of Computer Engineering, Alanya Alaaddin Keykubat University, Alanya, Antalya, Turkey
| | - Yalcin Isler
- Faculty of Engineering and Architecture, Department of Biomedical Engineering, Izmir Katip Celebi University, Cigli, Izmir, Turkey.
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Vidal-Manyari PA, Arriola-Guillén LE, Jimenez-Valdivia LM, Dias-Da Silveira HL, Boessio-Vizzotto M. Upper airways evaluation in young adults with an anterior open bite: A CBCT retrospective controlled and cross-sectional study. Int Orthod 2020; 18:276-285. [PMID: 32199748 DOI: 10.1016/j.ortho.2020.02.007] [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: 01/17/2020] [Revised: 02/23/2020] [Accepted: 02/24/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the dimensions of the upper airway in young adults with anterior open bite versus matched individuals with an adequate overbite (control group) using different measurement approaches (linear, area, and volume measures). MATERIALS AND METHODS The sample included 137 cone-beam computed tomographies (CBCTs) of young adults (74 men and 63 women) divided into two groups: 47 CBCTs of individuals (mean age 27.89) with open bite (overbite depth indicator (ODI) 56.84°±9.48° and Frankfort mandibular plane angle (FMA) 31.21°±6.44°) and 90 CBCTs of individuals (mean age 26.87) without an open bite (ODI 62.24°±9.47°, FMA 26.79°±5.81°). Two trained and calibrated orthodontists made all linear, area, and volume measurements on the CBCT records of the upper airways using Planmeca Romexis software. The Mann-Whitney U-test, chi-squared test, and multiple linear regression were applied. Significance was set at P<0.05. RESULTS There were no differences in linear or volume measurements between groups, but there was a greater area in the open bite group (greater mean difference between groups 928.3 mm2) than the control group. No variable influenced nasopharyngeal airway volume, but ANB angle affected oropharyngeal airway volume (β=-623.87) and total airway volume (β=-651.48). CONCLUSIONS Orthodontists should be aware that the airways diagnosis can vary depending on the measurement approach used, the volumetric method being the gold standard. The pharyngeal airway volume was similar in individuals with vs. without an open bite and is mainly influenced by ANB angle in both groups.
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Affiliation(s)
| | | | | | | | - Mariana Boessio-Vizzotto
- Universidade Federal do Rio Grande do Sul, Division of Oral radiology, Faculty of Dentistry, Porto Alegre, Brazil
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Cho SH, Jeon JY, Jang KS, Kim SY, Kim KR, Ryu S, Hwang KG. Gender-specific cephalometric features related to obesity in sleep apnea patients: trilogy of soft palate-mandible-hyoid bone. Maxillofac Plast Reconstr Surg 2019; 41:58. [PMID: 31879661 PMCID: PMC6904695 DOI: 10.1186/s40902-019-0242-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 11/27/2019] [Indexed: 11/10/2022] Open
Abstract
Background The aim of this study is to investigate the relationship between gender-specific and obesity-related airway anatomy in patients with obstructive sleep apnea (OSA) by using cephalometric analyses. Methods We retrospectively evaluated 206 patients with suspected OSA undergoing polysomnography and anthropometric measurements such as body mass index, neck circumference, and waist-hip ratio. We checked lateral cephalometry to measure tissue landmarks including angle from A point to nasion to B point (ANB), soft palate length (SPL), soft palate thickness (SPT), retropalatal space (RPS), retrolingual space (RLS), and mandibular plane to hyoid (MPH). Results Male with OSA showed significantly increased SPL (P = .006) compared with controls. SPL and MPH had significant correlation with apnea-hypopnea index (AHI) and central obesity. Female with OSA showed significantly increased ANB (P = .013) and SPT (P = .004) compared with controls. The receiver operating characteristic curves revealed that SPT in male and ANB and SPT in female were significant in model 1 (AHI ≥ 5) and model 2 (AHI ≥ 15). MPH was also significant for male in model 2. Conclusion Male and female with OSA had distinct anatomic features of the upper airway and different interactions among soft palate, mandible, and hyoid bone.
