Three-dimensional skeletal and pharyngeal airway changes following therapy with functional appliances in growing skeletal Class II malocclusion patients

A controlled clinical trial

Dreidimensionale Veränderungen der skelettalen und pharyngealen Atemwege nach Therapie mit funktionellen Geräten bei heranwachsenden Patienten mit einer skelettalen Klasse-II-Malokklusion

Eine kontrollierte klinische Studie

Abstract

Introduction

To three-dimensionally analyze the skeletal and pharyngeal airway changes induced by Twin Block (TWB) and Forsus Fatigue Resistance Device (FFRD) in skeletal Class II female patients compared with untreated controls.

Materials and methods

The study comprised 62 growing female patients with skeletal Class II malocclusion due to mandibular retrusion treated with either TWB (n = 23) or FFRD (n = 21), or neither (n = 18; controls). Pre- and posttreatment/observational cone beam computed tomography images were used to evaluate the treatment changes.

Results

TWB induced more obvious mandibular skeletal changes and caused significant retrusive effects on the maxilla. Similarly, the sagittal and vertical jaw relationships were affected more obviously with TWB (P <0.001) compared to FFRD. Changes in oropharyngeal volume and minimal axial area were more obvious with TWB.

Discussion

The TWB functional appliance induced significant skeletal and pharyngeal airway changes. These changes were more obvious relative to the slight changes induced by FFRD or by natural growth.

Zusammenfassung

Einführung

Dreidimensional untersucht werden sollten TWB(Twin Block)- und FFRD(Forsus Fatigue Resistance Device)-induzierte Veränderungen der skelettalen und der pharyngealen Luftwege bei weiblichen Klasse-II-Patienten im Vergleich zu unbehandelten Kontrollen.

Material und Methoden

Die Studie umfasste 62 heranwachsende weibliche Patienten mit skelettaler Klasse-II-Malokklusion bei mandibulärer Retrusion, die entweder mit TWB (n = 23) oder FFRD (n = 21) behandelt wurden. Eine weitere, nicht behandelte Gruppe (n = 18) diente der Kontrolle. Zur Beurteilung der therapiebedingten Veränderungen wurden DVT(digitale Volumentomographie)-Aufnahmen vor und nach der Behandlung bzw. während der Beobachtungsphase analysiert.

Ergebnisse

Der TWB führte zu deutlicheren skelettalen Veränderungen der Mandibula und es kam zu signifikanten retrusiven Effekten auf die Maxilla. Auch die sagittalen und vertikalen Kieferrelationen wurden durch den TWB stärker verändert (<0,001) im Vergleich zum FFRD. Änderungen des oropharyngealen Volumens und der maximalen Engstelle des Atemweges waren bei TWB deutlicher zu erkennen.

Diskussion

Das TWB-Funktionsgerät führte zu signifikanten skelettalen Veränderungen und zu Veränderungen der pharyngealen Atemwege. Diese Veränderungen waren offensichtlicher im Vergleich zu den leichten Veränderungen, die durch die FFRD oder das natürliche Wachstum hervorgerufen wurden. .

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Correspondence to Assistant Professor Maged Sultan Alhammadi.

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Conflict of interest

M.S. Alhammadi, H.Y. Elfeky, M.S. Fayed, R.A.R. Ishaq, E. Halboub and A.A. Al-mashraqi declare that they have no competing interests.

Ethical standards

All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Alhammadi, M.S., Elfeky, H.Y., Fayed, M.S. et al. Three-dimensional skeletal and pharyngeal airway changes following therapy with functional appliances in growing skeletal Class II malocclusion patients. J Orofac Orthop 80, 254–265 (2019). https://doi.org/10.1007/s00056-019-00185-7

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Keywords

  • Twin Block
  • Pharyngeal airway
  • Cone-beam computed tomography
  • Functional appliance
  • Mandibular skeletal changes

Schlüsselwörter

  • Twin Block
  • Pharyngealer Atemweg
  • Digitale Volumentomographie
  • Funktionelle Apparatur
  • Skelettale Veränderungen der Mandibula