INVESTIGATION THE RETROSPECTIVE CEPHALOMETRIC GROWTH CHANGES OF SAGITTAL AIRWAY IN SKELETAL CLASS 2 PATIENTS WITH COMPLETED FUNCTIONAL THERAPY

Year 2023, Volume: 32 Issue: 2, 244 - 251, 04.08.2023

İbrahim Berat Ay , Orhan Çiçek , Nurhat Özkalaycı

https://doi.org/10.34108/eujhs.1163116

Abstract

The aim of this study is to compare the changes in sagittal airway dimension after functionaltreatment. A total of 101 patients, 47 maleand 54 female, wereincluded in the study. Group were formed according to gender and appliance type and in patients with 65 removable (monoblock) and 36 fixed appliances (ForsusTM), Sella-Nasion-A angles (SNA), Sella-Nasion-B angles (SNB), and A noktası-Nasion-B angles (ANB) as airway dimensions; lower airway size (PNS-AD1), upper airway size (PNS-AD2), lower adenoid tissue (AD1-BA), upper adenoid tissue (AD2-HO), superior pharyngeal space (SPS), middle pharyngeal space (MPS) and inferior pharyngeal space (IPS) were measured and recorded. A significant increase was observed in all pharyngeal spaces in boys (p<0.05). While a significant increase was observed in the superior and inferior pharyngeal spaces in girls and in removable appliance group, a significant increase was observed only in the inferior pharyngeal space in fixed group (p<0.05). A significantly decrease in SNA and ANB and an increase in SNB were observed in all groups (p<0.05). The amount of increase in SNB and decrease in ANB were found to be significantly higher in removable group than in fixed group (p<0.05). It was seen that with the functional therapy of skeletal class 2 maloc clusions, both significant increases in sagittalair way dimensions were obtained and normal growth and development were managed.

Keywords

Growth, Functional Therapy, Malocclusion, Cephalometry

FONKSİYONEL TEDAVİSİ TAMAMLANMIŞ İSKELETSEL SINIF 2 HASTALARIN SAGİTTAL HAVAYOLUNUN RETROSPEKTİF SEFALOMETRİK BÜYÜME DEĞİŞİKLİKLERİNİN İNCELENMESİ

Abstract

Bu çalışmanın amacı, fonksiyonel tedavi sonrası sagittal havayolu boyutlarında meydana gelen değişikliklerin karşılaştırılmasıdır. Çalışmaya; 47 erkek ve 54 kız toplam 101 hasta dahil edildi. Gruplar; cinsiyet ve aparey tipine göre oluşturuldu.65 adet hareketli (monoblok) ve 36 adet sabit (ForsusTM) aparey kullanılmış hastalarda Sella-Nasion-A açısı (SNA), Sella-Nasion-B açısı (SNB), ve A-Nasion-B açısı (ANB)ve havayolu boyutlarında; alt havayolu boyutu (PNS-AD1), üst havayolu boyutu(PNS-AD2), alt adenoid doku boyutu (AD1-BA), üst adenoid doku boyutu (AD2-HO), üst faringeal boşluk (SPS), orta faringeal boşluk (MPS) ve alt faringeal boşluk (IPS) ölçülerek kaydedildi. Erkeklerde, faringeal boşlukların tümünde anlamlı artma gözlendi (p<0.05). Kızlarda ve hareketli aparey grubunda, üst ve alt faringeal boşluklarda anlamlı artma görülürken, sabit aparey grubunda sadece alt faringeal boşlukta anlamlı artma gözlendi (p<0.05). Tüm gruplarda, anlamlı şekilde SNA ve ANB açılarında azalma ve SNB açılarında artma gözlendi (p<0.05). SNB’de artma ve ANB’de azalma miktarı hareketli aparey grubunda sabit aparey grubuna göre anlamlı şekilde daha fazla bulundu (p<0.05). İskeletsel sınıf 2 maloklüzyonların fonksiyonel tedavisiyle, hem sagittal havayolu boyutlarında anlamlı artışlar sağlanırken hem de normal büyüme ve gelişmenin yönlendirildiği görüldü.

