Skip to main content
Erschienen in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 6/2016

21.10.2016 | Original Article

Upper airway changes following single-step or stepwise advancement using the Functional Mandibular Advancer

verfasst von: Isil Aras, Aylin Pasaoglu, Sultan Olmez, Idil Unal, Aynur Aras

Erschienen in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie | Ausgabe 6/2016

Einloggen, um Zugang zu erhalten

Abstract

Objectives

Purpose of the present study was to determine and compare possible changes in the dimensions of the pharyngeal airway, morphology of the soft palate, and position of the tongue and hyoid bone after single-step or stepwise mandibular advancement using the Functional Mandibular Advancer (FMA).

Patients and methods

The sample included 51 peak-pubertal Class II subjects. In all, 34 patients were allocated to two groups using matched randomization: a single-step mandibular advancement group (SSG) and a stepwise mandibular advancement group (SWG). Both groups were treated with FMA followed by fixed appliance therapy; the remaining 17 subjects who underwent only fixed appliance therapy constituted the control group (CG). The study was conducted using pre- and posttreatment lateral cephalometric radiographs. Data were analyzed by paired t test, one-way analysis of variance, and Pearson’s correlation coefficient.

Result

In the SWG and SSG, although increases in nasopharyngeal airway dimensions were not significant compared with those in the CG, enlargements in the oropharyngeal airway dimensions at the level of the soft palate tip and behind the tongue, and decreases in soft palate angulation, were significant. Tongue height increased significantly only in the SWG. Compared with the CG, while forward movement of the hyoid was more prominent in SSG and SWG, the change in the vertical movement of the hyoid was not significant. No significant difference between SWG and SSG was observed in pharyngeal airway, soft palate, tongue or hyoid measurements.