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Affiliation(s)
- Seok Hyun Cho
- 1Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Hanyang University, Seoul, Korea
| | - Jae-Yun Jeon
- 2Department of Dentistry/Oral and Maxillofacial Surgery, School of Medicine, Hanyang University, 222-1 Wangshimniro, Seongdong-gu, Seoul, 133-792 Korea
| | - Kun-Soo Jang
- 2Department of Dentistry/Oral and Maxillofacial Surgery, School of Medicine, Hanyang University, 222-1 Wangshimniro, Seongdong-gu, Seoul, 133-792 Korea
| | - Sang Yoon Kim
- 3Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA.,Vienna, USA
| | - Kyung Rae Kim
- 1Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Hanyang University, Seoul, Korea
| | - Seungho Ryu
- 5Department of Occupational Medicine, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, Seoul, Korea
| | - Kyung-Gyun Hwang
- 2Department of Dentistry/Oral and Maxillofacial Surgery, School of Medicine, Hanyang University, 222-1 Wangshimniro, Seongdong-gu, Seoul, 133-792 Korea
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Cornelis MA, Cattaneo PM. [Upper airways: tridimensional analysis and effect of treatment by functional appliances]. Orthod Fr 2019; 90:337-342. [PMID: 34643520 DOI: 10.1051/orthodfr/2019020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This article revolves around three questions summarizing the main lines of research into the upper airways conducted at Aarhus University. 1. Can the upper airway be reliably evaluated by Cone Beam CT (CBCT)? 2. Is there a link between airway dimension and craniofacial morphology? 3. Do functional appliances increase the volume of the upper airway? 1. The CBCTs of 34 patients were used for this three-dimensional assessment of the upper airway, comparing linear measurements, surfaces and volumes. 2. CBCTs of 90 healthy adults with skeletal class I, II or III were compared. The dimensions of the upper airway were correlated with the cephalometric measurements in 3D. 3. A retrospective CBCT study investigated changes in the upper airway after functional appliance therapy in 20 patients. 1. The upper airway cannot be correctly described using linear measurements. 2. No correlation could be identified between the size and morphology of the upper airway and the morphology of sagittal skeletal class I, II or III malocclusions. 3. An increase in volume of the upper airway was observed after treatment with functional appliances, mainly at the level of the oropharynx. A three-dimensional analysis by CBCT gives a better representation of the anatomical characteristics of the upper airway. This type of 3D analysis revealed a positive effect of treatment by functional appliances on the oropharynx in healthy, growing patients.
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Gurani SF, Cattaneo PM, Rafaelsen SR, Pedersen MR, Thorn JJ, Pinholt EM. The effect of altered head and tongue posture on upper airway volume based on a validated upper airway analysis-An MRI pilot study. Orthod Craniofac Res 2019; 23:102-109. [PMID: 31550076 DOI: 10.1111/ocr.12348] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To determine the influence of altered head or tongue posture on upper airway (UA) volumes using MRI imaging based on a new objective and validated UA evaluation protocol. SETTING AND SAMPLE POPULATION One supine CBCT and five sagittal MRI scans were obtained from ten subjects in different head and tongue positions: (a) supine neutral head position (NHP) with the tongue in a natural resting position with the tip of the tongue in contact with the lingual aspect of the lower incisors (TRP); (b) head extension with TRP; (c) head flexion with TRP; (d) NHP with the tip of the tongue in contact with the posterior edge of the hard palate (THP); and (e) NHP with the tip of the tongue in contact with the floor of the mouth in contact with the caruncula sublingualis. MATERIAL AND METHODS Based on a validated CBCT UA analysis, the retropalatal, oropharyngeal and the corresponding total volumes were measured from each MRI scan. Wilcoxon signed-rank test was applied to determine the statistically significant difference in mean volume between the baseline head and tongue posture (NHP with TRP) and the other postures. RESULTS Five females and five males with a mean age of 46.5 ± 13.7 years volunteered for this pilot study. UA volumes, particularly the oropharyngeal volume, increased significantly with head extension and NHP with THP and decreased significantly with head flexion. CONCLUSION Altered head and tongue posture proved to affect UA volumes, thus representing confounding variables during three-dimensional radiographic image acquisition.
