Hooman Shafaee; Bahareh Mazloumhoseini; Erfan Bardideh; Maliheh Dadgarmoghaddam
Abstract
Context: Maxillary deficiency can lead to the reduction of airway space and increase the chances of development of obstructive airway disorders. Facemask therapy is one of the main treatment protocols in developing maxillary deficient patients.Objectives: The purpose of this systematic review and meta-analysis ...
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Context: Maxillary deficiency can lead to the reduction of airway space and increase the chances of development of obstructive airway disorders. Facemask therapy is one of the main treatment protocols in developing maxillary deficient patients.Objectives: The purpose of this systematic review and meta-analysis was to assess the changes in the airway dimensions after face-mask therapy in both cleft lip and palate and non-cleft patients.Methods: A systematic search in different electronic databases (EMBASE, Pubmed, Cochrance Central register of controlled trials), IADR proceedings and a hand search by October 2020 were conducted and a meta-analysis and systematic review was performed.Results: In patients without cleft lip and palate, upper pharyngeal width was significantly increased by mean of 2.05 mm (CI = 95%, 0.61 - 3.50) following facemask therapy in comparison to patients who did not receive the treatment. Other upper pharyngeal (nasopharyngeal) measurements also showed a statistically significant improvement after therapy: S-PNS by 4.64 mm (CI = 95%, 3.34 - 5.94), AD1-PNS by 3.81 mm (CI = 95%, 2.40 - 5.21), AD2-PNS by 2.90 mm (CI = 95%, 0.13 - 5.67) and Pm’-SPL by 2.53 (CI = 95%, 0.54 - 4.51). Lower pharyngeal measurments did not show any significant changes after the treatment (P > 0.05). In the analysis of studies with 3D imaging modalities, upper pharyngeal volume was also significantly increased by 499.29 mm3 (CI = 95%, 69.58-929.00) after the treatment. In addition, a review of articles that included cleft lip and palate patients also showed after the treatment, the upper pharyngeal measurements all showed a significant improvement (P < 0.05), whereas the oropharyngeal region was relatively stable.Conclusions: In maxillary deficient patients with or without an orofacial cleft, facemask therapy can improve the nasopharyngeal area dimensions; however, this treatment protocol appears not to have an effect on the oropharyngeal area of the airway tract.
Majid Heidarpour; Saeid Sadeghian; Amir Siadat; Sara Siadat; Maryam Keimasi
Abstract
Objectives: The aim of this study was to evaluate and compare the effects of concomitant use of a facemask and a removable appliance and a removable appliance alone for antero-posterior expansion in Cl III children with maxillary deficiency.
Methods: In this retrospective analytical study, 21 Cl III ...
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Objectives: The aim of this study was to evaluate and compare the effects of concomitant use of a facemask and a removable appliance and a removable appliance alone for antero-posterior expansion in Cl III children with maxillary deficiency.
Methods: In this retrospective analytical study, 21 Cl III children aged 8 - 10 years were selected using the census sampling technique. The subjects were divided into two groups based on the treatment modality. In group A, the subjects received an antero-posterior-expanding removable appliance and in group B, they received the same removable appliance concomitant with a facemask. Pre- and post-therapeutic cephalograms were analyzed and changes and angles on both images were determined. Mann-Whitney U and Wilcoxon tests were used to compare the results of the two treatment modalities and before-after results respectively (α = 0.05). Results: Wits appraisal, overjet, ANB, U1-SN, U1-PP and A-B difference increased in both groups after treatment (P < 0.05). In the removable appliance group, overbite, SNB and inter-incisal angle decreased (P < 0.05). In the facemask group, IMPA decreased significantly (P < 0.05). Comparison of the two treatment modalities showed that changes in SNA, ANB, overbite, IMPA, U1-SN, U1-PP and inter-incisal angle were significant between the two groups (P < 0.05).
Conclusions: Use of a removable appliance alone or in combination with a facemask resulted in the forward movement of point A and protrusion of upper incisors. The removable appliance increased the anterior facial height and decreased overbite. A combination of facemask-removable appliance did not result in the backward and downward rotation of the mandible.
