scholarly journals Evaluation of the upper airway dimensions following Herbst appliance treatment in adolescents: A retrospective study

2020 ◽  
Vol 10 ◽  
pp. 153-163
Author(s):  
Min Gu ◽  
Yifan Lin ◽  
Colman Patrick Joseph McGrath ◽  
Urban Hägg ◽  
Ricky Wing Kit Wong ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Soft Palate ◽  
Upper Airway ◽  
Class Ii Malocclusion ◽  
Growth Data ◽  
Herbst Appliance ◽  
Downward Movement ◽  
Dimensional Changes ◽  
Lateral Cephalograms ◽  
Airway Dimensions

Objectives: This retrospective study investigated dimensional changes in the upper airway following Herbst appliance therapy in adolescents with Class II malocclusion and compared those changes with growth data. Materials and Methods: Lateral cephalograms from 44 Herbst-treated adolescents (23 boys, mean age = 13.3 ± 1.1 years, and 21 girls, mean age = 12.6 ± 1.1 years) were analyzed for the changes in the upper airway and craniofacial variables. Longitudinal cephalometric data of 34 untreated adolescents (15 boys, mean age = 12.6 ± 0.3 years, and 19 girls, mean age = 12.9 ± 0.4 years) were used as growth data for comparison. Results: Following treatment, significant changes were noted in most of the variables. Boys displayed greater downward movement of the hyoid bone than girls did (P = 0.021). Compared with the growth data, a greater increase in retroglossal oropharyngeal depth and hypopharyngeal depth was observed in boys and girls, respectively. Both displayed a decrease in the inclination of the soft palate and a smaller change in nasopharyngeal depth. Conclusion: Herbst appliance therapy enlarges the upper airway dimensions at two dissimilar sites in girls (oropharynx) and boys (hypopharynx). Boys display a greater increase in anterior and posterior facial heights than girls do, potentially accounting for the site dissimilarities. Moreover, a Herbst appliance improves the inclination of the soft palate and restricts the growth of the nasopharynx in both boys and girls.

scholarly journals Effects of Two-Phase Treatment with the Herbst and Preadjusted Edgewise Appliances on the Upper Airway Dimensions

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Woei Li Koay ◽  
Yanqi Yang ◽  
Christine Shuk Kwan Tse ◽  
Min Gu
Keyword(s):  
Negative Correlation ◽  
Upper Airway ◽  
Second Phase ◽  
Plane Angle ◽  
Herbst Appliance ◽  
Two Phase ◽  
Mandibular Plane ◽  
Lateral Cephalograms ◽  
Airway Dimensions ◽  
Mandibular Plane Angle

Aims. To assess the effects of two-phase treatment with the Herbst and the preadjusted edgewise appliances on upper airway dimensions and to investigate the correlation between changes in the upper airway dimensions and skeletal morphologies.Methods. A total of 27 Chinese male adolescents aged12.8±1.3years were selected. Lateral cephalograms were collected to assess the skeletal morphology and upper airway dimensions.Results. Following Herbst appliance treatment, the upper airway space was significantly enlarged, with the retropalatal (U-MPW) increasing by1.1±1.6 mm (P<0.001), the retroglossal (PASmin) increasing by1.3±2.9 mm (P<0.05), and the hypopharynx (V-LPW) enlarging by1.6±3.0 mm (P<0.01). PASmin was found to show a negative correlation to the mandibular plane angle (MnPl-SN) byr=-0.413(P<0.05). There was no significant change (P>0.05) in upper airway dimensions during the second-phase treatment.Conclusions. Herbst appliance treatment increased the oropharyngeal and hypopharyngeal airway dimensions among adolescents with Class II malocclusion, and the effects were maintained throughout the second treatment phase with a preadjusted edgewise appliance. There was a negative correlation between the change in the depth of the retroglossal pharynx and the mandibular plane angle.