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Affiliation(s)
- Sirwan Fernandez Gurani
- Department of Oral & Maxillofacial Surgery, Hospital of South West Denmark, University Hospital of Southern Denmark, Esbjerg, Denmark.,Faculty of Health Sciences, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Paolo Maria Cattaneo
- Faculty of Health Sciences, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Section of Orthodontics, Department of Dentistry and Oral Health, Faculty of Health Science, Aarhus University, Aarhus C, Denmark
| | - Søren Rafael Rafaelsen
- Faculty of Health Sciences, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Radiology, Vejle Hospital, Vejle, Denmark
| | - Malene Roland Pedersen
- Faculty of Health Sciences, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Radiology, Vejle Hospital, Vejle, Denmark
| | - Jens Jørgen Thorn
- Department of Oral & Maxillofacial Surgery, Hospital of South West Denmark, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Else Marie Pinholt
- Department of Oral & Maxillofacial Surgery, Hospital of South West Denmark, University Hospital of Southern Denmark, Esbjerg, Denmark.,Faculty of Health Sciences, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Moscarino S, Kötter F, Brandt M, Modabber A, Kniha K, Hölzle F, Wolf M, Möhlhenrich SC. Influence of different surgical concepts for moderate skeletal class II and III treatment on the nasopharyngeal airway space. J Craniomaxillofac Surg 2019; 47:1489-1497. [DOI: 10.1016/j.jcms.2019.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 06/12/2019] [Accepted: 07/14/2019] [Indexed: 11/28/2022] Open
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Mouhanna-Fattal C, Papadopoulos M, Bouserhal J, Tauk A, Bassil-Nassif N, Athanasiou A. Evaluation of upper airway volume and craniofacial volumetric structures in obstructive sleep apnoea adults: A descriptive CBCT study. Int Orthod 2019; 17:678-686. [PMID: 31488344 DOI: 10.1016/j.ortho.2019.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this investigation was to assess, with a descriptive three-dimensional evaluation, the volume of upper airway (UAWV) and the volume of craniofacial structures in adult patients suffering from obstructive sleep apnoea (OSA) and compare them to the corresponding findings in adults with no sleep disorders. MATERIALS AND METHODS The sample consisted of 54 adult males, 27 suffering from OSA diagnosed by means of the Apnoea Hypopnea Index and 27 with no history of sleep disorders. All subjects had a cone beam computerized tomography scan performed with the same head position. UAWV was assessed with the Amira® software, and craniofacial volumes by means of a specially developed data-processing program, which allowed the construction of tetrahedrons using anatomical landmarks. Assessed volumes were naso-maxillary, cranium upper anterior, oral cavity, post-oral cavity, hyoid to mandible, and post-hyoid. SPSS (version 19.0) was used for the statistical analysis. The Levene's test for Equality of Variance, the t-test for Equality of Means and the Mann-Whitney test were used to evaluate the variables. The level of significance was set at P ≤ 0.05. RESULTS The mean value of UAWV was smaller in the OSA group. The post-hyoid volume, the calculated posterior volume, and the ratio of posterior to total volume showed differences between the groups. CONCLUSIONS Craniofacial structures did not show significant differences between the groups, but in the OSA group the posterior space released for upper airway was significantly bigger and UAWV was significantly smaller.
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Affiliation(s)
| | - Moschos Papadopoulos
- Aristotle University of Thessaloniki, Department of Orthodontics, Faculty of Dentistry, School of Health Sciences, 54124 Thessaloniki, Greece
| | - Joseph Bouserhal
- Saint Joseph University, Department of Orthodontics, Beirut, Lebanon; Boston University, Department of Orthodontics and Dentofacial Orthopedics, Boston, USA.
| | - Alain Tauk
- Saint Joseph University, Department of Orthodontics, Beirut, Lebanon
| | | | - Athanasios Athanasiou
- European University Cyprus, School of Medicine, Department of Dentistry, P.O. Box 22006, Nicosia, Cyprus
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da Silva Machado V, Cantharino de Carvalho BA, Vedovello SAS, Valdrighi H, Santamaria Júnior M. Pharyngeal Airway Modifications in Skeletal Class III Patients Undergoing Bimaxillary Advancement Surgery. J Oral Maxillofac Surg 2019; 77:2126.e1-2126.e8. [PMID: 31276653 DOI: 10.1016/j.joms.2019.05.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 05/13/2019] [Accepted: 05/31/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE The purposes were to study the pharyngeal airway in patients with skeletal Class III malocclusion submitted to surgical orthodontic treatment and to correlate the alterations with bone movements. MATERIALS AND METHODS The sample consisted of multislice computed tomography images from 13 patients obtained before and 6 months after maxillomandibular advancement surgery. The following measurements were obtained using Dolphin Imaging software (Dolphin Imaging, Chatsworth, CA): volume and area of the oropharynx, nasopharynx, and total airway, as well as the most constricted area, anteroposterior and lateral dimensions of the narrowest axial cross-sectional area, and airway length. The paired t test was applied at a significance level of 5%. RESULTS Sagittal displacement of the maxilla and mandible was correlated with airway alterations using the Pearson correlation test. Alterations in airway measurements were observed in all patients after surgery. We noted a significant increase (P < .05) in total airway area, oropharyngeal area, and anteroposterior dimension of the most constricted area, as well as a significant reduction (P < .05) in airway length. A significant correlation (P < .05) was observed between nasopharyngeal area and maxillary movement and between airway length and mandibular movement (P < .05). CONCLUSIONS The results of this study suggest significant alterations in pharyngeal airway measurements when preoperative and postoperative periods of bimaxillary advancement surgery were compared.
