Effect of extraction treatment on upper airway dimensions in patients with bimaxillary skeletal protrusion relative to their vertical skeletal pattern
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Objective: To investigate dimensional changes in regional pharyngeal airway spaces after premolar extraction in bimaxillary skeletal protrusion (BSP) patients according to vertical skeletal pattern, and to further identify dentoskeletal risk factors to predict posttreatment pharyngeal changes. Methods: Fifty-five adults showing BSP treated with microimplant anchorage after four premolar extractions were included in this retrospective study. The subjects were divided into two groups according to the mandibular plane steepness: hyperdivergent (Frankfort horizontal plane to mandibular plane [FH-MP] ≥ 30) and nonhyperdivergent groups (FH-MP < 30). The control group consisted of 20 untreated adults with skeletal Class I normodivergent pattern and favorable profile. Treatment changes in cephalometric variables were evaluated and compared. The association between posttreatment changes in the dentoskeletal and upper airway variables were analyzed using linear regression analysis. Results: The BSP patients showed no significant decrease in the pharyngeal dimensions to the lower level in comparison with controls, except for middle airway space (MAS, p < 0.01). The upper airway variable representing greater decrease in the hyperdivergent group than in the nonhyperdivergent group was the MAS (p < 0.01). Posttreatment changes in FH-MP had negative correlation with changes in MAS (β = –0.42, p < 0.01) and inferior airway space (β = –0.52, p < 0.01) as a result of multivariable regression analysis adjusted for sagittal skeletal relationship. Conclusions: Decreased pharyngeal dimensions after treatment in BSP patients showed no significant difference from the normal range of pharyngeal dimensions. However, the glossopharyngeal airway space may be susceptible to treatment when vertical dimension increased in hyperdivergent BSP patients.
Abstract
Objective: To investigate dimensional changes in regional pharyngeal airway spaces after premolar extraction in bimaxillary skeletal protrusion (BSP) patients according to vertical skeletal pattern, and to further identify dentoskeletal risk factors to predict posttreatment pharyngeal changes. Methods: Fifty-five adults showing BSP treated with microimplant anchorage after four premolar extractions were included in this retrospective study. The subjects were divided into two groups according to the mandibular plane steepness: hyperdivergent (Frankfort horizontal plane to mandibular plane [FH-MP] ≥ 30) and nonhyperdivergent groups (FH-MP < 30). The control group consisted of 20 untreated adults with skeletal Class I normodivergent pattern and favorable profile. Treatment changes in cephalometric variables were evaluated and compared. The association between posttreatment changes in the dentoskeletal and upper airway variables were analyzed using linear regression analysis. Results: The BSP patients showed no significant decrease in the pharyngeal dimensions to the lower level in comparison with controls, except for middle airway space (MAS, p < 0.01). The upper airway variable representing greater decrease in the hyperdivergent group than in the nonhyperdivergent group was the MAS (p < 0.01). Posttreatment changes in FH-MP had negative correlation with changes in MAS (β = –0.42, p < 0.01) and inferior airway space (β = –0.52, p < 0.01) as a result of multivariable regression analysis adjusted for sagittal skeletal relationship. Conclusions: Decreased pharyngeal dimensions after treatment in BSP patients showed no significant difference from the normal range of pharyngeal dimensions. However, the glossopharyngeal airway space may be susceptible to treatment when vertical dimension increased in hyperdivergent BSP patients.