Three-dimensional changes of the upper airway in patients with Class II malocclusion treated with the Herbst appliance: A cone-beam computed tomography study

2020 ◽  
Vol 157 (2) ◽  
pp. 205-211 ◽  
Author(s):  
Paula Moreira Oliveira ◽  
Paula Loureiro Cheib-Vilefort ◽  
Henrique de Pársia Gontijo ◽  
Camilo Aquino Melgaço ◽  
Lorenzo Franchi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Three Dimensional ◽  
Upper Airway ◽  
Class Ii ◽  
Cone Beam ◽  
Class Ii Malocclusion ◽  
Herbst Appliance ◽  
Dimensional Changes

scholarly journals Influence of Vertical Facial Growth Pattern on Herbst Appliance Effects in Prepubertal Patients: A Retrospective Controlled Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Maria Rita Giuca ◽  
Marco Pasini ◽  
Sara Drago ◽  
Leonardo Del Corso ◽  
Arianna Vanni ◽  
...  
Keyword(s):  
Growth Pattern ◽  
Class Ii ◽  
Growth Patterns ◽  
Response To Treatment ◽  
Controlled Study ◽  
Class Ii Malocclusion ◽  
Facial Growth ◽  
Herbst Appliance ◽  
Lateral Cephalograms ◽  
Vertical Growth Pattern

Introduction. The Herbst device is widely used for correction of class II malocclusions; however, most of the researches carried out on the Herbst appliance in literature do not take into account patients with a different mandibular divergence. The aim of this study was to investigate the effects of Herbst on dental and skeletal structures and to evaluate possible influence of vertical facial growth patterns. Methods. A retrospective study was conducted on lateral cephalograms of 75 growing patients (mean age: 9.9 ± 1.9 years) with class II malocclusion treated with Herbst. Subjects were divided into 3 groups using the mandibular divergence index (SN and GoMe angle). Cephalometric parameters were evaluated using the modified SO (sagittal occlusion) Pancherz’s analysis. A statistical analysis was conducted to evaluate differences among groups using ANOVA. Results. Our study showed differences in response to treatment depending on patient’s facial vertical growth pattern. Cranial base angle and mandibular rotation were significantly different (p<0.05) between hypodivergent patients and normodivergent patients and between hypodivergent and hyperdivergent subjects. Conclusion. Hypodivergent patients increased their mandibular divergence during treatment to a greater extent than normodivergents; moreover, hyperdivergent patients exhibited a decreased mandibular divergence at the end of the treatment.

scholarly journals Upper Airway Dimensions in Class II Malocclusion

2007 ◽  
Vol 77 (6) ◽  
pp. 1046-1053 ◽  
Author(s):  
Mirja Kirjavainen ◽  
Turkka Kirjavainen
Keyword(s):  
Treatment Time ◽  
Upper Airway ◽  
Class Ii ◽  
Class I ◽  
Class Ii Malocclusion ◽  
Cross Sectional ◽  
Lateral Cephalograms ◽  
Division 1 ◽  
Upper Airway Structure ◽  
Class Ii Division 1

Abstract Objective: To study the effects of cervical headgear treatment of Class II division 1 malocclusion on upper airway structures in children. Materials and Methods: Forty children aged 9.1 (7.2–11.5) years with Class II division 1 malocclusion were treated using a cervical headgear as the only treatment appliance. The headgear consisted of a long outer bow bent 15° upward and a large inner bow expanded 10 mm larger than the intermolar distance. Lateral cephalograms were taken before and after the treatment. Upper airway structures were estimated from the cephalograms. The results were compared to cross-sectional data of 80 age-matched controls with a Class I molar relationship. Results: A Class I molar relationship was achieved in all treated children. The mean treatment time was 1.6 (0.3–3.1) years. The Class II malocclusion was accompanied by a similar or wider nasopharyngeal space than in the controls but narrower oro- and hypopharyngeal spaces. The retropalatal area was widened by the treatment (P &lt; .05), whereas the rest of the oropharynx and hypopharynx remained narrower than in the controls. Before the treatment, the mandibular plane was in a more horizontal position than in the controls, but during the treatment, it rotated to a position similar to that of the controls. Conclusion: Class II division 1 malocclusion is associated with a narrower upper airway structure even without retrognathia. Headgear treatment is associated with an increase in the retropalatal airway space.

scholarly journals Twin block appliance: Effect on pharyngeal airway

2018 ◽  
Vol 7 (4) ◽  
pp. 147-152
Author(s):  
Vivek Bikram Thapa ◽  
Amrita Shrestha ◽  
Prabesh Sherchan ◽  
Prakash Poudel ◽  
Luna Joshi
Keyword(s):  
Soft Palate ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Twin Block ◽  
Skeletal Class ◽  
Pharyngeal Airway ◽  
Skeletal Class Ii ◽  
Obstructive Sleep ◽  
Lateral Cephalograms ◽  
Mandibular Retrusion

