Objective: The aim of this study was to evaluate long-term changes in the pharyngeal airway dimensions after functional appliance treatment in adolescents with skeletal Class II malocclusions. Methods: Pharyngeal airway dimensions were compared between subjects with skeletal Class II malocclusions (...
Objective: The aim of this study was to evaluate long-term changes in the pharyngeal airway dimensions after functional appliance treatment in adolescents with skeletal Class II malocclusions. Methods: Pharyngeal airway dimensions were compared between subjects with skeletal Class II malocclusions (n = 24; mean age: $11.6{\pm}1.29$ years) treated with a Class II bionator and age-matched control subjects with skeletal Class I occlusions (n = 24; mean age: $11.0{\pm}1.21$ years) using a series of lateral cephalograms obtained at the initial visit (T0), after treatment (T1), and at the completion of growth (T2). Results: The length of the nasopharyngeal region was similar between adolescents with skeletal Class I and Class II malocclusions at all time points, while the lengths of the upper and lower oropharyngeal regions and the pharyngeal airway areas were significantly smaller in the skeletal Class II adolescents before treatment when compared to the control adolescents (p < 0.05). However, following treatment with a functional appliance, the skeletal Class II adolescents had increased pharyngeal airway dimensions, which became similar to those of the control subjects. Conclusions: Functional appliance therapy can increase the pharyngeal airway dimensions in growing adolescents with skeletal Class II malocclusions, and this effect is maintained until the completion of growth.
Objective: The aim of this study was to evaluate long-term changes in the pharyngeal airway dimensions after functional appliance treatment in adolescents with skeletal Class II malocclusions. Methods: Pharyngeal airway dimensions were compared between subjects with skeletal Class II malocclusions (n = 24; mean age: $11.6{\pm}1.29$ years) treated with a Class II bionator and age-matched control subjects with skeletal Class I occlusions (n = 24; mean age: $11.0{\pm}1.21$ years) using a series of lateral cephalograms obtained at the initial visit (T0), after treatment (T1), and at the completion of growth (T2). Results: The length of the nasopharyngeal region was similar between adolescents with skeletal Class I and Class II malocclusions at all time points, while the lengths of the upper and lower oropharyngeal regions and the pharyngeal airway areas were significantly smaller in the skeletal Class II adolescents before treatment when compared to the control adolescents (p < 0.05). However, following treatment with a functional appliance, the skeletal Class II adolescents had increased pharyngeal airway dimensions, which became similar to those of the control subjects. Conclusions: Functional appliance therapy can increase the pharyngeal airway dimensions in growing adolescents with skeletal Class II malocclusions, and this effect is maintained until the completion of growth.
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문제 정의
Thus, the objective of this study was to evaluate the short-term and long-term changes in pharyngeal airway dimensions in adolescents with skeletal Class II malocclusions treated only with functional appliances.
제안 방법
A two-sample t-test was conducted to compare intergroup differences in changes in pharyngeal airway dimensions. The interaction effect was calculated by using a linear mixed model in order to identify the relationship between the skeletal measurements and pharyngeal airway measurements. One operator examined all measurements.
The interaction effects between the skeletal measurements (SNA, SNB, ANB, gonial angle, Mn plane angle, Mx base, Mn base, and Mx-Mn) and pharyngeal airway measurements (D1, D2, D3, and Area) were examined using a linear mixed model. Gonial angle (p < 0.
The software program, V-Ceph 6.0 (Osstem Implant Co. Ltd., Seoul, Korea), was used to perform five linear and four angular measurements. A line was reconstructed 7o upward from the Sella-Nasion line at Nasion and was defined as the horizontal reference plane (HRP); a line perpendicular to the HRP and tangent to the anterior wall of Sella was defined as the vertical reference plane (VRP) (Figure 1).
Therefore, in this study, the narrowest distances from the posterior soft palate to the posterior pharyngeal wall and the narrowest distance from the posterior tongue base to the posterior pharyngeal wall were used as measurements for the upper and lower oropharyngeal regions, respectively. From a comparison of the bionator and control groups, adolescents with skeletal Class II malocclusions had significantly smaller oropharyngeal regions when compared to adolescents with skeletal Class I malocclusions at the initial visit (p < 0.
One operator examined all measurements. To evaluate the intra-operator reliability, the same operator reanalyzed 30 randomly selected cephalometric tracings in a two-week interval. The intraclass correlation coefficient showed a high reliability (> 0.
대상 데이터
A total of 24 subjects were included in the bionator group (mean age: 11.6 ± 1.29 years), and the mean treatment period with a Class II bionator was around 2 years.
For the control group, age-matched subjects (mean age: 11.0 ± 1.21 years) who were diagnosed as skeletal Class I (0o < ANB < 4o) with minor dental crowding and had serial lateral cephalograms (T0; T1, taken 2 years after T0; and T2) along with matching hand-wrist radiographs were selected.
데이터처리
Paired t-test was used to compare changes in the pharyngeal airway dimensions within the groups during each observation period (T1-T0, T2-T1, and T2-T0). A two-sample t-test was conducted to compare intergroup differences in changes in pharyngeal airway dimensions. The interaction effect was calculated by using a linear mixed model in order to identify the relationship between the skeletal measurements and pharyngeal airway measurements.
