Oropharyngeal airway dimensions after treatment with functional appliances in class II retrognathic children

Abstract

Class II skeletal malocclusion and respiratory disorders owing to the obstruction of the upper airway at early growth stages have been correlated. The retro/micrognathism can be treated with functional appliances. However, the effects of an early functional orthopedic treatment on the airway dimensions have not been evaluated before the growth peak. Therefore, the objective of this study was to evaluate the changes in the airway dimensions of class II retrognathic children who received treatment with either Klammt or Bionator on a pre-pubertal stage. The sample consisted of 50 lateral cephalograms of class II retrognathic patients in a pre-puberal stage, before and after the use of a Klammt or Bionator II treatment for 1 year. The data were evaluated by Student's t-test or Mann-Whitney test, and significance was set at 5% (P < 0·05). When the measurements before and after treatment were compared, a statistically significant increase in the airway dimensions was found at the space where the adenoid tissue was located. The only airway dimensions that increased after treatment with functional appliances were the ones located at the nasopharynx. The adenoid tissue is still in the peak of growing at the ages of the subjects included in this study. However, the measurements along the nasopharynx increased when compared with the initial ones. Still, similar retrospective and prospective studies are needed at older stages.

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

“…However, in contrast to our observation, Restrepo et al 15 reported a significant increase in the nasopharyngeal airway dimensions among Class II subjects treated by Klammt or bionator appliance.…”

“…9,10 Although there are numerous studies those have evaluated the nature of Class II correction by various functional appliances in growing skeletal Class II children, there are only a few studies that mention the PAP dimension changes following functional appliance treatment. Studies have been conducted to evaluate the effect of the Harvold activator, 11 an activator with high-pull headgear, 12 cervical headgear, 6 the Farmand appliance, 13 the modified bionator, 14 the Klammt appliance, 15 the Herbst appliance, 16 and rapid maxillary expansion with Herbst appliance therapy 17 on the PAP in Class II patients. However, to our knowledge there is no study in the literature mentioning the effect of the most commonly used functional appliance, that is, the twinblock appliance, in the improvement of PAP dimension among subjects with Class II malocclusion.…”

Effects of Functional Appliance Therapy on the Depth of the Pharyngeal Airways: Activator vs. Forsus

“…Eventually, the main objective of our study, i.e., subsequent effects of these appliances on the dimensions of pharyngeal airways, will be addressed. Having reviewed the literature, there are very few published studies [4,[10][11][12][13][14] that have investigated the effect of functional appliances on the dimensions of awake pharyngeal airways. Of these studies, four have included either headgear [4,10,12] or maxillary expansion [11] appliances in combination with functional appliances, and the other two studies have used only removable [13] The sample was then divided into two groups.…”

“…Having reviewed the literature, there are very few published studies [4,[10][11][12][13][14] that have investigated the effect of functional appliances on the dimensions of awake pharyngeal airways. Of these studies, four have included either headgear [4,10,12] or maxillary expansion [11] appliances in combination with functional appliances, and the other two studies have used only removable [13] The sample was then divided into two groups. The first group consisted of the subjects who were treated with removable functional appliances (Activator type), and the second group consisted of those who were treated with fixed functional appliances, Forsus Fatigue Resistant Device (FRD) (3M Unitek Corp, Monrovia, Calif).The sex and age distribution of the treatment groups are shown in Table 1.…”

Successful Long-Term Airway Stabilization With a Modified Pacifier in a Syndromic Infant

“…An oropharyngeal airway is a medical apparatus used to maintain a patent airway by preventing the tongue from obstructing the aperture of the upper airway. 1,2 Cleft palate is among the conditions that can cause difficult airway management, due to inability to optimally position the head, and to maldevelopment, which makes it difficult to obtain a good view of the upper airway structures. 3,4 We describe a syndromic infant with alobar holoprosencephaly, whose long-term airway patency was maintained with a modified infant pacifier.…”