Abstract
Background: This study aimed to compare the minimum axial (min Ax) area and the volumes of the nasopharyngeal (NP) and oropharyngeal (OP) airways of patients with Class II malocclusion with different sagittal positions of the mandible and maxilla and patients with Class I malocclusion with normal jaw positions.
Methods: Airway areas and volumes of 51 patients with Class I malocclusion with normal maxillary and mandibular positions (0 < ANB < 4, 84 > SNA > 80, and 82 > SNB > 78) were compared with 21 patients with Class II malocclusion with normal maxillary and retrognathic mandibular positions (ANB>4, 84>SNA>80, and SNB4, SNA>84, and 82>SNB>78).
Results: In the comparison of airway measurements between Class I and Class II groups, significant differences were found in the OP airway volume, total airway volume, and minimum OP axial area. Patients with Class II mandibular retrusion had smaller OP airway volume. The total airway volume and min Ax area were significantly lower in the Class II mandibular retrusion group than in other groups.
Conclusions: The sagittal position of the jaws affects the OP airway volume and the minimum axial airway area, but not the NP airway volume.
References
- Ackerman JL, Proffit WR. The characteristics of malocclusion: A modern approach to classification and diagnosis. Am J Orthod. 1969;56:443–54.
- McNamara JA, Bookstein FL, Shaughnessy TG. Skeletal and dental changes following functional regulator therapy on Class II patients. Am J Orthod. 1985;88:91–110.
- Kerr WJS. The nasopharynx, face height, and overbite. Angle Orthod. 1985;55:31–6.
- Zhong Z, Tang Z, Gao X, Zeng XL. A comparison study of upper airway among different skeletal craniofacial patterns in nonsnoring Chinese children. Angle Orthod. 2010;80:267–74.
- Joseph AA, Elbaum J, Cisneros GJ, Eisig SB. A cephalometric comparative study of the soft tissue airway dimensions in persons with hyperdivergent and normodivergent facial patterns. J Oral Maxillofac Surg. 1998;56:135–9.
- de Freitas MR, Alcazar NM, Janson G, de Freitas KM, Henriques JF. Upper and lower pharyngeal airways in subjects with Class I and Class II malocclusions and different growth patterns. Am J Orthod Dentofacial Orthop. 2006;130:742–5.
- Banno K, Kryger MH. Sleep apnea: Clinical investigations in humans. Sleep Med. 2007;8:400–26.
- Tourné LP. Growth of the pharynx and its physiologic implications. Am J Orthod Dentofacial Orthop. 1991;99:129–39.
- Uçar Fİ, Uysal T. Orofacial airway dimensions in subjects with Class I malocclusion and different growth patterns. Angle Orthod. 2011;81:460–8.
- Alves M, Franzotti E, Baratieri C, Nunes L, Nojima L, Ruellas A. Evaluation of pharyngeal airway space amongst different skeletal patterns. Int J Oral Maxillofac Surg. 2012;41:814–9.
- Oz U, Orhan K, Rubenduz M. Two-dimensional lateral cephalometric evaluation of varying types of Class II subgroups on posterior airway space in postadolescent girls: A pilot study. J Orofac Orthop. 2013;74:18–27.
- Ceylan I, Oktay H. A study on the pharyngeal size in different skeletal patterns. Am J Orthod Dentofacial Orthop. 1995;108:69–75.
- Eslami E, Katz ES, Baghdady M, Abramovitch K, Masoud MI. Are three-dimensional airway evaluations obtained through computed and cone-beam computed tomography scans predictable from lateral cephalograms? A systematic review of evidence. Angle Orthod. 2017;87:159–67.
- Aboudara C, Nielsen I, Huang JC, Maki K, Miller AJ, Hatcher D. Comparison of airway space with conventional lateral headfilms and 3-dimensional reconstruction from cone-beam computed tomography. Am J Orthod Dentofacial Orthop. 2009;135:468–79.
- Palomo JM, Rao PS, Hans MG. Influence of CBCT exposure conditions on radiation dose. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105:773–82.
- Yeung AW, Jacobs R, Bornstein MM. Novel low-dose protocols using cone beam computed tomography in dental medicine: A review focusing on indications, limitations, and future possibilities. Clin Oral Investig. 2019;23:2573–81.
- Thakur VK, Londhe S, Kumar P, Sharma M, Jain A, Pradhan I. Evaluation and quantification of airway changes in Class II division 1 patients undergoing myofunctional therapy using twin block appliance. Med J Armed Forces India. 2021;77:28–31.