The Wilcoxon rank sum test was used for gender comparison of the pharyngeal airway measurements at T0. Two-sample t-test was conducted to compare measurements between the bionator and control group. Paired t-test was used to compare changes in the pharyngeal airway dimensions within the groups during each observation period (T1-T0, T2-T1, and T2-T0).
성능/효과
For the overall changes from T0 to T2, the bionator group had significantly greater changes in D2, D3, and Area compared to those of the control group (p< 0.05).
This study showed that adolescents with skeletal Class II malocclusions treated with functional appliances experienced increased pharyngeal airway dimensions and that such changes were maintained throughout growth until the completion of growth.
참고문헌 (25)
1 Li Y Early orthodontic treatment of skeletal Class II malocclusion may be effective to prevent the potential for OSAHS and snoring Med Hypotheses 2009 73 594 595 19560281
2 Kim YJ Hong JS Hwang YI Park YH Three-dimensional analysis of pharyngeal airway in preadolescent children with different anteroposterior skeletal patterns Am J Orthod Dentofacial Orthop 2010 137 306.e1 306.e11 20197163
3 Subtelny JD To treat or not to treat Int Dent J 1973 23 292 303 4516310
4 Bishara SE Hoppens BJ Jakobsen JR Kohout FJ Changes in the molar relationship between the deciduous and permanent dentitions: a longitudinal study Am J Orthod Dentofacial Orthop 1988 93 19 28 3422119
5 You ZH Fishman LS Rosenblum RE Subtelny JD Dentoalveolar changes related to mandibular forward growth in untreated Class II persons Am J Orthod Dentofacial Orthop 2001 120 598 607 11742304
6 Proffit WR Fields HW Sarver DM Contemporary orthodontics 5th ed St. Louis Elsevier 2012 141 145
7 Späth-Schwalbe E Hundenborn C Kern W Fehm HL Born J Nocturnal wakefulness inhibits growth hormone (GH)-releasing hormone-induced GH secretion J Clin Endocrinol Metab 1995 80 214 219 7829614
8 Born J Muth S Fehm HL The significance of sleep onset and slow wave sleep for nocturnal release of growth hormone (GH) and cortisol Psychoneuroendocrinology 1988 13 233 243 3406323
9 Agren K Nordlander B Linder-Aronsson S Zettergren-Wijk L Svanborg E Children with nocturnal upper airway obstruction: postoperative orthodontic and respiratory improvement Acta Otolaryngol 1998 118 581 587 9726687
10 Williams EF 3rd Woo P Miller R Kellman RM The effects of adenotonsillectomy on growth in young children Otolaryngol Head Neck Surg 1991 104 509 516 1903865
11 Hiyama S Kuribayashi G Ono T Ishiwata Y Kuroda T Nocturnal masseter and suprahyoid muscle activity induced by wearing a bionator Angle Orthod 2002 72 48 54 11843273
12 Ozbek MM Memikoglu TU Gögen H Lowe AA Baspinar E Oropharyngeal airway dimensions and functional-orthopedic treatment in skeletal Class II cases Angle Orthod 1998 68 327 336 9709833
13 Hänggi MP Teuscher UM Roos M Peltomäki TA Long-term changes in pharyngeal airway dimensions following activator-headgear and fixed appliance treatment Eur J Orthod 2008 30 598 605 18974068
14 Fishman LS Radiographic evaluation of skeletal maturation. A clinically oriented method based on hand-wrist films Angle Orthod 1982 52 88 112 6980608
15 Baccetti T Franchi L McNamara JA Jr Tollaro I Early dentofacial features of Class II malocclusion: a longitudinal study from the deciduous through the mixed dentition Am J Orthod Dentofacial Orthop 1997 111 502 509 9155809
16 Goncalves JR Buschang PH Goncalves DG Wolford LM Postsurgical stability of oropharyngeal airway changes following counter-clockwise maxillo-mandibular advancement surgery J Oral Maxillofac Surg 2006 64 755 762 16631481
17 Restrepo C Santamaría A Peláez S Tapias A Oropharyngeal airway dimensions after treatment with functional appliances in class II retrognathic children J Oral Rehabil 2011 38 588 594 21294763
18 Hwang CJ Ryu YK A longitudinal study of nasopharynx and adenoid growth of Korean children Korean J Orthod 1985 15 93 103
19 Harris JA Jacksn CM Paterson DG Scammon RE The measurement of man Minneapolis University of Minnesota Press 1930
20 Subtelny JD Baker HK The significance of adenoid tissue in velopharyngeal function Plast Reconstr Surg (1946) 1956 17 235 250 13310262
21 Avrahami E Englender M Relation between CT axial cross-sectional area of the oropharynx and obstructive sleep apnea syndrome in adults AJNR Am J Neuroradiol 1995 16 135 140 7900582
22 Abu Allhaija ES Al-Khateeb SN Uvulo-glosso-pharyngeal dimensions in different anteroposterior skeletal patterns Angle Orthod 2005 75 1012 1018 16448247
23 Ceylan I Oktay H A study on the pharyngeal size in different skeletal patterns Am J Orthod Dentofacial Orthop 1995 108 69 75 7598107
24 Rose EC Germann M Sorichter S Jonas IE Case control study in the treatment of obstructive sleep-disordered breathing with an intraoral protrusive appliance J Orofac Orthop 2004 65 489 500 15570407
25 McNamara JA Jr A method of cephalometric evaluation Am J Orthod 1984 86 449 469 6594933
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