Keywords

Büyüme, Fonksiyonel tedavi, Maloklüzyon, Sefalometri

References

• Erbas B, Kocadereli I. Upper airway changes after Xbow appliance therapy evaluated with cone beam computed tomography. Angle Orthod 2014;84(4):693-700.
• Ali B, Shaikh A, Fida M. Effect of Clark’s twin-block appliance (CTB) and non-extraction fixed mechano-therapy on the pharyngeal dimensions of growing children. Dental Press J Orthod 2015;20(1):82-88.
• Rongo R, Martina S, Bucci R, et al. Short‐term effects of the Sander bite‐jumping appliance on the pharyngeal airways in subjects with skeletal Class II malocclusion: A retrospective case‐control study. J Oral Rehabil 2020;47(11):1337-1345.
• Rizk S, Kulbersh VP, Al-Qawasmi R. Changes in the oropharyngeal airway of Class II patients treated with the mandibular anterior repositioning appliance. Angle Orthod 2016;86(6):955-961.
• Tseng Y-C, Tsai F-C, Chou S-T, et al. Evaluation of pharyngeal airway volume for different dentofacial skeletal patterns using cone-beam computed tomography. J Dent Sci 2021;16(1):51-57.
• Elfeky H, Fayed MM. Three-dimensional effects of twin block therapy on pharyngeal airway parameters in Class II malocclusion patients. J World Fed Orthod 2015;4(3):114-119.
• Ekizer A, Türker G. Upper airway changes between different skeletal malocclusions. Cumhuriyet Dent J 2014;18(1):9-16.
• Kannan A, Sathyanarayana HP, Padmanabhan S. Effect of functional appliances on the airway dimensions in patients with skeletal class II malocclusion: A systematic review. J Orthod Sci 2017;6(2):54-64.
• Jena AK, Singh SP, Utreja AK. Effectiveness of twin-block and Mandibular Protraction Appliance-IV in the improvement of pharyngeal airway passage dimensions in Class II malocclusion subjects with a retrognathic mandible. Angle Orthod 2013;83(4):728-734.
• Aras I, Pasaoglu A, Olmez S, Unal I, Aras A. Upper airway changes following single-step or stepwise advancement using the Functional Mandibular Advancer. J Orofac Orthop 2016;77(6):454-462.
• Bavbek NC, Tuncer BB, Turkoz C, et al. Changes in airway dimensions and hyoid bone position following class II correction with forsus fatigue resistant device. Clin Oral Invest 2016;20(7):1747-1755.
• Ozdemir F, Ulkur F, Nalbantgil D. Effects of fixed functional therapy on tongue and hyoid positions and posterior airway. Angle Orthod 2014;84(2):260-264.
• Yavuz B, Kocadereli İ. Sınıf II malokluzyonlarda uygulanan tedavi yaklaşımlarının üst hava yolu üzerine etkileri. EÜ Dişhek Fak Derg 2013;34(2):66-72.
• Cortese M, Pigato G, Casiraghi G, et al. Evaluation of the oropharyngeal airway space in Class II malocclusion treated with mandibular activator: a retrospective study. J Contemp Dent Pract 2020;21(1):666-672.
• Trenouth M, Desmond S. A cephalometric evaluation of oropharyngeal airway changes during Twin-block appliance treatment. Int J Dent Oral Sci 2016;4004(1):22-30.
• Vizzotto MB, Liedke GS, Delamare EL, et al. A comparative study of lateral cephalograms and cone-beam computed tomographic images in upper airway assessment. Eur J Orthod 2012;34(3):390-393.
• Koretsi V, Zymperdikas VF, Papageorgiou SN, et al. Treatment effects of removable functional appliances in patients with Class II malocclusion: a systematic review and meta-analysis. Eur J Orthod 2015;37(4):418-434.