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Affiliation(s)
- Viviane da Silva Machado
- Master in Orthodontics, Graduate Program, University Center of the Hermínio Ometto Foundation, Araras, Brazil
| | | | | | - Heloisa Valdrighi
- Professor, Graduate Program of Orthodontics, University Center of the Hermínio Ometto Foundation, Araras, Brazil
| | - Milton Santamaria Júnior
- Professor, Graduate Program of Orthodontics, and Graduate Program of Biomedical Sciences, University Center of the Hermínio Ometto Foundation, Araras, Brazil.
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Two-Year Postoperative Upper Airway Cone-Beam Computed Tomographic Outcomes Based on a Verified Upper Airway Analysis Following Bimaxillary Orthognathic Surgery. J Oral Maxillofac Surg 2019; 77:1435-1445. [DOI: 10.1016/j.joms.2019.02.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 02/15/2019] [Accepted: 02/18/2019] [Indexed: 01/14/2023]
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Staderini E, Patini R, De Luca M, Gallenzi P. Three-dimensional stereophotogrammetric analysis of nasolabial soft tissue effects of rapid maxillary expansion: a systematic review of clinical trials. ACTA OTORHINOLARYNGOLOGICA ITALICA 2019; 38:399-408. [PMID: 30498268 PMCID: PMC6265666 DOI: 10.14639/0392-100x-2059] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 04/28/2018] [Indexed: 11/28/2022]
Abstract
The aim of this systematic review is to analyse the quality and clinical evidence in the literature analysing, through 3D stereophotogrammetry, the nasolabial soft tissue modifications that may occur after rapid maxillary expansion (RME). This systematic literature review was based on the PRISMA-P statement and was registered in the PROSPERO database with the following protocol ID: CRD42017079875. Pubmed, Cochrane, EBSCO, Scopus, Web of Science databases were searched with no restriction of year or publication status. Selection criteria were: randomised clinical trials, controlled clinical trials, cohort studies, cross-sectional studies, case-control studies on patients with unilateral/bilateral crossbite, transverse maxillary deficiency and crowding, treated with RME and monitored by 3D stereophotogrammetry. 652 articles were retrieved in the initial search. After the review process, 11 full-text articles met inclusion criteria. After the evaluation process, 4 publications were included for the present literature review. Due to the heterogeneous methodology meta-analysis was not possible; consequently, a systematic assessment of the studies and summary of the findings from the available evidence were used to answer the research question. The maximum widening of the alar cartilage is 1.41 ± 0.95 mm, whose clinical significance is open to question. The effect of RME on the mouth width remains controversial. In Altindis et al., the difference between pre-treatment and post-treatment mouth width (1.80 mm increment in the banded RME group) was statistically significant, while in Baysal 1.86 mm was considered a non-significant value. Inconsistencies and limitations in the study population and measurement protocols were detected between studies. These data underline the necessity for updated guidelines that allow to standardise, for this type of study, sample selection, measurement methods and collection of results.
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Affiliation(s)
- E Staderini
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Università Cattolica del Sacro Cuore, Institute of Dentistry and Maxillofacial Surgery, Rome, Italy
| | - R Patini
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Università Cattolica del Sacro Cuore, Institute of Dentistry and Maxillofacial Surgery, Rome, Italy
| | - M De Luca
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Università Cattolica del Sacro Cuore, Institute of Dentistry and Maxillofacial Surgery, Rome, Italy
| | - P Gallenzi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Università Cattolica del Sacro Cuore, Institute of Dentistry and Maxillofacial Surgery, Rome, Italy
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De Felice F, Di Carlo G, Saccucci M, Tombolini V, Polimeni A. Dental Cone Beam Computed Tomography in Children: Clinical Effectiveness and Cancer Risk due to Radiation Exposure. Oncology 2019; 96:173-178. [PMID: 30836369 DOI: 10.1159/000497059] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 01/13/2019] [Indexed: 11/19/2022]
Abstract
Firstly used in the early 90s to generate 3-dimensional projections of X-ray images, cone beam computed tomography (CBCT) has resulted in a large application in dentomaxillofacial imaging, even in children. CBCT uses ionizing radiation that may cause damage to the DNA, and children are at the greatest carcinogenesis risk due to their higher tissue radiosensitivity and their longer life expectancy compared to adults. The questions of whether the cancer risk is really increased after repeated dental CBCT in childhood and of what the underlying biological basis is have become hot topics in the field of dentistry and radiobiology. We performed an overview of the current literature to assess an acceptable role of CBCT in pediatric dentistry.
