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Pharyngeal airway and hyoid bone position changes of skeletal anchored Forsus Fatigue Resistant Device and activator appliances

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Abstract

Objectives

To evaluate the effects of miniplate anchored Forsus Fatigue Resistant Device (MAF) and activator treatments in the pharyngeal airway dimensions and hyoid bone position.

Materials and methods

Thirty-eight patients with mandibular retrusion who were treated with either MAF or activator were selected retrospectively and compared with an untreated control group. The data of 114 lateral cephalograms, comprising those taken before treatment (T1) and at the end of functional treatment (T2), were evaluated with regard to their linear, angular, and area measurements.

Results

The mandibular length increased and the hyoid bone moved forward with both treatments (P < 0.05). The horizontal change in the hyoid bone position with MAF treatment was correlated with changes in the point B and ANB angle. Increases of 1.8 mm, 1.4 mm, and 1.8 mm in the pharyngeal airway dimensions were obtained at the levels of the second, third, and fourth cervical vertebra, respectively, with the MAF treatment. On the other hand, an increase of 1.9 mm was found at the level of the fourth cervical vertebra with the activator treatment. The greatest vertical movement in the Menton and the highest increase in the oropharyngeal area were observed in the MAF group (P < 0.05).

Conclusion

Both the MAF and activator treatments caused favorable maxillomandibular changes; however, the MAF treatment provided a greater increase in the oropharyngeal area according to both the increase in mandibular length and the change in the vertical position of the mandible.

Clinical relevance

Functional appliances were found to be useful in increasing the pharyngeal airway dimensions in the short-term. The skeletal anchored fixed functional appliance caused a greater increase in the oropharyngeal airway area that may be beneficial for Class II patients who carry a risk of having respiratory problems.

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References

  1. Aksu M, Gorucu-Coskuner H, Taner T (2017) Assessment of upper airway size after orthopedic treatment for maxillary protrusion or mandibular retrusion. Am J Orthod Dentofac Orthop 152:364–370. https://doi.org/10.1016/j.ajodo.2016.12.027

    Article  Google Scholar 

  2. Hourfar J, Kinzinger GSM, Meißner LK, Lisson JA (2017) Effects of two different removable functional appliances on depth of the posterior airway space.Effekte zweier verschiedener herausnehmbarer funktionskieferorthopädischer Apparaturen auf die Tiefe des extrathorakalen Luftraums. J Orofac Orthop / Fortschritte der Kieferorthopädie 78:166–175. https://doi.org/10.1007/s00056-016-0071-z

    Article  PubMed  Google Scholar 

  3. Gul Amuk N, Kurt G, Baysal A, Turker G (2019) Changes in pharyngeal airway dimensions following incremental and maximum bite advancement during Herbst-rapid palatal expander appliance therapy in late adolescent and young adult patients: a randomized non-controlled prospective clinical study. Eur J Orthod 41:322–330. https://doi.org/10.1093/ejo/cjz011

    Article  PubMed  Google Scholar 

  4. Godt A, Koos B, Hagen H, Göz G (2011) Changes in upper airway width associated with Class II treatments (headgear vs activator) and different growth patterns. Angle Orthod 81:440–446. https://doi.org/10.2319/090710-525.1

    Article  PubMed  Google Scholar 

  5. Ulusoy C, Canigur Bavbek N, Tuncer B et al (2014) Evaluation of airway dimensions and changes in hyoid bone position following class II functional therapy with activator. Acta Odontol Scand 72:917–925. https://doi.org/10.3109/00016357.2014.923109

    Article  PubMed  Google Scholar 

  6. Han S, Choi YJ, Chung CJ, Kim JY, Kim KH (2014) Long-term pharyngeal airway changes after bionator treatment in adolescents with skeletal Class II malocclusions. Korean J Orthod 44:13–19. https://doi.org/10.4041/kjod.2014.44.1.13

