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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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Ceylan Eser N, Arslan C, Altuğ AT. Validation of a Finite Element Model for Clinical and Virtual Evaluation of the Changes in Airway Dimensions Following Class III Bimaxillary Orthognathic Surgery. J Maxillofac Oral Surg 2023; 22:217-225. [PMID: 36703662 PMCID: PMC9871107 DOI: 10.1007/s12663-022-01781-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/05/2022] [Indexed: 01/29/2023] Open
Abstract
Introduction The aim of this study was to evaluate pharyngeal airway changes in adult skeletal Class III cases whose bimaxillary surgical treatments were planned with different amounts of maxillary and mandibular movement using lateral cephalometric radiographs and finite element analysis (FEA). Our null hypothesis was that bimaxillary orthognathic surgery in which maxillary forward movement (MF) is greater than mandibular backward movement (MB) will result in more expansion of the pharyngeal airway. Materials and Methods A total of 31 individuals (11 females, 20 males) with class III skeletal deformity were included in the study. Patients who underwent bimaxillary orthognathic surgery with greater maxillary advancement (MF > MB) were categorized in Group 1 (n = 15), and those with greater mandibular set-back (MB > MF) as Group 2 (n = 16). Changes in airway dimensions were evaluated from lateral cephalometric radiographs. In addition, FEA modeling was used to determine pharyngeal airway changes with 5 different MF/MB combinations performed in skeletal class III bimaxillary surgeries. Results Nasopharyngeal and oropharyngeal airway dimensions increased in direct proportion to the amount of MF. Hypopharyngeal volume decreased compared to preoperative value in direct proportion to the decrease in MB. According to the FEA models, total pharyngeal airway volume decreased when MF was less than or equal to MB, was nearly unchanged when MF was 2 mm greater than MB, and increased when MF was 4 mm greater than MB. The results of FEA and lateral cephalometric analysis were compatible. Conclusion Our results supported the null hypothesis. We concluded that when possible, planning slightly more maxillary advancement than mandibular set-back will not have an adverse impact on the airway. Although the skeletal deformity only causes forward displacement of the mandible, dividing the skeletal correction between the maxilla and mandible may be considered to avoid the risk to patients' quality of life in terms of respiratory function.
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Affiliation(s)
| | - Can Arslan
- Department of Orthodontics, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
- Yeditepe Üniversitesi Diş Hastanesi, Bağdat Caddesi, Istanbul, 34728 Turkey
| | - Ayşe Tuba Altuğ
- Department of Orthodontics, Faculty of Dentistry, Ankara University, Ankara, Turkey
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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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TÜRKER G, ARIKAN ES. Evaluation of pharyngeal airway and hyoid bone position in skeletal Class 1 individuals with different vertical growth patterns in Turkish population. ACTA ODONTOLOGICA TURCICA 2022. [DOI: 10.17214/gaziaot.950613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Amaç: Bu araştırmada, iskeletsel Sınıf 1 ilişkiye sahip bireylerde dik yön büyüme paterninin farengeal havayolu boyutlarına ve hyoid kemik pozisyonuna etkisinin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Bu retrospektif araştırmaya, ANB açısı temel alınarak iskeletsel Sınıf 1 ilişkiye sahip toplam 72 birey (36 kadın, 36 erkek; ortalama yaş: 17.78 ± 1.39 yıl) dahil edildi. Bireyler dik yön büyüme paternine göre; normodiverjan, hipodiverjan ve hiperdiverjan olmak üzere 3 gruba ayrıldı. Lateral sefalometrik radyografiler üzerinde farengeal havayolu ve hyoid kemik pozisyonu ölçümleri, 1 açısal ve 10 lineer ölçüm kullanılarak yapıldı. Verilerin analizinde bağımsız örneklem t-testi ve tek yönlü varyans analizi (ANOVA) kullanılarak grup içi ve gruplar arası farklılıklar değerlendirildi (p<0.05).