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Affiliation(s)
- Francesca De Felice
- Department of Radiotherapy, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy,
| | - Gabriele Di Carlo
- Department of Oral and Maxillofacial Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Matteo Saccucci
- Department of Oral and Maxillofacial Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Vincenzo Tombolini
- Department of Radiotherapy, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
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Alhammadi MS, Almashraqi AA, Halboub E, Almahdi S, Jali T, Atafi A, Alomar F. Pharyngeal airway spaces in different skeletal malocclusions: a CBCT 3D assessment. Cranio 2019; 39:97-106. [PMID: 30821659 DOI: 10.1080/08869634.2019.1583301] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective: To three-dimensionally evaluate the upper pharyngeal airway spaces in adults with different anteroposterior and vertical skeletal malocclusions.Methods: In this retrospective study, three-dimensional airway volume and the minimum constricted areas of 120 adults were measured from cone beam computed tomography volume scans. The sample was divided into skeletal Class I and Class II and subdivided into average and long face malocclusions in each skeletal Class. Airway volumes of the naso-, palato-, and glossopharynx, and the minimum constricted area were measured and compared.Results: Skeletal Class II reduced glossopharyngeal airway volume and larger total minimum constricted area in average faces and more nasal minimum constricted area in long faces. Skeletal Class II with long face significantly increased palatopharyngeal and glossopharyngeal airway volumes as well as larger palatopharyngeal minimum constricted area (p < 0.05).Conclusion: This paper found a likely association between jaw skeletal classification and airway dimensions.
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Affiliation(s)
- Maged Sultan Alhammadi
- Department of Preventive Dental Sciences, Division of Orthodontics and Dentofacial Orthopedics, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Abeer Abdulkareem Almashraqi
- Department of Maxillofacial Surgery and Diagnostic Sciences, Oral and Maxillofacial Radiology Division, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | | | - Tasneem Jali
- College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Aisha Atafi
- College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Fatima Alomar
- College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Zimmerman JN, Lee J, Pliska BT. Reliability of upper pharyngeal airway assessment using dental CBCT: a systematic review. Eur J Orthod 2018; 39:489-496. [PMID: 27999121 DOI: 10.1093/ejo/cjw079] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Background Upper airway analysis is an often-cited use of cone beam computed tomography (CBCT) imaging in orthodontics. However, the reliability of this process in a clinical setting is largely unknown. Objective Our objective was to systematically review the literature to evaluate the reliability of upper pharyngeal airway assessment using dental CBCT. Search methods MEDLINE, EMBASE, Web of Science, and Google Scholar were searched through June 2015. Selection criteria Human studies that measured reliability of upper airway assessment in patients using CBCT as part of the study protocol were considered. Data collection and analysis The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was followed. Data were collected on overall study characteristics and measurements, CBCT unit and machine settings used, and examination characteristics of the included studies. Methodological quality of the included studies was evaluated. Results Forty-two studies were evaluated, representing the CBCT scans of 956 patients. Studies included a wide variety of patients and CBCT machines with various scan settings. Only five studies were deemed high quality. The available evidence indicates that under specific restricted conditions there is moderate to excellent intra- and inter-examiner reliability. Airway volume demonstrated greater intra- and inter-examiner reliability than did minimum cross-sectional area. However, significant methodological limitations of the current literature, most importantly a lack of manual orientation of the images and selection of threshold sensitivity in study protocols, suggest that reliability has not been adequately established. Conclusions The current literature reports moderate to excellent reliability, with airway volume having higher reliability than minimum cross-sectional area. However, only limited aspects of the process of airway analysis have been evaluated, indicating that further research is required to adequately establish the reliability of upper pharyngeal airway assessment of patients using dental CBCT. Registration None.