    Article  PubMed  PubMed Central  Google Scholar 

  7. Drosen C, Bock NC, von Bremen J, Pancherz H, Ruf S (2018) Long-term effects of Class II Herbst treatment on the pharyngeal airway width. Eur J Orthod 40:82–89. https://doi.org/10.1093/ejo/cjx032

    Article  PubMed  Google Scholar 

  8. Saaresranta T, Polo O (2006) Sleep-disordered breathing and hormones. Neuroendocr Correl Sleep/Wakefulness 437–470. https://doi.org/10.1007/0-387-23692-9_23

  9. Kaditis AG, Alvarez MLA, Boudewyns A et al (2016) Obstructive sleep disordered breathing in 2- to 18-year-old children: diagnosis and management. Eur Respir J 47:69–94. https://doi.org/10.1183/13993003.00385-2015

    Article  PubMed  Google Scholar 

  10. Celikoglu M, Buyuk SK, Ekizer A, Unal T (2016) Pharyngeal airway effects of Herbst and skeletal anchored Forsus FRD EZ appliances. Int J Pediatr Otorhinolaryngol 90:23–28. https://doi.org/10.1016/j.ijporl.2016.08.020

    Article  PubMed  Google Scholar 

  11. Lin YC, Lin HC, Tsai HH (2011) Changes in the pharyngeal airway and position of the hyoid bone after treatment with a modified bionator in growing patients with retrognathia. J Exp Clin Med 3:93–98. https://doi.org/10.1016/j.jecm.2011.02.005

    Article  Google Scholar 

  12. Bavbek NC, Tuncer BB, Turkoz C, Ulusoy C, Tuncer C (2016) Changes in airway dimensions and hyoid bone position following class II correction with forsus fatigue resistant device. Clin Oral Investig 20:1747–1755. https://doi.org/10.1007/s00784-015-1659-1

    Article  PubMed  Google Scholar 

  13. Elkordy SA, Abouelezz AM, Fayed MMS, Aboulfotouh MH, Mostafa YA (2019) Evaluation of the miniplate-anchored Forsus Fatigue Resistant Device in skeletal Class II growing subjects: a randomized controlled trial. Angle Orthod 89:391–403. https://doi.org/10.2319/062018-468.1

    Article  PubMed  Google Scholar 

  14. Pandis N (2012) Sample calculations for comparison of 2 means. Am J Orthod Dentofac Orthop 141:519–521

    Article  Google Scholar 

  15. Kannan A, Sathyanarayana HP, Padmanabhan S (2017) Effect of functional appliances on the airway dimensions in patients with skeletal class II malocclusion: a systematic review. J Orthod Sci 6:54–64. https://doi.org/10.4103/jos.JOS_154_16

    Article  PubMed  PubMed Central  Google Scholar 

  16. Hänggi MP, Teuscher UM, Roos M, Peltomäki TA (2008) Long-term changes in pharyngeal airway dimensions following activator-headgear and fixed appliance treatment. Eur J Orthod 30:598–605. https://doi.org/10.1093/ejo/cjn055

    Article  PubMed  Google Scholar 

  17. Kinzinger G, Czapka K, Ludwig B, Glasl B, Gross U, Lisson J (2011) Effects of fixed appliances in correcting Angle Class II on the depth of the posterior airway space: FMA vs. Herbst appliance--a retrospective cephalometric study. J Orofac Orthop 72:301–320. https://doi.org/10.1007/s00056-011-0035-2

    Article  PubMed  Google Scholar 

  18. Joseph AA, Elbaum J, Cisneros GJ, Eisig SB (1998) A cephalometric comparative study of the soft tissue airway dimensions in persons with hyperdivergent and normodivergent facial patterns. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg 56:135–140. https://doi.org/10.1016/s0278-2391(98)90850-3

    Article  Google Scholar 

  19. Jena AK, Singh SP, Utreja AK (2010) Sagittal mandibular development effects on the dimensions of the awake pharyngeal airway passage. Angle Orthod 80:1061–1067. https://doi.org/10.2319/030210-125.1

