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.
Amirfarhang Miresmaili; Nasrin Farhadian; Sanaz Soheilifar
Abstract
Aim: Class Ill skeletal deformity may be the result of mandibular prognathism and/or maxillary deficiency. In adult patients , orthognathic surgery is used for treatment. Historically, the surgical correction of class III deformities was achieved just by mandibular setback, but nowadays other methods ...
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Aim: Class Ill skeletal deformity may be the result of mandibular prognathism and/or maxillary deficiency. In adult patients , orthognathic surgery is used for treatment. Historically, the surgical correction of class III deformities was achieved just by mandibular setback, but nowadays other methods of surgery are used. Orthosurgery treatments, in addition to improvement in masticatory function, occlusion and esthetics, may lead to changes in upper airway dimensions, position of hyoid, tongue and soft palate. The purpose of this study was to evaluate cephalometric changes in upper airway dimensions of skeletal class III patients following orthodontic treatment and bimaxillary surgery.
Material and methods: In this retrospective study, pre-treatment and post-treatment (6-12 months after surgery) lateral cephalograms of skeletal class III patients were used for analysis. All of the patients of a private office in Hamadan who had the inclusion criteria were selected. Cephalograms were traced manually. All the measurements were done with ruler.Then paired t test was used for analysing the data.
Results: Changes in upper airway linear measurements, position of hyoid, base of tongue, soft palate size and angle. and craniocervical angle, were not statistically significant (p>0.05). But there was a significant increase in nasopharynx and oropharynx surface area (p<0.05).
Conclusion: Orthodontic treatment with bimaxillay surgery in surgical class III cases can increase surface area of oropharynx and nasopharynx, and it seems that there is no risk factor for breathing disorders.