Bulgular: Verilerin grup içi karşılaştırmalarında farengeal havayolu boyutlarına ait ölçümlerin cinsiyetler arasında benzer olduğu (p˃0.05) ve tüm gruplarda hyoid kemiğin servikal vertebralara ve mandibular düzleme olan uzaklıklarının kızlarda anlamlı düzeyde daha az olduğu görüldü (p<0.05). Normodiverjan, hipodiverjan ve hiperdiverjan bireylerin farengeal havayolu boyutları ve hyoid kemik pozisyonunda istatistiksel olarak anlamlı farklılıklar olmadığı belirlendi.
Sonuç: Normodiverjan, hipodiverjan ve hiperdiverjan bireylerde farengeal havayolu boyutlarının ve hyoid kemik pozisyonlarının benzer olduğu görüldü. Bununla birlikte, tüm gruplarda erkeklerde hyoid kemiğinin kızlara göre daha aşağıda ve daha önde pozisyonlandığı belirlendi.
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Lo Giudice A, Ronsivalle V, Gastaldi G, Leonardi R. Assessment of the accuracy of imaging software for 3D rendering of the upper airway, usable in orthodontic and craniofacial clinical settings. Prog Orthod 2022; 23:22. [PMID: 35691961 PMCID: PMC9189077 DOI: 10.1186/s40510-022-00413-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several semi-automatic software are available for the three-dimensional reconstruction of the airway from DICOM files. The aim of this study was to evaluate the accuracy of the segmentation of the upper airway testing four free source and one commercially available semi-automatic software. A total of 20 cone-beam computed tomography (CBCT) were selected to perform semi-automatic segmentation of the upper airway. The software tested were Invesalius, ITK-Snap, Dolphin 3D, 3D Slicer and Seg3D. The same upper airway models were manually segmented (Mimics software) and set as the gold standard (GS) reference of the investigation. A specific 3D imaging technology was used to perform the superimposition between the upper airway model obtained with semi-automatic software and the GS model, and to perform the surface-to-surface matching analysis. The accuracy of semi-automatic segmentation was evaluated calculating the volumetric mean differences (mean bias and limits of agreement) and the percentage of matching of the upper airway models compared to the manual segmentation (GS). Qualitative assessments were performed using color-coded maps. All data were statistically analyzed for software comparisons. RESULTS Statistically significant differences were found in the volumetric dimensions of the upper airway models and in the matching percentage among the tested software (p < 0.001). Invesalius was the most accurate software for 3D rendering of the upper airway (mean bias = 1.54 cm3; matching = 90.05%) followed by ITK-Snap (mean bias = - 2.52 cm3; matching = 84.44%), Seg 3D (mean bias = 3.21 cm3, matching = 87.36%), 3D Slicer (mean bias = - 4.77 cm3; matching = 82.08%) and Dolphin 3D (difference mean = - 6.06 cm3; matching = 78.26%). According to the color-coded map, the dis-matched area was mainly located at the most anterior nasal region of the airway. Volumetric data showed excellent inter-software reliability (GS vs semi-automatic software), with coefficient values ranging from 0.904 to 0.993, confirming proportional equivalence with manual segmentation. CONCLUSION Despite the excellent inter-software reliability, different semi-automatic segmentation algorithms could generate different patterns of inaccuracy error (underestimation/overestimation) of the upper airway models. Thus, is unreasonable to expect volumetric agreement among different software packages for the 3D rendering of the upper airway anatomy.
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Affiliation(s)
- Antonino Lo Giudice
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, Unit of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy.
| | - Vincenzo Ronsivalle
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, Unit of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Giorgio Gastaldi
- Department Orthodontics, Vita-Salute San Raffaele University, Milan, Italy
| | - Rosalia Leonardi
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, Unit of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
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Daluz ADJ, da Silva TVS, Tôrres BO, Costa DFN, Santos LADM. Long-term airway evolution after orthognathic surgery: Systematic Review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:191-198. [PMID: 33882343 DOI: 10.1016/j.jormas.2021.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/06/2021] [Accepted: 04/14/2021] [Indexed: 10/21/2022]
Abstract
Orthognathic surgery is a procedure that consists of correcting the abnormalities of the maxilla, mandible or both. Maxillary movements have a direct effect on the upper airways. For this reason, in the preoperative period, bone movements should be carefully analyzed and planned to avoid causing any damages to the airways. The goal of this study was to discuss the long-term evolution of the airways after orthognathic surgery. In order to do that, a search was performed through the databases PubMed, Virtual Health Library (VHL) and Scopus, using the acronym PICO strategy and a guiding question to conduct the search. Through the keywords and boolean operators "and" and "or" we found 930 articles. After reading the titles, abstracts and application of inclusion and exclusion criteria, we had 21 articles that were studied in their integrity. At the end of the selection, only 8 studies were included in the review. The postoperative evaluations from the selected studies showed that the airways suffered variations, independently of the patient's facial pattern. In addition, the airways tend to return to initial volumes, but none of the included studies obtained a complete return to the initial airways, even 6 years after surgery. Therefore, more studies with controlled methodologies should be conducted in order to have a better understanding of the airways and their changes.