    Article  PubMed  Google Scholar 

  20. Turkkahraman H, Eliacik SK, Findik Y (2016) Effects of miniplate anchored and conventional Forsus Fatigue Resistant Devices in the treatment of Class II malocclusion. Angle Orthod 86:1026–1032. https://doi.org/10.2319/122515-887.1

    Article  PubMed  Google Scholar 

  21. Rizk S, Kulbersh VP, Al-Qawasmi R (2016) Changes in the oropharyngeal airway of Class II patients treated with the mandibular anterior repositioning appliance. Angle Orthod 86:955–961. https://doi.org/10.2319/042915-295.1

    Article  PubMed  Google Scholar 

  22. Zhou L, Zhao Z, Lu D (2000) The analysis of the changes of tongue shape and position, hyoid position in Class II, division 1 malocclusion treated with functional appliances (FR-I). West China J Stomatol 18:123–125

    Google Scholar 

  23. Chung DH, Hatch JP, Dolce C, van Sickels JE, Bays RA, Rugh JD (2001) Positional change of the hyoid bone after bilateral sagittal split osteotomy with rigid and wire fixation. Am J Orthod Dentofac Orthop 119:382–389. https://doi.org/10.1067/mod.2001.112670

    Article  Google Scholar 

  24. Tsuiki S, Hiyama S, Ono T, Imamura N, Ishiwata Y, Kuroda T, Lowe AA (2001) Effects of a titratable oral appliance on supine airway size in awake non-apneic individuals. Sleep 24:554–560. https://doi.org/10.1093/sleep/24.5.554

    Article  PubMed  Google Scholar 

  25. Eggensperger N, Smolka K, Johner A, Rahal A, Thüer U, Iizuka T (2005) Long-term changes of hyoid bone and pharyngeal airway size following advancement of the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 99:404–410. https://doi.org/10.1016/j.tripleo.2004.07.019

    Article  PubMed  Google Scholar 

  26. Bronoosh P, Khojastepour L (2015) Analysis of pharyngeal airway using lateral cephalogram vs CBCT images: a cross-sectional retrospective study. Open Dent J 9:263–266. https://doi.org/10.2174/1874210601509010263

    Article  PubMed  PubMed Central  Google Scholar 

  27. Vizzotto MB, Liedke GS, Delamare EL, Silveira HD, Dutra V, Silveira HE (2012) A comparative study of lateral cephalograms and cone-beam computed tomographic images in upper airway assessment. Eur J Orthod 34:390–393. https://doi.org/10.1093/ejo/cjr012

    Article  PubMed  Google Scholar 

  28. Aras I, Pasaoglu A, Olmez S, Unal I, Aras A (2016) Upper airway changes following single-step or stepwise advancement using the Functional Mandibular Advancer. J Orofac Orthop 77:454–462. https://doi.org/10.1007/s00056-016-0062-0

    Article  PubMed  Google Scholar 

  29. Colceriu-Șimon IM, Băciuț M, Ştiufiuc RI et al (2019) Clinical indications and radiation doses of cone beam computed tomography in orthodontics. Med Pharm Rep 92:346–351. https://doi.org/10.15386/mpr-1434

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

The authors would like to thank the American Association of Orthodontists Foundation for their kindness in the donation of growth study records.

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Authors and Affiliations

  1. Department of Orthodontics, Faculty of Dentistry, Baskent University, 1. Cad No: 107 Bahcelievler, Ankara, Turkey

    Sinem İnce-Bingöl & Burçak Kaya

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  1. Sinem İnce-Bingöl
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  2. Burçak Kaya
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All the authors have read and approved the manuscript statement.

Corresponding author

Correspondence to Sinem İnce-Bingöl.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Baskent University Institutional Review Board and Ethics Committee (Project number: D-KA 19/14). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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İnce-Bingöl, S., Kaya, B. Pharyngeal airway and hyoid bone position changes of skeletal anchored Forsus Fatigue Resistant Device and activator appliances. Clin Oral Invest 25, 4841–4850 (2021). https://doi.org/10.1007/s00784-021-03789-9

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  • DOI: https://doi.org/10.1007/s00784-021-03789-9

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