참고문헌 (25)
- Kim TK, "Lip profile changes after orthodontic tooth movement in female adult with bimaxillary protrusion", Korean J Orthod, 24, pp.135~148 (1994)
- Chu YM, "Surgical approach to the patient with bimaxillary protrusion", Clin Plast Surg, 34, pp.535~546 (2007)
- Bills DA, "Bimaxillary dentoalveolar protrusion : traits and orthodontic correction", Angle Orthod, 75, pp.333~339 (2005)
- Leonardi R, "Soft tissue changes following the extraction of premolars in nongrowing patients with bimaxillary protrusion. A systematic review", Angle Orthod, 80, pp.211~216 (2010)
- Shunsuke Uesugi, "Cone-beam computed tomography-based diagnosis and treatment simulation for a patient with a protrusive profile and a gummy smile", 대한치과교정학회지, 48(3), pp.189~199 (2018), 대한치과교정학회
- Sharma K, "Effects of first premolar extraction on airway dimensions in young adolescents : a retrospective cephalometric appraisal", Contemp Clin Dent, 5, pp.190~194 (2014)
- Valiathan M, "Effects of extraction versus non-extraction treatment on oropharyngeal airway volume", Angle Orthod, 80, pp.1068~1074 (2010)
- Jones AG, "A study of nasal respiratory resistance and craniofacial dimensions in white and West Indian black children", Am J Orthod Dentofacial Orthop, 106, pp.34~39 (1994)
- Chen Y, "Effect of large incisor retraction on upper airway morphology in adult bimaxillary protrusion patients", Angle Orthod, 82, pp.964~970 (2012)
- Wang Q, "Changes of pharyngeal airway size and hyoid bone position following orthodontic treatment of Class I bimaxillary protrusion", Angle Orthod, 82, pp.115~121 (2012)
- Al Maaitah E, "First premolar extraction effects on upper airway dimension in bimaxillary proclination patients", Angle Orthod, 82, pp.853~859 (2012)
- Zheng ZH, "Three-dimensional evaluation of upper airway in patients with different anteroposterior skeletal patterns", Orthod Craniofac Res, 17, pp.38~48 (2014)
- Baik UB, "Relationship between cephalometric characteristics and obstructive sites in obstructive sleep apnea syndrome", Angle Orthod, 72, pp.124~134 (2002)
- Joseph AA, "A cephalometric comparative study of the soft tissue airway dimensions in persons with hyperdivergent and normodivergent facial patterns", J Oral Maxillofac Surg, 56, pp.135~139 (1998)
- Ucar FI, "Orofacial airway dimensions in subjects with Class I malocclusion and different growth patterns", Angle Orthod, 81, pp.460~468 (2011)
- Behrents RG, "Obstructive sleep apnea and orthodontics : an American Association of Or thodontists White Paper", Am J Orthod Dentofacial Orthop, 156, pp.13~28.e1 (2019)
- Marşan G, "Changes in pharyngeal(airway)morphology in Class III Turkish female patients after mandibular setback surgery", J Craniomaxillofac Surg, 36, pp.341~345 (2008)
- 금병탁, "Effects of bodily retraction of mandibular incisors versus mandibular setback surgery on pharyngeal airway space: A comparative study", 대한치과교정학회지, 47(6), pp.344~352 (2017), 대한치과교정학회
- Germec-Cakan D, "Uvulo-glossopharyngeal dimensions in non-extraction, extraction with minimum anchorage, and extraction with maximum anchorage", Eur J Orthod, 33, pp.515~520 (2011)
- Iwasaki T, "Tongue posture improvement and pharyngeal airway enlargement as secondary effects of rapid maxillary expansion : a cone-beam computed tomography study", Am J Orthod Dentofacial Orthop, 143, pp.235~245 (2013)
- Hu Z, "The effect of teeth extraction for orthodontic treatment on the upper airway : a systematic review", Sleep Breath, 19, pp.441~451 (2015)
- Jena AK, "Sagittal mandibular development effects on the dimensions of the awake pharyngeal airway passage", Angle Orthod, 80, pp.1061~1067 (2010)
- Zheng Z, "Computational fluid dynamics simulation of the upper airway response to large incisor retraction in adult class I bimaxillary protrusion patients", Sci Rep, 7, pp.45706~ (2017)
- Eggensperger N, "Long-term changes of hyoid bone position and pharyngeal airway size following mandibular setback by sagittal split ramus osteotomy", J Craniomaxillofac Surg, 33, pp.111~117 (2005)
- Zinchuk AV, "Phenotypes in obstructive sleep apnea : a definition, examples and evolution of approaches", Sleep Med Rev, 35, pp.113~123 (2017)