Effect of Orthopedic Treatment for Class III Malocclusion on Upper Airways: A Systematic Review and Meta-Analysis

Havakeshian, Golnar; Koretsi, Vasiliki; Eliades, Theodore; Papageorgiou, Spyridon N.

doi:10.3390/jcm9093015

Cited by 19 publications

(15 citation statements)

References 51 publications

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“…In the SA group with a higher level of maxillary protraction, AD1‐PNS, AD2‐PNS, PNS‐Ba and PNS‐Ho measurements increased in parallel with the skeletal measurements. In the literature, a mean of 2.1 mm in maxillary protraction with a face mask and in AD1‐PNS measurement has been associated with an average increase of 2.45 mm in AD2‐PNS 38 . Our study results indicated that a similar increase was observed in the RME and Alt‐RAMEC groups in AD1‐PNS, AD2‐PNS and PNS‐Ba measurements, whereas a higher than average increase was found in the SA group.…”

Section: Discussionsupporting

confidence: 77%

Determining the short‐term effects of different maxillary protraction methods on pharyngeal airway dimensions

Kale

Büyükçavuş

2021

Orthod Craniofacial Res

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Objective This study sought to evaluate the effects of different maxillary protraction methods on the pharyngeal airway in Class III patients with maxillary retrognathia. Setting and Sample Population A total of 59 individuals (31 females and 28 males) with a mean age of 11.38 ± 1.24 years were included in this study. Material and Methods Fifty‐nine treated maxillary retrognathic patients who underwent different protraction methods were evaluated. Twenty patients treated with RME (Rapid Maxillary Expansion) made up the first group, and 20 patients treated with 5‐week Alt‐RAMEC (Alternate Rapid Maxillary Expansion and Constriction) protocol comprised the second group. Lastly, 19 patients on whom face masks with miniplates were applied were included in the skeletal anchorage (SA) group. Sixteen linear and four areal pharyngeal airway measurements were made on lateral cephalograms before and after treatment. Differences between the groups were assessed using analysis of variance (ANOVA) tests. Results The mean maxillary protraction levels were determined as 2.7, 3.69 and 4.01 mm in the RME, Alt‐RAMEC and SA groups, respectively. In the nasopharynx, AD1‐PNS, AD2‐PNS, PNS‐Ba and PNS‐Ho measurements revealed a significant increase in the SA group compared to the other groups (P < .05). In the oropharynx, PNS‐Ep measurement increased significantly in the RME group (P < .05). In the total pharyngeal airway area, an increase was detected in the SA, Alt‐RAMEC, and RME groups. Conclusion The most effective protraction method in terms of pharyngeal airway dimensions, especially in the nasopharynx, is the application of the face mask with skeletal anchorage. A greater increase in vertical airway length (PNS‐Ep) was observed with RME.

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Section: Discussionsupporting

confidence: 77%

Determining the short‐term effects of different maxillary protraction methods on pharyngeal airway dimensions

Kale

Büyükçavuş

2021

Orthod Craniofacial Res

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“…The sole included study assessing long-term status of treated Class II patients [35] indicated that not only were the benefits of functional appliance treatment retained 6 years afterwards, but a significantly greater post-treatment increase was seen. This is also consistent with previous evidence on the long-term stability of increased airway dimensions among patients with skeletal Class III treated orthopedically with maxillary protraction [55].…”

Section: Evidence In Contextsupporting

confidence: 92%

Orthopedic Treatment for Class II Malocclusion with Functional Appliances and Its Effect on Upper Airways: A Systematic Review with Meta-Analysis

