Effects of the long-term use of maxillary protraction facemasks with skeletal anchorage on pharyngeal airway dimensions in growing patients with cleft lip and palate
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective: To investigate the effects of the long-term use of a maxillary protraction facemask with miniplate (FM-MP) on pharyngeal airway dimensions in growing patients with cleft lip and palate (CLP). Methods: The study included 24 boys with CLP (mean age, 12.2 years; mean duration of FM-MP therapy, 4.9 years), divided into two groups according to the amount of A point advancement to the vertical reference plane (VRP): Group 1, > 4 mm; Group 2, < 2 mm; n = 12/group. After evaluating the skeletodental and airway variables using lateral cephalograms acquired before and after FM-MP therapy, statistical analyses were performed. Results: Group 1 showed greater forward and downward displacements of the posterior maxilla (posterior nasal spine [PNS]-horizontal reference plane [HRP]; PNSVRP), greater increase in ANB, more forward tongue position (tongue tip-Pt vertical line to Frankfort horizontal plane), and greater increase in the oropharynx (superior posterior airway space [SPAS]; middle airway space [MAS]) and upper nasopharynx (PNS-adenoid2) than did Group 2. While maxillary advancement (A-VRP and PNS-VRP) correlated with increases in SPAS, MAS, and PNS-adenoid2, downward displacement of the PNS (PNS-HRP) correlated with increases in SPAS, MAS, PNSadenoid1, and PNS-adenoid2, and with a decrease in vertical airway length (VAL). Mandibular forward displacement and decrease in mandibular plane correlated with increases in MAS. Conclusions: FM-MP therapy had positive effects on the oropharyngeal and nasopharyngeal airway spaces without increases in VAL in Group 1 rather than in Group 2. However, further validation using an untreated control group is necessary.
Abstract
Objective: To investigate the effects of the long-term use of a maxillary protraction facemask with miniplate (FM-MP) on pharyngeal airway dimensions in growing patients with cleft lip and palate (CLP). Methods: The study included 24 boys with CLP (mean age, 12.2 years; mean duration of FM-MP therapy, 4.9 years), divided into two groups according to the amount of A point advancement to the vertical reference plane (VRP): Group 1, > 4 mm; Group 2, < 2 mm; n = 12/group. After evaluating the skeletodental and airway variables using lateral cephalograms acquired before and after FM-MP therapy, statistical analyses were performed. Results: Group 1 showed greater forward and downward displacements of the posterior maxilla (posterior nasal spine [PNS]-horizontal reference plane [HRP]; PNSVRP), greater increase in ANB, more forward tongue position (tongue tip-Pt vertical line to Frankfort horizontal plane), and greater increase in the oropharynx (superior posterior airway space [SPAS]; middle airway space [MAS]) and upper nasopharynx (PNS-adenoid2) than did Group 2. While maxillary advancement (A-VRP and PNS-VRP) correlated with increases in SPAS, MAS, and PNS-adenoid2, downward displacement of the PNS (PNS-HRP) correlated with increases in SPAS, MAS, PNSadenoid1, and PNS-adenoid2, and with a decrease in vertical airway length (VAL). Mandibular forward displacement and decrease in mandibular plane correlated with increases in MAS. Conclusions: FM-MP therapy had positive effects on the oropharyngeal and nasopharyngeal airway spaces without increases in VAL in Group 1 rather than in Group 2. However, further validation using an untreated control group is necessary.