• Perinetti G, Contardo L. Reliability of growth indicators and efficiency of functional treatment for skeletal Class II malocclusion: current evidence and controversies. Biomed Res Int 2017;2017(1):1-19.
• Akhoon AB, Mushtaq M, Akhoon ZA. Myofunctional Appliances: An Overview. Int J Contemp Med 2021;8(9):11-15.
• Installation Instructions. In: Forsus™ Fatigue Resistant Device Treatment Guide. 3M Oral Care, 2510 Conway Avenue, St. Paul, USA; 2016. p.13-22.
• Galvão MCdS, Sato JR, Coelho EC. Dahlberg formula: a novel approach for its evaluation. Dental Press Journal of Orthodontics 2012;17(1):115-124.
• Xiang M, Hu B, Liu Y, Sun J, Song J. Changes in airway dimensions following functional appliances in growing patients with skeletal class II malocclusion: A systematic review and meta-analysis. Int J Pediatr Otorhinolaryngol 2017;97(1):170-180.
• Gandhi V, Mehta F, Joshi H. Treatment of class II malocclusion and impacted canines with two-phase orthodontic treatment. Contemp Clin Dent 2017;8(1):161-166.
• Fabiani G, Galván Galván J, Raucci G, et al. Pharyngeal airway changes in pre-pubertal children with Class II malocclusion after Fränkel-2 treatment. Eur J Paediatr Dent2017;18(1):291-295.
• Yassaei S, Tabatabaei Z, Ghafurifard R. Stability of pharyngeal airway dimensions, tongue and hyoid changes after treatment with a functional appliance. Int J Orthod Milwaukee 2012;23(1):9-15.
• Kaur S, Rai S, Kaur M. Comparison of reliability of lateral cephalogram and computed tomography for assessment of airway space. Niger J Clin Pract 2014;17(5):629-636.
• Martins LS, Liedke GS, Heraldo LDdS, et al. Airway volume analysis: is there a correlation between two and three-dimensions? Eur J Orthod 2018;40(3):262-267.
• Bronoosh P, Khojastepour L. Suppl 2: M2: Analysis of Pharyngeal Airway Using Lateral Cephalogram vs CBCT Images: A Cross-sectional Retrospective Study. Open Dent J 2015;9(1):263-266.
• Uslu-Akcam O. Pharyngeal airway dimensions in skeletal class II: A cephalometric growth study. Imaging Sci Dent 2017;47(1):1-9.
• Sarmadi S, Chalipa J, Tanbakuchi B, et al. Two-dimensional analysis of the size of nasopharynx and adenoids in non-syndromic unilateral cleft lip and palate patients using lateral cephalograms. J Dent (Tehran) 2018;15(3):161-168.
• Erdur EA, Bekir L. Twin-blok ve iskeletsel destekli forsus FRD apareylerinin faringeal havayolu üzerine etkilerinin karşılaştırılması. Selcuk Dent J 2020;7(3):455-461.
• Bilgiç F, Başaran G, Hamamci O. Comparison of Forsus FRD EZ and Andresen activator in the treatment of class II, division 1 malocclusions. Clin Oral Invest 2015;19(2):445-451.
• Shetty K, Saidath K, Shetty A, et al. Assessment and Comparison of Oropharyngeal Airway Dimensions in Skeletal Class II Cases Treated With Forsus FRD and Twin Block Appliances. J Health and Allied Sciences NU2017;7(2):8-18.
• Baka ZM, Fidanboy MO. Pharyngeal airway, hyoid bone, and soft palate changes after Class II treatment with Twin-block and Forsus appliances during the postpeak growth period. Am J Orthod Dentofacial Orthop 2021;159(2):148-157.
• Pavoni C, Lombardo EC, Franchi L, Lione R, Cozza P. Treatment and post-treatment effects of functional therapy on the sagittal pharyngeal dimensions in Class II subjects. Int J Pediatr Otorhinolaryngol 2017;101(1):47-50.
• Ali B, Shaikh A, Fida M. Changes in oro-pharyngeal airway dimensions after treatment with functional appliance in class II skeletal pattern. J Ayub Med Coll Abbottabad 2015;27(4):759-763.