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Effects of chincup or facemask therapies on the orofacial airway and hyoid position in Class III subjects

Auswirkungen einer Kinnkappen- oder Gesichtsmaskentherapie auf den orofazialen Atemweg und die Zungenbeinposition von Klasse-III-Patienten

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Objective

The purpose of this work was to evaluate orofacial airway dimensions and the position of the hyoid bone related to changes induced by facemask therapy (combined with rapid palatal expansion) or by chincup therapy as compared to an untreated Class III control group.

Methods

In all, 67 patients with skeletal Class III malocclusion were divided into a facemask group (n = 25; 15 girls and 10 boys), a chincup group (n = 15; 16 girls and 9 boys), and a control group (n = 17; 9 girls and 8 boys). Hard- and soft-tissue parameters were analyzed on lateral cephalograms, which were available for all patients and included a baseline radiograph (T1) obtained before treatment and a follow-up radiograph (T2) taken upon completion of active treatment or, in the control group, after a 6-month interval. Statistical analysis was performed at the p ≤ 0.05 level and included a paired-sample t-test, a generalized linear mixed model (GLMM), and a post hoc Tukey test.

Results

In the chincup group, significant changes in the perpendicular distance from the hyoid (H) to the C3-Me line were found compared to the control group (p < 0.05). The facemask group, by contrast, showed significant anteroposterior width increases of the pharynx—as measured at the level of the soft palate (p < 0.001)—as well as significant area increases of the nasopharynx based on its anterior portion (p < 0.001) and on its total area (p < 0.001). Both the chincup and the facemask (combined with rapid palatal expansion) therapies were found to induce clockwise rotational effects on the mandible.

Conclusion

Orofacial airway dimensions were enlarged significantly by facemask treatment in comparison with both chincup treatment and with the control group.

Zusammenfassung

Studienziel

Untersuchung der orofazialen Atemwegsdimensionen und der Position des Zungenbeins im Rahmen von Veränderungen, wie sie durch Behandlungen per Gesichtsmaske (kombiniert mit Gaumennahterweiterung) oder Kopf-Kinn-Kappe im Vergleich zu einer unbehandelten Kontrollgruppe entstehen.

Methode

Insgesamt 67 Patienten mit skelettalen Klasse-III-Dysgnathien wurden 3 Gruppen zugeordnet: einer Gesichtsmasken- (n=25; 15 Mädchen, 10 Jungen), einer Kinnkappen- (n=25; 16 Mädchen, 9 Jungen) und einer Kontrollgruppe (n=17; 9Mädchen, 8 Jungen). Die Hart- und Weichgewebemessungen erfolgten auf Fernröntgenseitenbildern, die für alle Patienten vorlagen und jeweils die Ausgangssituation (T1) sowie die Folgesituation (T2) nach der aktiven Therapie (bzw. in der Kontrollgruppe 6 Monate später) dokumentierten. Die statistische Datenauswertung (Signifikanzniveau p ≤ 0,05) umfasste einen t-Test für gepaarte Stichproben, ein generalisiertes lineares Mischmodell (GLMM) und einen Post-hoc-Test nach Tukey.

Resultate

Die Kinnkappengruppe zeigte gegenüber der Kontrollgruppe eine signifikante Streckenveränderung des im H-Punkt (vordersten Punkt des Zungenbeins) gefällten Lots auf die Verbindungslinie C3-Me (p < 0,05). Dagegen zeigte die Gesichtsmaskengruppe signifikante Zuwächse der auf Höhe des weichen Gaumens gemessenen anteroposterioren Rachenbreite (p < 0,001) sowie signifikante Flächenvergrößerungen des Nasopharynx sowohl in seinem vorderem Abschnitt (p < 0,001) als auch bezogen auf seine Gesamtfläche (p < 0,001). Die Behandlungen per Kinnkappe wie auch die Behandlungen per Gesichtsmaske (kombiniert mit Gaumennahterweiterung) bewirkten eine Rotation des Unterkiefers im Uhrzeigersinn.

Schlussfolgerung

Gegenüber einer unbehandelten Kontrollgruppe wie auch einer Behandlungsgruppe mit Kopf-Kinn-Kappe vergrößerten sich in der Behandlungsgruppe mit Gesichtsmaske signifikant die orofazialen Atemwegsdimensionen.

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Compliance with ethical guidelines

Conflict of interest. Mehmet Akin, Faruk Izzet Ucar, Chousein Chousein, and Zafer Sari state that there are no conflicts of interest.

All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies.

Einhaltung ethischer Richtlinien

Interessenkonflikt. Mehmet Akin, Faruk Izzet Ucar, Chousein Chousein und Zafer Sari geben an, dass kein Interessenkonflikt besteht.

Alle im vorliegenden Manuskript beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethik-Kommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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Authors and Affiliations

  1. Department of Orthodontics, Faculty of Dentistry, Selcuk University, Konya, Deutschland

    M. Akin &  F.I. Ucar

  2. Private Practice, Bursa, Turkey

    C. Chousein

  3. Department of Orthodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey

    Z. Sari

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  1. M. Akin
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  2. F.I. Ucar
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  3. C. Chousein
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  4. Z. Sari
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Correspondence to F.I. Ucar.

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Akin, M., Ucar, F., Chousein, C. et al. Effects of chincup or facemask therapies on the orofacial airway and hyoid position in Class III subjects. J Orofac Orthop 76, 520–530 (2015). https://doi.org/10.1007/s00056-015-0315-3

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