Skip to main content
Erschienen in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 4/2011

01.08.2011 | Original article

Effects of fixed appliances in correcting Angle Class II on the depth of the posterior airway space

FMA vs. Herbst appliance—a retrospective cephalometric study

verfasst von: Prof. Dr. G. Kinzinger, K. Czapka, B. Ludwig, B. Glasl, U. Gross, J. Lisson

Erschienen in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie | Ausgabe 4/2011

Einloggen, um Zugang zu erhalten

Abstract

Objective

The objective of this retrospective study based on the metric evaluation of lateral cephalograms was to investigate the extent to which treatment with two different fixed appliances for the correction of Angle Class II influenced the morphology of the extrathoracic airway space (the posterior airway space, PAS).

Patients and methods

A total of 43 patients with Angle Class II malocclusion were classified into two groups according to the appliance used for treatment: the functional mandibular advancer (FMA; n = 18) or the Herbst appliance (n = 25). Lateral cephalograms were taken of each patient at the start of functional jaw orthopedic treatment (time point T1) and at its completion (time point T2). Specific distances and angles were measured and analyzed in a cephalometric analysis.

Results

We observed major differences among the 43 patients in the depth of the posterior airway space during treatment with fixed appliances for Angle Class II correction. Regression analysis revealed that changes in sagittal and vertical positions had different effects on the depth of specific PAS sections: increases in anterior facial height are associated proportionately with increases in PAS width, particularly in the upper region. On the other hand, increases in posterior facial height and in the mandible’s forward displacement correlated inversely to the decreases in depth, particularly in the central and lower PAS regions. The two treatment appliances (FMA, Herbst appliance) had the same effects on extrathoracic airway depth.

