Evaluation of the Oropharyngeal Airway Space in Class II Malocclusion Treated with Mandibular Activator: A Retrospective Study

Evaluation of Skeletal, Dentoalveolar, and Sagittal Airway Changes Induced by the Mandibular Anterior Repositioning Appliance (MARA) in Class II Malocclusion: A Retrospective Controlled Study on Lateral Cephalograms

“…In disagreement with what was observed in Rizk et al's study [12], Cortese et al [26] evaluated changes in airway dimensions on lateral cephalograms in 10 patients treated with mandibular activators, such as the Andresen monoblock and the Twin Block, according to Clark, compared to a control group of 10 untreated subjects. In line with the results of our study, Cortese et al [26] found no significant differences in upper, middle, and lower airway changes between the two groups during the observation period (superior-posterior airway space (SPAS) 1.3 mm vs. −0.5 mm, p = 0.1157; middle airway space (MAS) 1 mm vs. 0.2 mm, p = 0.2954; inferior airway space (IAS) 1.1 mm vs. −0.3 mm, p = 0.4682).…”

Novel Therapies for Preventing, Managing and Treating Obstructive Sleep Apnea and Snoring in Pediatric and Adult Patients

“…[27][28][29][30] While a few studies enrolled children with confirmed OSA, 31,32 most studies did not assess for the presence of OSA by a diagnostic PSG prior to study inclusion. [33][34][35][36][37][38][39][40][41][42][43][44] Instead, these studies enrolled participants who might have OSA as demonstrated by an increased risk for sleepdisordered breathing, using methods such as questionnaires (PSQ 45 or other unidentified questionnaires), parental report, symptoms, and/or craniofacial characteristics, [33][34][35][36][37][38][39][40][41][42]44,46 all of which compromise the conclusions in addressing OSA. While the AHI is an imperfect measure of OSA, it is still recognized as the current standard measure in diagnosing pediatric OSA.…”

“…Unfortunately, awake airway size does not reflect supine sleep airway anatomy due to an altered physiological state and head position. 14,[34][35][36][37][38][39][40][41][42][43][44]46,51,52 In addition to the lack of pre-intervention and postintervention AHI data, another major study limitation was the lack of untreated controls to account for normal growth and development and, hence, self-correction during the study period. In essence, treating a child's airway space would be equivalent to treating a child's height and attributing credit for growth to an intervention that was simply coincident to the outcome of measured growth.…”