Conclusions

The mode of mandibular advancement in FMA treatment did not significantly affect changes in the pharyngeal airway, soft palate, tongue, and hyoid bone.
Literatur
1.
Zurück zum Zitat Aras I, Pasaoglu A, Olmez S, Unal I, Tuncer AV, Aras A (2016) Comparison of stepwise vs single-step advancement with the functional mandibular advancer in Class II Division 1 treatment. Angle Orthod. doi:10.2319/032416-241.1 Aras I, Pasaoglu A, Olmez S, Unal I, Tuncer AV, Aras A (2016) Comparison of stepwise vs single-step advancement with the functional mandibular advancer in Class II Division 1 treatment. Angle Orthod. doi:10.​2319/​032416-241.​1
2.
Zurück zum Zitat Bavbek NC, Tuncer BB, Turkoz C, Ulusoy C, Tuncer C (2015) Changes in airway dimensions and hyoid bone position following class II correction with forsus fatigue resistant device. Clin Oral Investig. doi:10.1007/s00784-015-1659-1 PubMed Bavbek NC, Tuncer BB, Turkoz C, Ulusoy C, Tuncer C (2015) Changes in airway dimensions and hyoid bone position following class II correction with forsus fatigue resistant device. Clin Oral Investig. doi:10.​1007/​s00784-015-1659-1 PubMed
3.
Zurück zum Zitat Chen Y, Hong L, Wang CL, Zhang SJ, Cao C, Wei F et al (2012) Effect of large incisor retraction on upper airway morphology in adult bimaxillary protrusion patients. Angle Orthod 82:964–970CrossRefPubMed Chen Y, Hong L, Wang CL, Zhang SJ, Cao C, Wei F et al (2012) Effect of large incisor retraction on upper airway morphology in adult bimaxillary protrusion patients. Angle Orthod 82:964–970CrossRefPubMed
4.
Zurück zum Zitat Chung DH, Hatch JP, Dolce C, Van Sickels JE, Bays RA, Rugh JD (2001) Positional change of the hyoid bone after bilateral sagittal split osteotomy with rigid and wire fixation. Am J Orthod Dentofac Orthop 119:382–389CrossRef Chung DH, Hatch JP, Dolce C, Van Sickels JE, Bays RA, Rugh JD (2001) Positional change of the hyoid bone after bilateral sagittal split osteotomy with rigid and wire fixation. Am J Orthod Dentofac Orthop 119:382–389CrossRef
5.
Zurück zum Zitat Cozza P, Baccetti T, Franchi L, De Toffol L, McNamara JA Jr (2006) Mandibular changes produced by functional appliances in Class II malocclusion: a systematic review. Am J Orthod Dentofac Orthop 129(599):e1–12 Cozza P, Baccetti T, Franchi L, De Toffol L, McNamara JA Jr (2006) Mandibular changes produced by functional appliances in Class II malocclusion: a systematic review. Am J Orthod Dentofac Orthop 129(599):e1–12
6.
Zurück zum Zitat Eggensperger N, Smolka K, Johner A, Rahal A, Thuer U, Iizuka T (2005) Long-term changes of hyoid bone and pharyngeal airway size following advancement of the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 99:404–410CrossRefPubMed Eggensperger N, Smolka K, Johner A, Rahal A, Thuer U, Iizuka T (2005) Long-term changes of hyoid bone and pharyngeal airway size following advancement of the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 99:404–410CrossRefPubMed
7.
Zurück zum Zitat Feng X, Li G, Qu Z, Liu L, Nasstrom K, Shi XQ (2015) Comparative analysis of upper airway volume with lateral cephalograms and cone-beam computed tomography. Am J Orthod Dentofac Orthop 147:197–204CrossRef Feng X, Li G, Qu Z, Liu L, Nasstrom K, Shi XQ (2015) Comparative analysis of upper airway volume with lateral cephalograms and cone-beam computed tomography. Am J Orthod Dentofac Orthop 147:197–204CrossRef
8.
Zurück zum Zitat Germec-Cakan D, Taner T, Akan S (2011) Uvulo-glossopharyngeal dimensions in non-extraction, extraction with minimum anchorage, and extraction with maximum anchorage. Eur J Orthod 33:515–520CrossRefPubMed Germec-Cakan D, Taner T, Akan S (2011) Uvulo-glossopharyngeal dimensions in non-extraction, extraction with minimum anchorage, and extraction with maximum anchorage. Eur J Orthod 33:515–520CrossRefPubMed
9.