Background: Mandibular retrusion is the main cause of Skeletal Class II malocclusion characterized by skeletal retrusion of mandible with skeletal or dentoalveolar protrusion of maxillary. Objectives: This study was conducted to evaluate effect of treatment with twin-block appliances on pharyngeal dimensions. Methodology: This study was conducted in in the Department of Orthodontics & Dentofacial Orthopedics in Kathmandu Medical College. Twenty patients of age group 7 to 14 years with skeletal class II malocclusion with mandibular retrusion were selected. Variables evaluated were depth of nasopharynx; height of nasopharynx; depth of oropharynx; depth of hypopharynx; soft palate length; soft palate thickness and soft palate inclination. The lateral cephalograms were obtained for all subjects before the start of treatment and after a follow-up period of approximately three months in treatment. Results: Results showed that depth of nasopharynx increased by 1 mm, height of nasopharynx increased by 0.78 mm, depth of nasopharynx increased by 1.97 mm, depth of hypopharynx increased by 0.79 mm, soft palate length decreased by 4 mm, soft palate thickness increased by 2 mm and soft palate inclination decreased by 7.01 mm. The results for depth of pharynx and soft palate thickness were statistically significant. Conclusion: This study concluded that the use of twin block appliance for class II patients corrects sagittal dimension of oropharynx and hypopharynx. Early intervention for mandibular retrognathism in class II malocclusion helps enlarge the airway dimensions and decrease potential risk of obstructive sleep apnea syndrome for growing patients in the future.

scholarly journals Upper Airway Changes following Functional Treatment with the Headgear Herbst or Headgear Twin Block Appliance Assessed on Lateral Cephalograms and Magnetic Resonance Imaging

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Min Gu ◽  
Fabio Savoldi ◽  
Urban Hägg ◽  
Colman P. J. McGrath ◽  
Ricky W. K. Wong ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Soft Tissues ◽  
Upper Airway ◽  
Functional Treatment ◽  
Resonance Imaging ◽  
Twin Block ◽  
Lateral Cephalograms ◽  
Magnetic Resonance Imaging Mri ◽  
Airway Dimensions

Objective. The present study compared the changes in the upper airway dimensions and sleep-related breathing disorder (SRBD) condition between functional treatment with the headgear Herbst (HG-Herbst) and headgear Twin Block (HG-TB) appliance. Soft tissues were assessed on lateral cephalometric X-ray and magnetic resonance imaging (MRI). Materials and Methods. Consecutive patients who sought orthodontic treatment at the Faculty of Dentistry of The University of Hong Kong were screened. Adolescents (12-17 year sold for boys and 10-15 years old for girls), with class II molar relationship and overjet >5 mm, with no severe transverse maxillary deficiency, were recruited. Patients were assigned either to the HG-Herbst or to the HG-TB treatment by stratified block randomisation, with sex as the stratification factor. Lateral cephalograms, magnetic resonance imaging (MRI), and the Paediatric Sleep Questionnaire (PSQ) were obtained at baseline and after treatment. Results. 28 patients were enrolled, and 26 patients (13 in each group) completed the treatment. Following 1 year of functional appliance treatment, a significantly lower increase of the lower anterior facial height was observed in the HG-Herbst group compared to the HG-TB group (p = 0.024). However, no significant differences were observed in the upper airway structures or SRBD between the two groups. Conclusion. The changes in upper airway dimensions and SRBD condition were not significantly different between the HG-Herbst and the HG-TB appliance treatment. Additional studies with larger sample size are warranted.