Conclusions

Analyses of lateral cephalograms indicate that Angle Class II treatment with fixed appliances does not prevent sleep apnea in patients at risk. Nevertheless, this study does not permit absolutely reliable conclusions about the dimensions of the pharyngeal airway space. As the lateral cephalogram provides good images of structures in the midsagittal plane but is incapable of imaging the transverse dimension, there is an automatic lack of information concerning the precise width and volume of the extrathoracic airway space.
Literatur
1.
Zurück zum Zitat Battagel J, Johal A, Kotecha B (2000) A cephalometric comparison of subjects with snoring and obstructive sleep apnea. Eur J Orthod 22:353–365PubMedCrossRef Battagel J, Johal A, Kotecha B (2000) A cephalometric comparison of subjects with snoring and obstructive sleep apnea. Eur J Orthod 22:353–365PubMedCrossRef
2.
Zurück zum Zitat Bishara SE, Jakobsen JR, Vorhies B et al (1997) Changes in dentofacial structures in untreated Class II division 1 and normal subjects: a longitudinal study. Angle Orthod 67:55–56PubMed Bishara SE, Jakobsen JR, Vorhies B et al (1997) Changes in dentofacial structures in untreated Class II division 1 and normal subjects: a longitudinal study. Angle Orthod 67:55–56PubMed
3.
Zurück zum Zitat Björk A (1963) Variations in the growth of the human mandible: longitudinal radiographic study by the implant method. J Dent Res [Suppl]42:400–411 Björk A (1963) Variations in the growth of the human mandible: longitudinal radiographic study by the implant method. J Dent Res [Suppl]42:400–411
4.
Zurück zum Zitat Björk A, Skieller V (1972) Facial development and tooth eruption. An implant study at the age of puberty. Am J Orthod 62:339–383PubMedCrossRef Björk A, Skieller V (1972) Facial development and tooth eruption. An implant study at the age of puberty. Am J Orthod 62:339–383PubMedCrossRef
5.
Zurück zum Zitat Björk A, Skieller V (1983) Normal and abnormal growth in the mandible. A synthesis of longitudinal cephalometric implant studies over a period of 25 years. Eur J Orthod 5:1–46PubMed Björk A, Skieller V (1983) Normal and abnormal growth in the mandible. A synthesis of longitudinal cephalometric implant studies over a period of 25 years. Eur J Orthod 5:1–46PubMed
6.
Zurück zum Zitat Buschang PH, Tanguay R, Turkewicz J et al (1986) Polynomial approach to craniofacial growth: description and comparison of adolescent males with normal occlusion and those with untreated Class II malocclusion. Am J Orthod Dentofacial Orthop 90:437–442PubMedCrossRef Buschang PH, Tanguay R, Turkewicz J et al (1986) Polynomial approach to craniofacial growth: description and comparison of adolescent males with normal occlusion and those with untreated Class II malocclusion. Am J Orthod Dentofacial Orthop 90:437–442PubMedCrossRef
7.
Zurück zum Zitat Buschang PH, Tanguay R, Demirjian A et al (1988) Mathematical models of longitudinal mandibular growth for children with normal and untreated Class II, division 1 malocclusion. Eur J Orthod 10:227–234PubMed Buschang PH, Tanguay R, Demirjian A et al (1988) Mathematical models of longitudinal mandibular growth for children with normal and untreated Class II, division 1 malocclusion. Eur J Orthod 10:227–234PubMed
8.
Zurück zum Zitat Cooke ME, Battagel JM (2006) A thermoplastic mandibular advancement device for the management of non-apnoeic snoring: a randomized controlled trial. Eur J Orthod 28:327–338PubMedCrossRef Cooke ME, Battagel JM (2006) A thermoplastic mandibular advancement device for the management of non-apnoeic snoring: a randomized controlled trial. Eur J Orthod 28:327–338PubMedCrossRef
9.
Zurück zum Zitat Dahlberg G (1940) Statistical methods for medical and biological students. Interscience Publications, New York Dahlberg G (1940) Statistical methods for medical and biological students. Interscience Publications, New York
10.
Zurück zum Zitat Fransson AMC, Tegelberg A, Svenson BAH et al (2000) Influence of mandibular protruding device on airway passages and dentofacial characteristics in obstructive sleep apnea and snoring. Am J Orthod Dentofacial Orthop 122:371–379CrossRef Fransson AMC, Tegelberg A, Svenson BAH et al (2000) Influence of mandibular protruding device on airway passages and dentofacial characteristics in obstructive sleep apnea and snoring. Am J Orthod Dentofacial Orthop 122:371–379CrossRef
11.
Zurück zum Zitat Frye L, Diedrich PR, Kinzinger GSM (2009) Class II treatment with fixed functional orthodontic appliances before and after the pubertal growth peak—a cephalometric study to evaluate differential therapeutic effects. J Orofac Orthop 70:511–527PubMedCrossRef Frye L, Diedrich PR, Kinzinger GSM (2009) Class II treatment with fixed functional orthodontic appliances before and after the pubertal growth peak—a cephalometric study to evaluate differential therapeutic effects. J Orofac Orthop 70:511–527PubMedCrossRef
12.
Zurück zum Zitat Grauer D, Cevidanes LSH, Styner MA et al (2009) Pharyngeal airway volume and shape from cone-beam computed tomography: relationship to facial morphology. Am J Orthod Dentofacial Orthop 136:805–814PubMedCrossRef Grauer D, Cevidanes LSH, Styner MA et al (2009) Pharyngeal airway volume and shape from cone-beam computed tomography: relationship to facial morphology. Am J Orthod Dentofacial Orthop 136:805–814PubMedCrossRef
13.
