Citation Information :
Cortese M, Pigato G, Casiraghi G, Ferrari M, Bianco E. Evaluation of the Oropharyngeal Airway Space in Class II Malocclusion Treated with Mandibular Activator: A Retrospective Study. J Contemp Dent Pract 2020; 21 (6):666-672.
Aim: The development of a class II malocclusion is usually related to a reduced oropharyngeal airway space. In order to prevent airway obstruction, functional appliances are commonly used for orthodontic therapy. The aim of the article is to verify if these appliances could positively influence oropharyngeal diameters preventing the onset of future respiratory disorders. Materials and methods: A group of 10 patients treated at the Dental Clinic of San Gerardo Hospital in Monza with mandibular activator was selected. Ten similar untreated class II subjects with retrognathic mandible were used as control group. The cephalometric tracings were made on lateral teleradiographs of the skull before and after the active therapy with functional devices for the treated group and before and after growth peak for the control one. Descriptive statistical analysis was calculated for all the cephalometric values in both study cases and control group using Excel worksheet. The data distribution was evaluated with Shapiro–Wilk test and the in-between group discrepancies were evaluated with Mann–Whitney U test. Results: At T1 period, both case and control groups showed a class II pattern. At T2 period, the study group shows an improvement in bones relationship with reduced ANB angles and OVJ measurements. The control group otherwise did not show any important changes in maxillo–mandibular discrepancies. The airway size increased in either group in most cases. No significant differences between the treated and control groups were detected for airway size neither in the upper, middle, nor lower level at the T1–T2 interval. Conclusion: The upper airway values did not show any significant discrepancies between the two groups during the observation period. Clinical significance: Functional devices were effective in solving class II relationships, but there is no evidence of successful breathing disorders prevention by using mandibular activators, probably due to the stability of airway tissues reached in pubertal age in both groups.
Galeotti A, Festa P, Viarani V, et al. Correlation between cephalometric variables and obstructive sleep apnoea severity in children. Eur J Paediatr Dent 2019;20(1):43–47. DOI: 10.23804/ejpd.2019.20. 01.09.
Özbek MM, Toygar Memikoglu TU, Gögen H, et al. Oropharyngeal airway dimensions and functional-orthopedic treatment in skeletal class II cases. Angle Orthod 1998;68(4):327–336. DOI: 10.1043/0003-3219(1998)0682.3.CO;2.
Maddalone M, Ferrari M, Stanizzi A, et al. Use of miniscrew implants in orthodontic distal movement [Utilizzo delle miniviti nelle meccaniche ortodontiche di distalizzazione]. Dent Cadmos 2010;78(8):97–105.
Maddalone M, Ferrari M, Barrila’ S, et al. Intrusive mechanics in orthodontics with the use of TAD's [Utilizzo delle miniviti nelle meccaniche ortodontiche di distalizzazione]. Dent Cadmos 2010;78(7):97–106.
Maddalone M. The association between the psychological status and the severity of facial deformity in orthognathic patients. Angle Orthodontist 2012;82(3):396–402. DOI: 10.2319/060211-363.1.
Shavakhi M, Mohamadian F, Zarif Najafi H. The effects of the headgear therapy on the airway dimensions in patients with class II malocclusion: a systematic review. Dent Med Probl 2019;56(2): 191–196. DOI: 10.17219/dmp/105957.
Maddalone M, Bianco E, Nanussi A, et al. Treatment of temporomandibular disorders of muscular origin with a silicon oral device (Alifix®): electromyographic analysis. J Contemp Dent Pract 2019;20(12):1367–1367. DOI: 10.5005/jp-journals-10024-2704.
Bianco E, Maddalone M, Porcaro G, et al. Treatment of osteoradionecrosis of the jaw with ozone in the form of oil-based gel: 1-year follow-up. J Contemp Dent Pract 2019;20(2):270–276. DOI: 10.5005/jp-journals-10024-2508.
Porcaro G, Busa A, Bianco E, et al. Use of a partial-thickness flap for Guided bone regeneration in the upper jaw. J Contemp Dent Pract 2017;18(12):1117–1121. DOI: 10.5005/jp-journals-10024-2186.
Ghodke S, Utreja AK, Singh SP, et al. An improved version of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth. Angle Orthod 2002;72(4):316–323. DOI: 10.1186/s40510-014-0068-3.
Afzal E, Fida M. Evaluation of the change in the tongue posture and in the hyoid bone position after twin block appliance therapy in skeletal class II subjects. Dent Med Probl 2019;56(4):379–384. DOI: 10.17219/dmp/111976.
Kawakami M, Yamamoto K, Fujimoto M, et al. Changes in tongue and hyoid positions, and posterior airway space following mandibular setback surgery. J Craniomaxillofac Surg 2005;33(2):107–110. DOI: 10.1016/j.jcms.2004.10.005.