참고문헌 (30)
- Celikoglu M, "Three-dimensional evaluation of the pharyngeal airway volumes in patients affected by unilateral cleft lip and palate", Am J Orthod Dentofacial Orthop, 145, pp.780~786 (2014)
- Satoh K, "A cephalometric study by multivariate analysis of growth of the bony nasopharynx in patients with clefts and non-cleft controls", J Craniomaxillofac Surg, 26, pp.394~399 (1998)
- Jolleys A, "A review of the results of operations on cleft palates with reference to maxillary growth and speech function", Br J Plast Surg, 7, pp.229~241 (1954)
- Shibasaki Y, "Facial growth in children with isolated cleft palate", Cleft Palate J, 6, pp.290~302 (1969)
- Hermann NV, "A comparison of the craniofacial morphology in 2-month-old unoperated infants with unilateral complete cleft lip and palate, and unilateral incomplete cleft lip", J Craniofac Genet Dev Biol, 19, pp.80~93 (1999)
- Karia H, "Three-dimensional evaluation of the airway spaces in patients with and without cleft lip and palate : a digital volume tomographic study", Am J Orthod Dentofacial Orthop, 152, pp.371~381 (2017)
- Akarsu-Guven B, "Growth-related changes of skeletal and upper-airway features in bilateral cleft lip and palate patients", Am J Orthod Dentofacial Orthop, 148, pp.576~586 (2015)
- Kunkel M, "Nasal airway in cleft-palate patients : acoustic rhinometric data", J Craniomaxillofac Surg, 25, pp.270~274 (1997)
- Muntz H, "Sleep disordered breathing and obstructive sleep apnea in the cleft population", Laryngoscope, 118, pp.348~353 (2008)
- Robison JG, "Increased prevalence of obstructive sleep apnea in patients with cleft palate", Arch Otolaryngol Head Neck Surg, 137, pp.269~274 (2011)
- Cordasco G, "Efficacy of ortho pedic treatment with protraction facemask on skeletal Class III malocclusion : a systematic review and meta-analysis", Orthod Craniofac Res, 17, pp.133~143 (2014)
- Baccetti T, "Skeletal effects of early treatment of Class III malocclusion with maxillary expansion and facemask therapy", Am J Orthod Dentofacial Orthop, 113, pp.333~343 (1998)
- Kaygisiz E, "Effects of maxillary protraction and fixed appliance therapy on the pharyngeal airway", Angle Orthod, 79, pp.660~667 (2009)
- Oktay H, "Maxillary protraction appliance effect on the size of the upper airway passage", Angle Orthod, 78, pp.209~214 (2008)
- Sayinsu K, "Sagittal airway dimensions following maxillary protraction : a pilot study", Eur J Orthod, 28, pp.184~189 (2006)
- Cevidanes L, "Comparison of two protocols for maxillary protraction : bone anchors versus face mask with rapid maxillary expansion", Angle Orthod, 80, pp.799~806 (2010)
- Baek SH, "New treatment modality for maxillary hypoplasia in cleft patients. Protraction facemask with miniplate anchorage", Angle Orthod, 80, pp.783~791 (2010)
- Ahn HW, "Comparison of the effects of maxillary protraction using facemask and miniplate anchorage between unilateral and bilateral cleft lip and palate patients", Angle Orthod, 82, pp.935~941 (2012)
- On SW, "Effect of long-term use of facemask with miniplate on maxillary protraction in patients with cleft lip and palate", J Craniofac Surg, 29, pp.309~314 (2018)
- Fishman LS, "Radiographic evaluation of skeletal maturation. A clinically oriented method based on hand-wrist films", Angle Orthod, 52, pp.88~112 (1982)
- Zhang Y, "Dentoskeletal effects of facemask therapy in skeletal Class III cleft patients with or without bone graft", Am J Orthod Dentofacial Orthop, 153, pp.542~549 (2018)
- Li HY, "Use of 3-dimensional computed tomography scan to evaluate upper airway patency for patients undergoing sleep-disordered breathing surgery", Otolaryngol Head Neck Surg, 129, pp.336~342 (2003)
- Ngan P, "Comparison of two maxillary protraction protocols : tooth-borne versus bone-anchored protraction facemask treatment", Prog Orthod, 16, pp.26~ (2015)
- Ozbek MM, "Oropharyngeal airway dimensions and functional-orthopedic treatment in skeletal Class II cases", Angle Orthod, 68, pp.327~336 (1998)
- Akcam MO, "Longitudinal investigation of soft palate and nasopharyngeal airway relations in different rotation types", Angle Orthod, 72, pp.521~526 (2002)
- van den Dungen GM, "Craniofacial morphology of Dutch patients with bilateral cleft lip and palate and noncleft controls at the age of 15 years", Cleft Palate Craniofac J, 45, pp.661~666 (2008)
- Lee JW, "Correlation between skeletal changes by maxillary protraction and upper airway dimensions", Angle Orthod, 81, pp.426~432 (2011)
- Xu Y, "3-dimensional computed tomographic analysis of the pharynx in adult patients with unrepaired isolated cleft palate", J Oral Maxillofac Surg, 71, pp.1424~1434 (2013)
- McNamara JA Jr, "An orthopedic approach to the treatment of Class III malocclusion in young patients", J Clin Orthod, 21, pp.598~608 (1987)
- Kapust AJ, "Cephalometric effects of face mask", expansion therapy in Class III children : a comparison of three age groups, 1998, pp.113, 204~212