Zurück zum Zitat Ghodke S, Utreja AK, Singh SP, Jena AK (2014) Effects of twin-block appliance on the anatomy of pharyngeal airway passage (PAP) in class II malocclusion subjects. Prog Orthod 15:68CrossRefPubMedPubMedCentral Ghodke S, Utreja AK, Singh SP, Jena AK (2014) Effects of twin-block appliance on the anatomy of pharyngeal airway passage (PAP) in class II malocclusion subjects. Prog Orthod 15:68CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Godt A, Koos B, Hagen H, Goz G (2011) Changes in upper airway width associated with Class II treatments (headgear vs activator) and different growth patterns. Angle Orthod 81:440–446CrossRefPubMed Godt A, Koos B, Hagen H, Goz G (2011) Changes in upper airway width associated with Class II treatments (headgear vs activator) and different growth patterns. Angle Orthod 81:440–446CrossRefPubMed
11.
Zurück zum Zitat Graber LW, Vanarsdall RL, Vig KWL (2012) Orthodontics: current principles and techniques. Elsevier/Mosby, Philadelphia Graber LW, Vanarsdall RL, Vig KWL (2012) Orthodontics: current principles and techniques. Elsevier/Mosby, Philadelphia
12.
Zurück zum Zitat Hagg U, Taranger J (1980) Skeletal stages of the hand and wrist as indicators of the pubertal growth spurt. Acta Odontol Scand 38:187–200CrossRefPubMed Hagg U, Taranger J (1980) Skeletal stages of the hand and wrist as indicators of the pubertal growth spurt. Acta Odontol Scand 38:187–200CrossRefPubMed
13.
Zurück zum Zitat Han S, Choi YJ, Chung CJ, Kim JY, Kim KH (2014) Long-term pharyngeal airway changes after bionator treatment in adolescents with skeletal Class II malocclusions. Korean J Orthod 44:13–19CrossRefPubMedPubMedCentral Han S, Choi YJ, Chung CJ, Kim JY, Kim KH (2014) Long-term pharyngeal airway changes after bionator treatment in adolescents with skeletal Class II malocclusions. Korean J Orthod 44:13–19CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Hanggi MP, Teuscher UM, Roos M, Peltomaki TA (2008) Long-term changes in pharyngeal airway dimensions following activator-headgear and fixed appliance treatment. Eur J Orthod 30:598–605CrossRefPubMed Hanggi MP, Teuscher UM, Roos M, Peltomaki TA (2008) Long-term changes in pharyngeal airway dimensions following activator-headgear and fixed appliance treatment. Eur J Orthod 30:598–605CrossRefPubMed
15.
Zurück zum Zitat Iwasaki T, Takemoto Y, Inada E, Sato H, Saitoh I, Kakuno E et al (2014) Three-dimensional cone-beam computed tomography analysis of enlargement of the pharyngeal airway by the Herbst appliance. Am J Orthod Dentofac Orthop 146:776–785CrossRef Iwasaki T, Takemoto Y, Inada E, Sato H, Saitoh I, Kakuno E et al (2014) Three-dimensional cone-beam computed tomography analysis of enlargement of the pharyngeal airway by the Herbst appliance. Am J Orthod Dentofac Orthop 146:776–785CrossRef
16.
Zurück zum Zitat Jena AK, Singh SP, Utreja AK (2013) 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. Angle Orthod 83:728–734CrossRefPubMed Jena AK, Singh SP, Utreja AK (2013) 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. Angle Orthod 83:728–734CrossRefPubMed
17.
Zurück zum Zitat Johnston CD, Richardson A (1999) Cephalometric changes in adult pharyngeal morphology. Eur J Orthod 21:357–362CrossRefPubMed Johnston CD, Richardson A (1999) Cephalometric changes in adult pharyngeal morphology. Eur J Orthod 21:357–362CrossRefPubMed
18.
Zurück zum Zitat Kandasamy S, Goonewardene M (2014) Class II malocclusion and sleep-disordered breathing. Semin Orthod 20:316–323CrossRef Kandasamy S, Goonewardene M (2014) Class II malocclusion and sleep-disordered breathing. Semin Orthod 20:316–323CrossRef
19.
Zurück zum Zitat Kinzinger G, Czapka K, Ludwig B, Glasl B, Gross U, Lisson J (2011) 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. J Orofac Orthop 72:301–320CrossRefPubMed Kinzinger G, Czapka K, Ludwig B, Glasl B, Gross U, Lisson J (2011) 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. J Orofac Orthop 72:301–320CrossRefPubMed
20.
Zurück zum Zitat Kinzinger G, Ostheimer J, Forster F, Kwandt PB, Reul H, Diedrich P (2002) Development of a new fixed functional appliance for treatment of skeletal class II malocclusion first report. J Orofac Orthop 63:384–399CrossRefPubMed Kinzinger G, Ostheimer J, Forster F, Kwandt PB, Reul H, Diedrich P (2002) Development of a new fixed functional appliance for treatment of skeletal class II malocclusion first report. J Orofac Orthop 63:384–399CrossRefPubMed