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Affiliation(s)
- Jason N Zimmerman
- Division of Orthodontics, Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Janson Lee
- Division of Orthodontics, Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Benjamin T Pliska
- Division of Orthodontics, Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
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Brito FC, Brunetto DP, Nojima MCG. Three-dimensional study of the upper airway in different skeletal Class II malocclusion patterns. Angle Orthod 2018; 89:93-101. [PMID: 30230378 DOI: 10.2319/112117-806.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To characterize upper airway volume and morphology in patients with different skeletal patterns of Class II malocclusion compared to Class I. MATERIALS AND METHODS A total of 197 individuals who had cone-beam computed tomography were allocated into groups according to ANB, SNA, and SNB angles (Class I, Class II maxillary protrusion, Class II mandibular retrusion), each subdivided into hypodivergent, normal, and hyperdivergent. Nasopharynx (NP), oropharynx (OP), and hypopharynx (HP) were assessed with three-dimensional image reconstruction software. RESULTS Intergroup comparison did not detect significant differences in volume and morphology of NP, OP, and HP. The males displayed larger OP and HP volume than the females. Positive correlations between age and NP, OP, HP volume and between craniocervical angle and OP and HP volume were observed. Linear regression analysis detected a tendency for OP and HP volume to increase as maxillary and mandibular length increased. CONCLUSIONS Upper airway volume and morphology were similar in different skeletal patterns of Class II malocclusion. Actual upper and lower jaw lengths were more closely related to upper airway volume and morphology than the angles that reflected their position relative to the cranial base.
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Occasi F, Perri L, Saccucci M, Di Carlo G, Ierardo G, Luzzi V, De Castro G, Brindisi G, Loffredo L, Duse M, Polimeni A, Zicari AM. Malocclusion and rhinitis in children: an easy-going relationship or a yet to be resolved paradox? A systematic literature revision. Ital J Pediatr 2018; 44:100. [PMID: 30134958 PMCID: PMC6106920 DOI: 10.1186/s13052-018-0537-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 08/07/2018] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The relation between nasal flow and malocclusion represents a practical concern to pediatricians, otorhinolaryngologists, orthodontists, allergists and speech therapists. If naso-respiratory function may influence craniofacial growth is still debated. Chronic mouth-breathing is reported to be associated also with a characteristic pattern of dental occlusion. On the other hand, also malocclusion may reduce nasal air flows promoting nasal obstruction. Hereby, the aim of this review was to describe the relationship between rhinitis and malocclusion in children. METHODS An electronic search was conducted using online database including Pubmed, Web of Science, Google Scholar and Embase. All studies published through to January 30, 2017 investigating the prevalence of malocclusion in children and adolescents (aged 0-20 years) affected by rhinitis and the prevalence of rhinitis in children with malocclusion were included. The protocol was registered at PROSPERO - International prospective register of systematic reviews under CRD42016053619. RESULTS Ten studies with 2733 patients were included in the analysis. The prevalence of malocclusion in children with rhinitis was specified in four of the studies ranging from as high as 78.2% to as low as 3%. Two out of the studies reported the prevalence of rhinitis in children with malocclusion with a rate ranging from 59.2 to 76.4%. CONCLUSION The results of this review underline the importance of the diagnosis and treatment of the nasal obstruction at an early age to prevent an altered facial growth, but the data currently available on this topic do not allow to establish a possible causal relationship between rhinitis and malocclusion.
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Affiliation(s)
- Francesca Occasi
- Department of Pediatrics, "Sapienza" University of Rome, Rome, Italy
| | - Ludovica Perri
- Department of Internal Medicine and Medical Specialities, "Sapienza" University of Rome, Rome, Italy.