Evaluation of Upper Airway Dimensional Changes and Hyoid Position Following Mandibular Advancement in Patients With Skeletal Class II Malocclusion

2012 ◽  
Vol 23 (6) ◽  
pp. e623-e627 ◽  
Author(s):  
Nanda Kishore Sahoo ◽  
Balakrishnan Jayan ◽  
N. Ramakrishna ◽  
Sukbir Singh Chopra ◽  
Gagandeep Kochar
Keyword(s):  
Upper Airway ◽  
Class Ii ◽  
Mandibular Advancement ◽  
Class Ii Malocclusion ◽  
Skeletal Class ◽  
Dimensional Changes ◽  
Skeletal Class Ii

Dimensional Changes in Dental Arches After Treatment with a Prefabricated Functional Appliance

2007 ◽  
Vol 31 (4) ◽  
pp. 279-283 ◽  
Author(s):  
G Ramirez-Yañez ◽  
A Sidlauskas ◽  
E Junior ◽  
J Fluter
Keyword(s):  
Retrospective Study ◽  
Treatment Choice ◽  
Early Age ◽  
Class Ii Malocclusion ◽  
Natural Growth ◽  
Functional Appliance ◽  
Dimensional Changes ◽  
Before And After ◽  
Clinically Significant ◽  
Maxilla And Mandible

The purpose of this study was to determine the effect of the T4K, a prefabricated functional appliance, on the transverse and anterior-height dimensions of the maxillary and mandibular dental arches. Dimensions before and after treatment were measured on the sample, then, natural growth was subtracted from the treatment effects and compared with twice the error of the method. A clinically significant increase of both dimensions was observed in the maxilla and mandible when Class II malocclusion patients were treated with the T4K. Therefore, this retrospective study demonstrates that T4K is a valid treatment choice at an early age when transverse expansion is part of the treatment goal.

Effect of Combined Mouth Closure and Chin Lift on Upper Airway Dimensions during Routine Magnetic Resonance Imaging in Pediatric Patients Sedated with Propofol

1999 ◽  
Vol 90 (6) ◽  
pp. 1617-1623. ◽  
Author(s):  
Adrian Reber ◽  
Stephan G. Wetzel ◽  
Karl Schnabel ◽  
Georg Bongartz ◽  
Franz J. Frei
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Soft Palate ◽  
Pediatric Patients ◽  
Upper Airway ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Propofol Sedation ◽  
Routine Magnetic Resonance Imaging ◽  
Airway Dimensions

Background In pediatric patients, obstruction of the upper airway is a common problem during general anesthesia. Chin lift is a commonly used technique to improve upper airway patency. However, little is known about the mechanism underlying this technique. Methods The authors studied the effect of the chin lift maneuver on airway dimensions in 10 spontaneously breathing children (aged 2-11 yr) sedated with propofol during routine magnetic resonance imaging. The minimal anteroposterior and corresponding transverse diameters of the pharynx were determined at the levels of the soft palate, dorsum of the tongue, and tip of the epiglottis before and during the chin lift maneuver. Additionally, cross-sectional areas were calculated at these sites, including tracheal areas 2 cm below the glottic level. Results Minimal anteroposterior diameter of the pharynx increased significantly during chin lift at all three levels in all patients. The diameters of the soft palate, tongue, and epiglottis increased from 6.7+/-2.8 mm (SD) to 9.9+/-3.6 mm, from 9.6+/-3.6 mm to 16.5+/-3.1 mm, and from 4.6+/-2.5 mm to 13.1+/-2.8 mm, respectively. The corresponding transverse diameter of the pharynx also increased significantly at all three levels in all patients but without significant predominance. The diameters at the levels of the soft palate, tongue, and epiglottis increased from 15.8+/-5.1 mm to 22.8+/-4.5 mm, from 13.5+/-4.9 mm to 18.7+/-5.3 mm, and from 17.2+/-3.9 mm to 21.2+/-3.7 mm, respectively. Cross-sectional pharyngeal areas increased significantly at all levels (soft palate, from 0.88+/-0.58 cm2 to 1.79+/-0.82 cm2; tongue, from 1.15+/-0.45 cm2 to 2.99+/-1.30 cm2; epiglottis, from 1.17+/-0.70 cm2 to 3.04+/-0.99 cm2), including the subglottic level (from 0.44+/-0.15 cm2 to 0.50+/-0.14 cm2). Conclusions This study shows that all children had a preserved upper airway at all measured sites during propofol sedation. Chin lift caused a widening of the entire pharyngeal airway that was most pronounced between the tip of the epiglottis and the posterior pharyngeal wall. In pediatric patients, chin lift may be used as a standard procedure during propofol sedation.

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