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Affiliation(s)
| | | | | | - Davi Felipe Neves Costa
- Department of Oral and Maxillofacial Surgery, University Hospital Lauro Wanderley - Federal University of Paraíba, João Pessoa, Paraíba, Brazil
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Comparing Pharyngeal Airway Dimensions and Hyoid Bone Position in the Subgroups of Skeletal Class III Malocclusions: A Cephalometric Study. JOURNAL OF ADVANCED ORAL RESEARCH 2020. [DOI: 10.1177/2320206820960860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim: To examine pharyngeal airway dimensions and hyoid bone position according to the subgroups of Class III malocclusion. Materials and Methods: This retrospective study consisted of patients divided into three subgroups with skeletal Class III malocclusion. The study included a total of 151 individuals (61 females and 90 males). The authors divided individuals with skeletal Class III malocclusion into three subgroups: maxillary retrognathia, mandibular prognathia, and combined. The study’s cephalometric analysis used eight nasopharyngeal, seven oropharyngeal, two hypopharyngeal, nine hyoid, and four area measurements. One-way analysis of variance was used to evaluate patients. Tukey’s post-hoc tests were used for bilateral comparisons of significant parameters. The results were considered statistically significant at a P < .05 significance level. Results: The study found no significant differences between the groups’ pharyngeal airway and area measurements ( P > .05). When the authors evaluated hyoid bone position, a statistically significant difference was found between the three groups’ Hy-A (mm), Hy-S (mm), Hy-SN (mm), and Hy-FH (mm) measurements ( P < .05). Conclusion: Linear and areal pharyngeal airway dimensions are similar in subgroups of Class III malocclusions, while the hyoid bone is vertically higher in individuals with maxillary retrognathia.
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Kocakara G, Buyukcavus MH, Orhan H. Evaluation of pharyngeal airway dimensions and hyoid bone position according to craniofacial growth pattern. Cranio 2020; 40:313-323. [PMID: 32692620 DOI: 10.1080/08869634.2020.1796060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To compare pharyngeal airway dimensions and hyoid bone position in different craniofacial growth patterns. METHODS In total, 611 patients divided into 9 subgroups were compared according to malocclusion classification and vertical growth pattern, and these subgroups were compared in terms of pharyngeal airway and hyoid measurements. A two-way ANOVA test was used to compare the findings of the subgroups. RESULTS No significant difference was found for the pharyngeal measurements between the groups (p>0.05). The vertical airway length (PNS-Ep) was significantly shorter in the Class III malocclusion group (p<0.05) and in the hypodivergent group (p<0.05). No statistically significant difference was found between any subgroups in any measurements of the position of the hyoid bone (p>0.05). CONCLUSION The pharyngeal airway dimensions and hyoid bone position are similar among individuals in the sagittal direction. The vertical airway length is significantly shorter in Class III and hypodivergent individuals.