- Silva NN, Lacerda RHW, Silva AWC, Ramos TB. Assessment of upper airways measurements in patients with mandibular skeletal Class II malocclusion. Dental Press J Orthod. 2015;20:86–93.
- El H, Palomo JM. An airway study of different maxillary and mandibular sagittal positions. Eur J Orthod. 2013;35:262–70.
- El H, Palomo JM. Measuring the airway in 3 dimensions: A reliability and accuracy study. Am J Orthod Dentofacial Orthop. 2010;137:S50.e1–9.
- Uslu-Akcam O. Pharyngeal airway dimensions in skeletal class II: A cephalometric growth study. Imaging Sci Dent. 2017;47:1–9.
- Jena AK, Singh SP, Utreja AK. Sagittal mandibular development effects on the dimensions of the awake pharyngeal airway passage. Angle Orthod. 2010;80:1061–7.
- 23. Muto T, Yamazaki A, Takeda S. A cephalometric evaluation of the pharyngeal airway space in patients with mandibular retrognathia and prognathia, and normal subjects. Int J Oral Maxillofac Surg. 2008;37:228–31.
- Grauer D, Cevidanes LS, Styner MA, Ackerman JL, Proffit WR. Pharyngeal airway volume and shape from cone-beam computed tomography: relationship to facial morphology. Am J Orthod Dentofacial Orthop. 2009;136:805–14.
- 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.e1–11.
- Kochhar AS, Sidhu MS, Bhasin R, Kochhar GK, Dadlani H, Sandhu J, et al. Cone beam computed tomographic evaluation of pharyngeal airway in North Indian children with different skeletal patterns. World J Radiol. 2021;13:40–52.
- Shokri A, Miresmaeili A, Ahmadi A, Amini P, Falah-Kooshki S. Comparison of pharyngeal airway volume in different skeletal facial patterns using cone beam computed tomography. J Clin Exp Dent. 2018;10:e1017–28.
- Shokri A, Mollabashi V, Zahedi F, Tapak L. Position of the hyoid bone and its correlation with airway dimensions in different classes of skeletal malocclusion using cone-beam computed tomography. Imaging Sci Dent. 2020;50:105–15.
- Chen YS, Chou ST, Cheng JH, Chen SC, Pan CY, Tseng YC. Importance in the occurrence distribution of minimum oropharyngeal cross-sectional area in the different skeletal patterns using cone-beam computed tomography. BioMed Res Int. 2021;2021:5585629.
- Wanzeler AMV, Renda MDO, de Oliveira Pereira ME, Alves-Junior SM, Tuji FM. Anatomical relation between nasal septum deviation and oropharynx volume in different facial patterns evaluated through cone beam computed tomography. Oral Maxillofac Surg. 2017;21:341–6.
- Kyung SH, Park YC, Pae EK. Obstructive sleep apnea patients with the oral appliance experience pharyngeal size and shape changes in three dimensions. Angle Orthod. 2005;75:15–22.
- Flores-Blancas AP, Carruitero MJ, Flores-Mir C. Comparison of airway dimensions in skeletal Class I malocclusion subjects with different vertical facial patterns. Dental Press J Orthod. 2017;22:35–42.
- Ung N, Koenig J, Shapiro PA, Shapiro G, Trask G. A quantitative assessment of respiratory patterns and their effects on dentofacial development. Am J Orthod Dentofacial Orthop. 1990;98:523–32.
- Mergen DC, Jacobs RM. The size of nasopharynx associated with normal occlusion and Class II malocclusion. Angle Orthod. 1970;40:342–6.
- Paul J, Nanda RS. Effect of mouth breathing on dental occlusion. Angle Orthod. 1973;43:201–6.
- El H, Palomo JM. Airway volume for different dentofacial skeletal patterns. Am J Orthod Dentofacial Orthop. 2011;139:e511–21.
- Kikuchi Y. Three-dimensional relationship between pharyngeal airway and maxillo-facial morphology. Bull Tokyo Dent Coll. 2008;49:65–75.
- Tso HH, Lee JS, Huang JC, Maki K, Hatcher D, Miller AJ. Evaluation of the human airway using cone-beam computerized tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:768–76.
Recommended Citation
Ay Ünüvar Y, Bilgiç Zortuk F, Özer T, Beycan K. The Pharyngeal Airways of Patients with Class II Malocclusion: A Cone-Beam Computed Tomography Analysis. Makara J Health Res. 2021;25.