Three-Dimensional Cephalometric Study of Upper Airway Space in Skeletal Class II and III Healthy Patients

Abstract

Because the pharynx and the dentofacial structures have close relationship, a mutual interaction can be expected to occur between them. The literature presents skeletal malocclusion as etiology for airway morphology changes and/or vice versa. The present three-dimensional cephalometric study from computed tomography scans was carried out to investigate upper airway space in normal nasal breathing patients presenting skeletal pattern of classes II and III. In addition, the statistical analysis was done according to gender criterion. The results revealed that the majority of the airway measurements have not been affected by type of malocclusion. The three-dimensional technology used in this study also allowed the volume and surface area calculations, and no statistical significance was found. The retroglossal width and posterior nasal cavity height mean were larger in males than females in the class II group, but volume and cross-section area were not statistically significant. However, in class III group, although the differences in linear and angular measures means were not significant, the retropalatal volume and retroglossal volume and cross-section area were larger in males. The authors highlight that the evaluation of upper airway space should be an integral part of diagnosis and treatment planning to achieve functional balance and stability of the results.

A comparative study of the pharyngeal airway space, measured with cone beam computed tomography, between patients with different craniofacial morphologies

“…Gravity can produce movements in oropharyngeal structures in response to postural changes between sitting upright and lying in the supine position (Sutthiprapaporn et al, 2008). Some investigators carried out their CBCT studies in an upright position (Hong et al, 2011;Oh et al, 2011;Claudino et al, 2013 andEl et al, 2011) whereas others performed them in a supine position (Alves et al, 2008 andDi Carlo et al, 2015).…”

Differences in pharyngeal according to angle class of malocclusion

“…Further evidence supports that anteroposterior jaw relationships are associated with airway morphology, which directly affects the OSA 4,10,11 . However, such studies have focused on skeletal criteria for defining their study groups.…”

“…1 at-So: the width of the pharyngeal tonsil between at and So. 10 Description of the parameters used to evaluate tongue position (Figure 4). pt-pw: the distance of the tongue from the posterior pharyngeal wall, measured between points pt and pw.…”

Three Dimensional Study of Upper Airway in Different Antero-posterior Jaw Relationships through Cone Beam Computed Tomography

“…But due to high radiation dose of CT, There will be some limitations for patients with severe craniofacial deformities and those who undergo surgical orthodontic treatment. (11)(12)(13) Recently Cone-Beam Computed Tomography(CBCT) systems are maxillofacial specific, and as the method used in CBCT scan is different from Multi Slice method in which the CT is used, its radiation dose would decrease and it can be used in a wide range of patients. (14) By developing the CBCT, the cross sectional and volumetric examinations about complicated anatomy of Pharyngeal airway have been possible, and the related researches confirm that airway volumetric measurements by CBCT is more accurate.…”

“…(9) Nowadays, modern technology of three-dimentional computed tomography(CT) has led to improvement in diagnostic abilities and has provided the possibility of airway volume evaluation. (10) Most three-dimentional studies of this field have been done by CT which provides high quality images for anatomic diagnosis of hard and soft tissues. But due to high radiation dose of CT, There will be some limitations for patients with severe craniofacial deformities and those who undergo surgical orthodontic treatment.…”