21.
Zurück zum Zitat Li L, Liu H, Cheng H, Han Y, Wang C, Chen Y et al (2014) CBCT evaluation of the upper airway morphological changes in growing patients of class II division 1 malocclusion with mandibular retrusion using twin block appliance: a comparative research. PLoS One 9:e94378CrossRefPubMedPubMedCentral Li L, Liu H, Cheng H, Han Y, Wang C, Chen Y et al (2014) CBCT evaluation of the upper airway morphological changes in growing patients of class II division 1 malocclusion with mandibular retrusion using twin block appliance: a comparative research. PLoS One 9:e94378CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Lin Y-C, Lin H-C, Hung-Huey T (2011) Changes in the Pharyngeal airway and position of the hyoid bone after treatment with a modified bionator in growing patients with retrognathia. J Exp Clin Med 3:93–98CrossRef Lin Y-C, Lin H-C, Hung-Huey T (2011) Changes in the Pharyngeal airway and position of the hyoid bone after treatment with a modified bionator in growing patients with retrognathia. J Exp Clin Med 3:93–98CrossRef
23.
Zurück zum Zitat Maciel Santos ME, Rocha NS, Laureano Filho JR, Ferraz EM, Campos JM (2009) Obstructive sleep apnea-hypopnea syndrome—the role of bariatric and maxillofacial surgeries. Obes Surg 19:796–801CrossRefPubMed Maciel Santos ME, Rocha NS, Laureano Filho JR, Ferraz EM, Campos JM (2009) Obstructive sleep apnea-hypopnea syndrome—the role of bariatric and maxillofacial surgeries. Obes Surg 19:796–801CrossRefPubMed
24.
Zurück zum Zitat Malkoc S, Usumez S, Nur M, Donaghy CE (2005) Reproducibility of airway dimensions and tongue and hyoid positions on lateral cephalograms. Am J Orthod Dentofac Orthop 128:513–516CrossRef Malkoc S, Usumez S, Nur M, Donaghy CE (2005) Reproducibility of airway dimensions and tongue and hyoid positions on lateral cephalograms. Am J Orthod Dentofac Orthop 128:513–516CrossRef
25.
Zurück zum Zitat Martin SE, Mathur R, Marshall I, Douglas NJ (1997) The effect of age, sex, obesity and posture on upper airway size. Eur Respir J 10:2087–2090CrossRefPubMed Martin SE, Mathur R, Marshall I, Douglas NJ (1997) The effect of age, sex, obesity and posture on upper airway size. Eur Respir J 10:2087–2090CrossRefPubMed
26.
Zurück zum Zitat Ozbek MM, Memikoglu TU, Gogen H, Lowe AA, Baspinar E (1998) Oropharyngeal airway dimensions and functional-orthopedic treatment in skeletal Class II cases. Angle Orthod 68:327–336PubMed Ozbek MM, Memikoglu TU, Gogen H, Lowe AA, Baspinar E (1998) Oropharyngeal airway dimensions and functional-orthopedic treatment in skeletal Class II cases. Angle Orthod 68:327–336PubMed
27.
Zurück zum Zitat Ozdemir F, Ulkur F, Nalbantgil D (2014) Effects of fixed functional therapy on tongue and hyoid positions and posterior airway. Angle Orthod 84:260–264CrossRefPubMed Ozdemir F, Ulkur F, Nalbantgil D (2014) Effects of fixed functional therapy on tongue and hyoid positions and posterior airway. Angle Orthod 84:260–264CrossRefPubMed
28.
Zurück zum Zitat Pirila-Parkkinen K, Lopponen H, Nieminen P, Tolonen U, Paakko E, Pirttiniemi P (2011) Validity of upper airway assessment in children: a clinical, cephalometric, and MRI study. Angle Orthod 81:433–439CrossRefPubMed Pirila-Parkkinen K, Lopponen H, Nieminen P, Tolonen U, Paakko E, Pirttiniemi P (2011) Validity of upper airway assessment in children: a clinical, cephalometric, and MRI study. Angle Orthod 81:433–439CrossRefPubMed
29.
Zurück zum Zitat Rama AN, Tekwani SH, Kushida CA (2002) Sites of obstruction in obstructive sleep apnea. Chest 122:1139–1147CrossRefPubMed Rama AN, Tekwani SH, Kushida CA (2002) Sites of obstruction in obstructive sleep apnea. Chest 122:1139–1147CrossRefPubMed
30.
Zurück zum Zitat Restrepo C, Santamaria A, Pelaez S, Tapias A (2011) Oropharyngeal airway dimensions after treatment with functional appliances in class II retrognathic children. J Oral Rehabil 38:588–594CrossRefPubMed Restrepo C, Santamaria A, Pelaez S, Tapias A (2011) Oropharyngeal airway dimensions after treatment with functional appliances in class II retrognathic children. J Oral Rehabil 38:588–594CrossRefPubMed