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Affiliation(s)
- Gönül Kocakara
- Department of Orthodontics, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
| | | | - Hikmet Orhan
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
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Jayaprakash PK, Modi P, Sapawat P, Thakur RS, Choudhari T, Chandrakar J. Correlation of soft palate morphology to growth pattern: A retrospective cephalometric study. J Family Med Prim Care 2019; 8:2468-2472. [PMID: 31463278 PMCID: PMC6691440 DOI: 10.4103/jfmpc.jfmpc_322_19] [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: 11/04/2022] Open
Abstract
Aim The aim of the present study was to evaluate the radiographic length of velum (LV), width of velum (WV), velum angle (AV), depth of pharynx (PD), Need's ratio (NR), inclination angle (AI) in different morphological types of soft palate according to growth patterns in skeletal class I individuals. Methodology 80 pretreatment lateral cephalograms of patients with skeletal class I malocclusion (ANB 2--4°) were divided on basis of six types of soft palate and further into three subgroups according to growth pattern and evaluation of LV, WV, angle with the palatal plane, and NR was done. Kruskal--Wallis test was used for the comparison between the groups. Results Statistically significant difference was verified among all groups for measurement of NR. The highest NR was seen in Crook type of soft palate (mean 0.9). Similarly, the vertical growth pattern in all the six types of soft palate exhibited a higher NR than the average and horizontal growth pattern group; the highest being exhibited by vertical group in type VI (crook shaped). Velopharyngeal insufficiency is directly related to NR. Conclusion Vertical growth pattern has the highest susceptibility to velopharyngeal insuffiency and speech and sleep apnea disorders.
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Affiliation(s)
- Poonam K Jayaprakash
- Department of Orthodontics and Dentofacial Orthopedics, Kothiwal Dental College and Research Center, Mora Mustaqueem, Moradabad, Uttar Pradesh, India
| | - Palash Modi
- Consultant Orthodontist, Phoenix Hospital, Panchkula, Haryana, India
| | - Pranav Sapawat
- Consultant Orthodontist, Ambedkar marg, Rajnagar Extension II, Palam Colony, New Delhi, India
| | - RudraPratap Singh Thakur
- Department of Orthodontics and Dentofacial Orthopedics, Maitri College of Dentistry and Research Center, Anjora, Durg, Chhattisgarh, India
| | - Tanuj Choudhari
- Department of Orthodontics and Dentofacial Orthopedics, Maitri College of Dentistry and Research Center, Anjora, Durg, Chhattisgarh, India
| | - Jayant Chandrakar
- Department of Orthodontics and Dentofacial Orthopedics, Maitri College of Dentistry and Research Center, Anjora, Durg, Chhattisgarh, India
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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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Noncontact identification of sleep-disturbed breathing from smartphone-recorded sounds validated by polysomnography. Sleep Breath 2018; 23:269-279. [PMID: 30022325 DOI: 10.1007/s11325-018-1695-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 06/12/2018] [Accepted: 06/27/2018] [Indexed: 02/08/2023]
Abstract
PURPOSE Diagnosis of obstructive sleep apnea by the gold-standard of polysomnography (PSG), or by home sleep testing (HST), requires numerous physical connections to the patient which may restrict use of these tools for early screening. We hypothesized that normal and disturbed breathing may be detected by a consumer smartphone without physical connections to the patient using novel algorithms to analyze ambient sound. METHODS We studied 91 patients undergoing clinically indicated PSG. Phase I: In a derivation cohort (n = 32), we placed an unmodified Samsung Galaxy S5 without external microphone near the bed to record ambient sounds. We analyzed 12,352 discrete breath/non-breath sounds (386/patient), from which we developed algorithms to remove noise, and detect breaths as envelopes of spectral peaks. Phase II: In a distinct validation cohort (n = 59), we tested the ability of acoustic algorithms to detect AHI < 15 vs AHI > 15 on PSG. RESULTS Smartphone-recorded sound analyses detected the presence, absence, and types of breath sound. Phase I: In the derivation cohort, spectral analysis identified breaths and apneas with a c-statistic of 0.91, and loud obstruction sounds with c-statistic of 0.95 on receiver operating characteristic analyses, relative to adjudicated events. Phase II: In the validation cohort, automated acoustic analysis provided a c-statistic of 0.87 compared to whole-night PSG. CONCLUSIONS Ambient sounds recorded from a smartphone during sleep can identify apnea and abnormal breathing verified on PSG. Future studies should determine if this approach may facilitate early screening of SDB to identify at-risk patients for definitive diagnosis and therapy. CLINICAL TRIALS NCT03288376; clinicaltrials.org.
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