Zurück zum Zitat Hilgers RD, Bauer P, Scheiber V (2002) Einführung in die medizinische Statistik. Springer, Berlin Heidelberg New York Hilgers RD, Bauer P, Scheiber V (2002) Einführung in die medizinische Statistik. Springer, Berlin Heidelberg New York
14.
Zurück zum Zitat Hochban W (1995) Das obstruktive Schlafapnoesyndrom. Diagnostik und Therapie unter besonderer Berücksichtigung kraniofazialer Anomalien 1. Blackwell Wissenschafts-Verlag, Berlin Wien Hochban W (1995) Das obstruktive Schlafapnoesyndrom. Diagnostik und Therapie unter besonderer Berücksichtigung kraniofazialer Anomalien 1. Blackwell Wissenschafts-Verlag, Berlin Wien
15.
Zurück zum Zitat Iwasaki T, Hayasaki H, Takemoto Y et al (2009) Oropharyngeal airway in children with Class III malocclusion evaluated by cone-beam computed tomography. Am J Orthod Dentofacial Orthop 136:318–319PubMedCrossRef Iwasaki T, Hayasaki H, Takemoto Y et al (2009) Oropharyngeal airway in children with Class III malocclusion evaluated by cone-beam computed tomography. Am J Orthod Dentofacial Orthop 136:318–319PubMedCrossRef
16.
Zurück zum Zitat Kinzinger G, Diedrich P (2005) Skeletal effects in Class II treatment with the Functional Mandibular Advancer (FMA)? J Orofac Orthop 66:469–490PubMedCrossRef Kinzinger G, Diedrich P (2005) Skeletal effects in Class II treatment with the Functional Mandibular Advancer (FMA)? J Orofac Orthop 66:469–490PubMedCrossRef
17.
Zurück zum Zitat Kinzinger G, Frye L, Diedrich P (2009) Class II treatment in adults: comparing camouflage orthodontics, dentofacial orthopedics and orthognathic surgery—a cephalometric study to evaluate various therapeutic effects. J Orofac Orthop 70:63–91PubMedCrossRef Kinzinger G, Frye L, Diedrich P (2009) Class II treatment in adults: comparing camouflage orthodontics, dentofacial orthopedics and orthognathic surgery—a cephalometric study to evaluate various therapeutic effects. J Orofac Orthop 70:63–91PubMedCrossRef
18.
Zurück zum Zitat Kinzinger G, Czapka K, Ludwig B et al (2011) Treatment effects of fixed functional appliances during correction of Angle Class II, Div. 1 malocclusions on the depth of the extrathoracal airway—4 case reports. Kieferorthop 25:37–50 Kinzinger G, Czapka K, Ludwig B et al (2011) Treatment effects of fixed functional appliances during correction of Angle Class II, Div. 1 malocclusions on the depth of the extrathoracal airway—4 case reports. Kieferorthop 25:37–50
19.
Zurück zum Zitat Kinzinger G, Czapka K, Ludwig B et al (2011) Bite jumping with the Herbst-appliance—short term and long term effects on the pharyngeal airway depth. J Clin Orthod (in press) Kinzinger G, Czapka K, Ludwig B et al (2011) Bite jumping with the Herbst-appliance—short term and long term effects on the pharyngeal airway depth. J Clin Orthod (in press)
20.
Zurück zum Zitat Lowe AA, Fleetham J, Adachi S et al (1995) Cephalometric and computed tomographic predictors of obstructive sleep apnea severity. Am J Orthod Dentofacial Orthop 107:589–595PubMedCrossRef Lowe AA, Fleetham J, Adachi S et al (1995) Cephalometric and computed tomographic predictors of obstructive sleep apnea severity. Am J Orthod Dentofacial Orthop 107:589–595PubMedCrossRef
21.
Zurück zum Zitat Rose EC, Staats R, Lehner M et al (2002) Cephalometric analysis in patients with obstructive sleep apnea. Part I: Diagnostic value. J Orofac Orthop 63:143–153PubMedCrossRef Rose EC, Staats R, Lehner M et al (2002) Cephalometric analysis in patients with obstructive sleep apnea. Part I: Diagnostic value. J Orofac Orthop 63:143–153PubMedCrossRef
22.
Zurück zum Zitat Rose EC, Germann M, Sorichter S et al (2004) Case control study in the treatment of obstructive sleep-disordered breathing with a mandibular protrusive appliance. J Orofac Orthop 65:489–500PubMedCrossRef Rose EC, Germann M, Sorichter S et al (2004) Case control study in the treatment of obstructive sleep-disordered breathing with a mandibular protrusive appliance. J Orofac Orthop 65:489–500PubMedCrossRef
23.
Zurück zum Zitat Ruf S, Pancherz H (1999) Dentoskeletal effects and facial profile changes in young adults treated with the Herbst appliance. Angle Orthod 69:239–246PubMed Ruf S, Pancherz H (1999) Dentoskeletal effects and facial profile changes in young adults treated with the Herbst appliance. Angle Orthod 69:239–246PubMed
24.
Zurück zum Zitat Schönhofer B, Hochban W, Siemon K et al (1998) Effektivität einer den Unterkiefer vorverlagernden Protrusionsschiene bei der obstruktiven Schlapapnoe. Somnologie 2:123–128CrossRef Schönhofer B, Hochban W, Siemon K et al (1998) Effektivität einer den Unterkiefer vorverlagernden Protrusionsschiene bei der obstruktiven Schlapapnoe. Somnologie 2:123–128CrossRef
Metadaten
Titel
Effects of fixed appliances in correcting Angle Class II on the depth of the posterior airway space
FMA vs. Herbst appliance—a retrospective cephalometric study
verfasst von
Prof. Dr. G. Kinzinger
K. Czapka
B. Ludwig
B. Glasl
U. Gross
J. Lisson
Publikationsdatum
01.08.2011
Verlag
Springer-Verlag
Erschienen in
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie / Ausgabe 4/2011
Print ISSN: 1434-5293
Elektronische ISSN: 1615-6714
DOI
https://doi.org/10.1007/s00056-011-0035-2

Weitere Artikel der Ausgabe 4/2011

Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 4/2011 Zur Ausgabe

Informationen

DGKFO-Seiten

Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Zahnmedizin und bleiben Sie gut informiert – ganz bequem per eMail.