31.
Zurück zum Zitat Rizk S, Kulbersh VP, Al-Qawasmi R (2015) Changes in the oropharyngeal airway of Class II patients treated with the mandibular anterior repositioning appliance. Angle Orthod. doi:10.2319/042915-295.1 PubMed Rizk S, Kulbersh VP, Al-Qawasmi R (2015) Changes in the oropharyngeal airway of Class II patients treated with the mandibular anterior repositioning appliance. Angle Orthod. doi:10.​2319/​042915-295.​1 PubMed
32.
Zurück zum Zitat Schendel SA, Jacobson R, Khalessi S (2012) Airway growth and development: a computerized 3-dimensional analysis. J Oral Maxillofac Surg 70:2174–2183CrossRefPubMed Schendel SA, Jacobson R, Khalessi S (2012) Airway growth and development: a computerized 3-dimensional analysis. J Oral Maxillofac Surg 70:2174–2183CrossRefPubMed
33.
Zurück zum Zitat Schutz TC, Dominguez GC, Hallinan MP, Cunha TC, Tufik S (2011) Class II correction improves nocturnal breathing in adolescents. Angle Orthod 81:222–228CrossRefPubMed Schutz TC, Dominguez GC, Hallinan MP, Cunha TC, Tufik S (2011) Class II correction improves nocturnal breathing in adolescents. Angle Orthod 81:222–228CrossRefPubMed
35.
Zurück zum Zitat Torgerson D, Torgerson C (2008) Designing randomized trials in health, education and social sciences. Palgrave Macmillan, LondonCrossRef Torgerson D, Torgerson C (2008) Designing randomized trials in health, education and social sciences. Palgrave Macmillan, LondonCrossRef
36.
Zurück zum Zitat Ulusoy C, Canigur Bavbek N, Tuncer BB, Tuncer C, Turkoz C, Gencturk Z (2014) Evaluation of airway dimensions and changes in hyoid bone position following class II functional therapy with activator. Acta Odontol Scand 72:917–925CrossRefPubMed Ulusoy C, Canigur Bavbek N, Tuncer BB, Tuncer C, Turkoz C, Gencturk Z (2014) Evaluation of airway dimensions and changes in hyoid bone position following class II functional therapy with activator. Acta Odontol Scand 72:917–925CrossRefPubMed
37.
Zurück zum Zitat Villa MP, Miano S, Rizzoli A (2012) Mandibular advancement devices are an alternative and valid treatment for pediatric obstructive sleep apnea syndrome. Sleep Breath 16:971–976CrossRefPubMed Villa MP, Miano S, Rizzoli A (2012) Mandibular advancement devices are an alternative and valid treatment for pediatric obstructive sleep apnea syndrome. Sleep Breath 16:971–976CrossRefPubMed
38.
Zurück zum Zitat Vizzotto MB, Liedke GS, Delamare EL, Silveira HD, Dutra V, Silveira HE (2012) A comparative study of lateral cephalograms and cone-beam computed tomographic images in upper airway assessment. Eur J Orthod 34:390–393CrossRefPubMed Vizzotto MB, Liedke GS, Delamare EL, Silveira HD, Dutra V, Silveira HE (2012) A comparative study of lateral cephalograms and cone-beam computed tomographic images in upper airway assessment. Eur J Orthod 34:390–393CrossRefPubMed
39.
Zurück zum Zitat Yassaei S, Tabatabaei Z, Ghafurifard R (2012) Stability of pharyngeal airway dimensions: tongue and hyoid changes after treatment with a functional appliance. Int J Orthod Milwaukee 23:9–15PubMed Yassaei S, Tabatabaei Z, Ghafurifard R (2012) Stability of pharyngeal airway dimensions: tongue and hyoid changes after treatment with a functional appliance. Int J Orthod Milwaukee 23:9–15PubMed
Metadaten
Titel
Upper airway changes following single-step or stepwise advancement using the Functional Mandibular Advancer
verfasst von
Isil Aras
Aylin Pasaoglu
Sultan Olmez
Idil Unal
Aynur Aras
Publikationsdatum
21.10.2016
Verlag
Springer Medizin
Erschienen in
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie / Ausgabe 6/2016
Print ISSN: 1434-5293
Elektronische ISSN: 1615-6714
DOI
https://doi.org/10.1007/s00056-016-0062-0

Weitere Artikel der Ausgabe 6/2016

Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 6/2016 Zur Ausgabe

Mitteilungen DGKFO

Mitteilungen der DGKFO

Newsletter

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