| | - Matteo Saccucci
- Department of Pediatric Otorhinolaryngology, "Sapienza" University of Rome, Rome, Italy
| | - Gabriele Di Carlo
- Department of Pediatric Otorhinolaryngology, "Sapienza" University of Rome, Rome, Italy
| | - Gaetano Ierardo
- Department of Pediatric Otorhinolaryngology, "Sapienza" University of Rome, Rome, Italy
| | - Valeria Luzzi
- Department of Pediatric Otorhinolaryngology, "Sapienza" University of Rome, Rome, Italy
| | | | - Giulia Brindisi
- Department of Pediatrics, "Sapienza" University of Rome, Rome, Italy
| | - Lorenzo Loffredo
- Department of Internal Medicine and Medical Specialities, "Sapienza" University of Rome, Rome, Italy
| | - Marzia Duse
- Department of Pediatrics, "Sapienza" University of Rome, Rome, Italy
| | - Antonella Polimeni
- Department of Pediatric Otorhinolaryngology, "Sapienza" University of Rome, Rome, Italy
| | - Anna Maria Zicari
- Department of Pediatrics, "Sapienza" University of Rome, Rome, Italy
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Nejaim Y, Aps JKM, Groppo FC, Haiter Neto F. Evaluation of pharyngeal space and its correlation with mandible and hyoid bone in patients with different skeletal classes and facial types. Am J Orthod Dentofacial Orthop 2018; 153:825-833. [PMID: 29853240 DOI: 10.1016/j.ajodo.2017.09.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 09/01/2017] [Accepted: 09/01/2017] [Indexed: 02/01/2023]
Abstract
INTRODUCTION The purpose of this article was to evaluate the pharyngeal space volume, and the size and shape of the mandible and the hyoid bone, as well as their relationships, in patients with different facial types and skeletal classes. Furthermore, we estimated the volume of the pharyngeal space with a formula using only linear measurements. METHODS A total of 161 i-CAT Next Generation (Imaging Sciences International, Hatfield, Pa) cone-beam computed tomography images (80 men, 81 women; ages, 21-58 years; mean age, 27 years) were retrospectively studied. Skeletal class and facial type were determined for each patient from multiplanar reconstructions using the NemoCeph software (Nemotec, Madrid, Spain). Linear and angular measurements were performed using 3D imaging software (version 3.4.3; Carestream Health, Rochester, NY), and volumetric analysis of the pharyngeal space was carried out with ITK-SNAP (version 2.4.0; Cognitica, Philadelphia, Pa) segmentation software. For the statistics, analysis of variance and the Tukey test with a significance level of 0.05, Pearson correlation, and linear regression were used. RESULTS The pharyngeal space volume, when correlated with mandible and hyoid bone linear and angular measurements, showed significant correlations with skeletal class or facial type. The linear regression performed to estimate the volume of the pharyngeal space showed an R of 0.92 and an adjusted R2 of 0.8362. CONCLUSIONS There were significant correlations between pharyngeal space volume, and the mandible and hyoid bone measurements, suggesting that the stomatognathic system should be evaluated in an integral and nonindividualized way. Furthermore, it was possible to develop a linear regression model, resulting in a useful formula for estimating the volume of the pharyngeal space.
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Affiliation(s)
- Yuri Nejaim
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
| | - Johan K M Aps
- Department of Pediatric Dentistry, University of Washington, Seattle, Wash
| | - Francisco Carlos Groppo
- Department of Physiological Sciences, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Francisco Haiter Neto
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
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Isidor S, Di Carlo G, Cornelis MA, Isidor F, Cattaneo PM. Three-dimensional evaluation of changes in upper airway volume in growing skeletal Class II patients following mandibular advancement treatment with functional orthopedic appliances. Angle Orthod 2018; 88:552-559. [PMID: 29809053 DOI: 10.2319/083117-587.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES The aim of this study was to assess three-dimensionally the upper airway changes following functional appliance treatment in growing Class II patients. MATERIALS AND METHODS Pre-and post-treatment Cone beam computed tomography scans of 20 patients (age range: 9 to 12; mean: 11.4 ± 1.0 years) were retrieved from the list of patients previously treated with functional appliances in the Postgraduate Clinic at the Section of Orthodontics, Aarhus University, Denmark. Total and partial volumes of the upper airway (ie, lower nasopharynx, velopharynx, and oropharynx) were calculated. To rule out the effect of growth, the changes in the functional appliance group were compared to an age-matched Class I group of 18 patients (age range: 8 to 14; mean: 11.8 ± 1.4 years). RESULTS In the functional appliance group, all the partial and total volumes were significantly larger at the end of treatment when compared to the start of treatment ( P < .003). On the other hand, when comparing the changes for the total and partial volumes of the upper airway in the functional appliance group with the Class I group, a statistical difference was seen only for the oropharynx ( P = .022) and total volume ( P = .025), with the functional appliance group showing a larger volume increment. CONCLUSIONS An increase in the upper airway volume was found after treatment with functional appliances. This difference was mainly related to the changes at the oropharynx level, which differed significantly from what was observed in the Class I group.