Marsan G, Vasfi Kuvat S, Oztas E, et al. Oropharyngeal airway changes following bimaxillary surgery in class III female adults. J Craniomaxillofac Surg 2009;37(2):69–73. DOI: 10.1016/j.jcms.2008.11.001.
Cozza P, Baccetti T, Franchi L, et al. Mandibular changes produced by functional appliances in class II malocclusion: a systematic review. Am J Orthod Dentofacial Orthop 2006;129(5):599. DOI: 10.1016/j.ajodo.2005.11.010.
Bianco E, Attuati S, Brugali C, et al. Restoration of the vertical posterior dimension in a grinding patient before orthodontic treatment: A case-report with electromyographic evaluation of masticatory muscles balance. The Journal of Dentists 2019;7:38–42; Tulloch JF, Proffit WR, Phillips C. Outcomes in a 2-phase randomized clinical trial of early class II treatment. Am J Orthod Dentofacial Orthop 2004;125(6):657–67.
Bianco E. Factors influencing immediate maxillary dental implant placement and bone resorption: a review of the literature and an outlook on the clinical possibilities. Dent Med Probl 2016;53(3): 408–412. DOI: 10.17219/dmp/63185.
Fransson AM, Tegelberg A, Johansson A, et al. Influence on the masticatory system in treatment of obstructive sleep apnea and snoring with a mandibular protruding device: a 2-year follow-up. Am J Orthod Dentofacial Orthop 2004;126(6):687–693. DOI: 10.1016/j.ajodo.2003.10.040.
Bonham PE, Currier GF, Orr WC, et al. The effect of a modified functional appliance on obstructive sleep apnea. Am J Orthod Dentofacial Orthop 1988;94(5):384–392. DOI: 10.1016/0889-5406(88)90127-8.
Papageorgiou SN, Koretsi V, Jäger A. Bias from historical control groups used in orthodontic research: a metaepidemiological study. Eur J Orthod 2017;39(1):98–105. DOI: 10.1093/ejo/cjw035.
Clark GT, Arand D, Chung E, et al. Effect of anterior mandibular positioning on obstructive sleep apnea. Am Rev Respir Dis 1993;147(3):624–629. DOI: 10.1164/ajrccm/147.3.624.
Haskell JA, McCrillis J, Haskell BS, et al. Effects of mandibular advancement device (MAD) on airway dimensions assessed with cone-beam computed tomography. Semin Orthod 2009;15(2): 132–158. DOI: 10.1053/j.sodo.2009.02.001.
Bank S, Rhodes G, Read A, et al. Face and body recognition show similar improvement during childhood. J Exp Child Psychol 2015;137:1–11. DOI: 10.1016/j.jecp.2015.02.011.
Bandeca MC, Borges AH, Porto AN, et al. Prevalence of malocclusion in students in a subpopulation of Mato Grosso, Brazil. World J Dent 2018;9(4):260–264. DOI: 10.5005/jp-journals-10015-1545.
Agarwal A, Mathur R. An overview of orthodontic indices. World J Dent 2012;3(1):77–86.
Arens R, McDonough JM, Corbin AM, et al. Linear dimensions of the upper airway structure during development: Assessment by magnetic resonance imaging. Am J Respir Crit Care Med 2002;165(1):117–122. DOI: 10.1164/ajrccm.165.1.2107140.
Fujioka M, Young LW, Girdany BR. Radiographic evaluation of adenoidal size in children: adenoidal-nasopharyngeal ratio. AJR Am J Roentgenol 1979;133(3):401–404. DOI: 10.2214/ajr.133.3.401.
Bianco E, Rota D. Oral findings in rett syndrome: an update and review of the literature. Dent Med Probl 2018;55(4):441–445. DOI: 10.17219/dmp/99203.
Siddiqui TM, Wali A, Siddiqui F, et al. Effect of prolonged endodontic treatment on temporomandibular joint and masticatory muscles. World J Dent 9(1):38–42. DOI: 10.5005/jp-journals-10015-1504.
Vogler RC, Wippold FJ, Pilgram TK. Age-specific size of the normal adenoid pad on magnetic resonance imaging. Clin Otolaryngol Allied Sci 2000;25(5):392–395. DOI: 10.1046/j.1365-2273.2000.00381.x.
Shetty S, Nambiar S, Khyati N, et al. Correlation of mandibular incisor inclination to marginal bone levels and Cortical bone thickness in different skeletal patterns: a retrospective, cone beam Computed tomography study. World J Dent 2018;9(4):291–296. DOI: 10.5005/jp-journals-10015-1551.