Bidjan

Sallmann

Eliades

et al. 2020

JCM

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Aim of this systematic review was to assess the effects of orthopedic treatment for Class II malocclusion with Functional Appliances (FAs) on the dimensions of the upper airways. Eight databases were searched up to October 2020 for randomized or nonrandomized clinical studies on FA treatment of Class II patients with untreated control groups. After duplicate study selection, data extraction, and risk of bias assessment according to Cochrane guidelines, random effects meta-analyses of mean differences (MDs) and their 95% confidence intervals (CIs) were performed, followed by subgroup/meta-regression analyses and assessment of the quality of evidence. A total of 20 nonrandomized clinical studies (4 prospective/16 retrospective) including 969 patients (47.9% male; mean age 10.9 years) were identified. Orthopedic treatment with FAs was associated with increased oropharynx volume (MD = 2356.14 mm3; 95% CI = 1276.36 to 3435.92 mm3; p < 0.001) compared to natural growth. Additionally, significant increases in nasopharynx volume, minimal constricted axial area of pharyngeal airway, and airway were seen, while removable FAs showed considerably greater effects than fixed FAs (p = 0.04). Finally, patient age and treatment duration had a significant influence in the effect of FAs on airways, as had baseline matching and sample size adequacy. Clinical evidence on orthopedic Class II treatment with FAs is associated with increased upper airway dimensions. However, the quality of evidence is very low due to methodological issues of existing studies, while the clinical relevance of increases in airway dimensions remains unclear.

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“…Maxillary deficiency in growing subjects, when left untreated, can lead to severe functional, aesthetic, breathing and psychological problems [ 1 , 2 , 3 , 4 , 5 , 6 ]. Important treatment goals in cleft patients are to establish a normal dental occlusion and to correct the skeletal discrepancy for psychological and functional well-being [ 7 , 8 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Skeletal Changes in Growing Cleft Patients with Class III Malocclusion Treated with Bone Anchored Maxillary Protraction—A 3.5-Year Follow-Up

Steegman

Meulekamp

Dieters

et al. 2021

JCM

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This prospective controlled trial aimed to evaluate the skeletal effect of 3.5-years bone anchored maxillary protraction (BAMP) in growing cleft subjects with a Class III malocclusion. Subjects and Method: Nineteen cleft patients (11.4 ± 0.7-years) were included from whom cone beam computed tomography (CBCT) scans were taken before the start of BAMP (T0), 1.5-years after (T1) and 3.5 y after (T2). Seventeen age- and malocclusion-matched, untreated cleft subjects with cephalograms available at T0 and T2 served as the control group. Three dimensional skeletal changes were measured qualitatively and quantitatively on CBCT scans. Two dimensional measurements were made on cephalograms. Results: Significant positive effects have been observed on the zygomaticomaxillary complex. Specifically, the A-point showed a displacement of 2.7 mm ± 0.9 mm from T0 to T2 (p < 0.05). A displacement of 3.8 mm ± 1.2 mm was observed in the zygoma regions (p < 0.05). On the cephalograms significant differences at T2 were observed between the BAMP and the control subjects in Wits, gonial angle, and overjet (p < 0.05), all in favor of the treatment of Class III malocclusion. The changes taking place in the two consecutive periods (ΔT1-T0, ΔT2-T1) did not differ, indicating that not only were the positive results from the first 1.5-years maintained, but continuous orthopedic effects were also achieved in the following 2-years. Conclusions: In conclusion, findings from the present prospective study with a 3.5-years follow-up provide the first evidence to support BAMP as an effective and reliable treatment option for growing cleft subjects with mild to moderate Class III malocclusion up to 15-years old.

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Effect of Orthopedic Treatment for Class III Malocclusion on Upper Airways: A Systematic Review and Meta-Analysis

Cited by 19 publications

References 51 publications

Determining the short‐term effects of different maxillary protraction methods on pharyngeal airway dimensions

Determining the short‐term effects of different maxillary protraction methods on pharyngeal airway dimensions

Orthopedic Treatment for Class II Malocclusion with Functional Appliances and Its Effect on Upper Airways: A Systematic Review with Meta-Analysis

Skeletal Changes in Growing Cleft Patients with Class III Malocclusion Treated with Bone Anchored Maxillary Protraction—A 3.5-Year Follow-Up

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