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Iwasaki T, Sato H, Suga H, Takemoto Y, Inada E, Saitoh I, Kakuno K, Kanomi R, Yamasaki Y. Influence of pharyngeal airway respiration pressure on Class II mandibular retrusion in children: A computational fluid dynamics study of inspiration and expiration. Orthod Craniofac Res 2018; 20:95-101. [PMID: 28414873 DOI: 10.1111/ocr.12145] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine the influence of negative pressure of the pharyngeal airway on mandibular retraction during inspiration in children with nasal obstruction using the computational fluid dynamics (CFD) method. SETTING AND SAMPLE POPULATION Sixty-two children were divided into Classes I, II (mandibular retrusion) and III (mandibular protrusion) malocclusion groups. MATERIAL AND METHODS Cone-beam computed tomography data were used to reconstruct three-dimensional shapes of the nasal and pharyngeal airways. Airflow pressure was simulated using CFD to calculate nasal resistance and pharyngeal airway pressure during inspiration and expiration. RESULTS Nasal resistance of the Class II group was significantly higher than that of the other two groups, and oropharyngeal airway inspiration pressure in the Class II (-247.64 Pa) group was larger than that in the Class I (-43.51 Pa) and Class III (-31.81 Pa) groups (P<.001). The oropharyngeal airway inspiration-expiration pressure difference in the Class II (-27.38 Pa) group was larger than that in the Class I (-5.17 Pa) and Class III (0.68 Pa) groups (P=.006). CONCLUSION Large negative inspiratory pharyngeal airway pressure due to nasal obstruction in children with Class II malocclusion may be related to their retrognathia.
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Affiliation(s)
- T Iwasaki
- Department of Pediatric Dentistry, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-City, Japan
| | - H Sato
- Department of Pediatric Dentistry, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-City, Japan
| | - H Suga
- Department of Pediatric Dentistry, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-City, Japan
| | - Y Takemoto
- Department of Pediatric Dentistry, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-City, Japan
| | - E Inada
- Department of Pediatric Dentistry, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-City, Japan
| | - I Saitoh
- Division of Pediatric Dentistry, Graduate School of Medical and Dental Sciences, Niigata University, Niigata-City, Japan
| | - K Kakuno
- Kanomi Orthodontic Office, Himeji-City, Japan
| | - R Kanomi
- Kanomi Orthodontic Office, Himeji-City, Japan
| | - Y Yamasaki
- Department of Pediatric Dentistry, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-City, Japan
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Di Carlo G, Gurani SF, Pinholt EM, Cattaneo PM. A new simple three-dimensional method to characterize upper airway in orthognathic surgery patient. Dentomaxillofac Radiol 2017; 46:20170042. [PMID: 28749703 DOI: 10.1259/dmfr.20170042] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To develop and validate a new reproducible 3D upper airway analysis based on skeletal structures not involved in the modification, which occur during orthognathic surgery. METHODS From retrospective cohort of orthognathic surgically treated patients, pre- and postsurgical CBCT-scans of 10 post-pubertal patients were randomly selected. Two operators identified the landmarks, calculated the airway volumes, cross sections and linear measurements on the 10 scans twice at two different time intervals. Statistical analysis included test for normal distribution, technical error measurements, and intra- and inter-observers reliability. RESULTS Intra- and inter-observer reliability was excellent for volumes and cross sections. The entire data sets exhibited normal distribution. Technical error of measurements showed an error in the range of 1.6 to 10.2% for volume, 1.6 to 12.2% for cross-sectional measurements, and 0.3 to 2.5% for linear measurements. No systematic errors were detected. CONCLUSIONS This new proposed definition of upper airway boundaries was shown to be technical feasible and tested to be reliable in measuring upper airway in patients undergoing orthognathic surgery.
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Affiliation(s)
- Gabriele Di Carlo
- 1 Department of Oral and Maxillofacial Science, Sapienza University of Rome, Rome, Italy.,2 Department of Dentistry, Faculty of Health Science, Section of Orthodontics, Aarhus University, Aarhus, Denmark
| | - Sirwan Fernandez Gurani
- 3 Department of Oral and Maxillofacial Surgery, Hospital of South West Jutland, Faculty of Health Sciences, Institute of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
| | - Else Marie Pinholt
- 3 Department of Oral and Maxillofacial Surgery, Hospital of South West Jutland, Faculty of Health Sciences, Institute of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
| | - Paolo Maria Cattaneo
- 2 Department of Dentistry, Faculty of Health Science, Section of Orthodontics, Aarhus University, Aarhus, Denmark
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