Effect of modified tandem traction bow appliance on airway size

Yıl 2019, Cilt: 36 Sayı: 2, 47 - 52, 01.05.2019

Emine Kaygısız , Merve Kurnaz Sema Yüksel , Tuba Tortop

https://doi.org/10.17214/gaziaot.452130

Cited By: 2

Öz

Objective: To investigate the effect of modified
tandem traction bow appliances (MTTBA) on pharyngeal airway dimensions in Class
III malocclusion treatment.

Materials and Method: The material of this study
consisted of pre-treatment (T1) and post-treatment (T2) lateral cephalometric
radiographs of 20 subjects with skeletal and dental Class III malocclusion (8
females and 12 males; mean chronologic age; 10 years and 1 month) who had been
treated with the MTTBA appliance. Elastics that exerted a force of 400-500 g were worn between the
upper splint and the traction bow with an angle of 35-40°. The average
treatment time was 12 months. Linear and area measurements were done to
determine the pharyngeal airway dimensions. Kolmogorov-Smirnov and paired t-tests
were used for the statistical analysis, and p<0.05 was considered as statistically
significant.

Results: Treatment changes indicated significant
forward-movement of the maxilla (p<0.001) and significant increases in
effective lengths of the maxilla and the mandible (p<0.001). The mandible
showed a clockwise rotation because of the increase in mandibular plane angle
(p<0.001). A significant increase in the oropharyngeal area (OA; p<0.05),
and an insignificant increase in the nasopharyngeal area (NA) was found. Hyoid
bone moved anterior and inferior insignificantly.

Conclusion: A favorable improvement was observed
in the oropharyngeal area by the MTTBA appliance that was used in the treatment
of Class III malocclusion.

Anahtar Kelimeler

Angle Class III, Airway management, malocclusion, orthodontic appliances, orthodontics

Modifiye tandem traksiyon yüz arkı apareyinin hava yolu boyutuna etkisi

Öz

Amaç: Sınıf III
maloklüzyon tedavisinde kullanılan modifiye tandem traksiyon yüz arkı (MTTYA)
apareyinin faringeal hava yolu boyutları üzerine olan etkisini incelemekti.

Gereç ve
Yöntem: Çalışmanın materyalini, iskeletsel ve dişsel Sınıf III
maloklüzyona sahip, MTTYA apareyi ile tedavi edilmiş olan 20 bireyin (8 kadın
ve 12 erkek; yaş ortalaması 10 yıl 1 ay) tedavi öncesi (T1) ve sonrası (T2)
lateral sefalometrik radyografileri oluşturdu. MTTYA apareyinin üst plağından
yüz arkına oklüzal düzlemle 35-40° açı yapacak şekilde 400-500 g. kuvvet uygulayan
elastikler asıldı. Ortalama 12 aylık tedavi uygulandı. Faringeal havayolu boyut
ve alan ölçümleri yapıldı. İstatistiksel analizde, Kolmogorov-Smirnov ve
eşleştirilmiş t testleri kullanıldı ve p<0.05 değeri anlamlı olarak kabul
edildi.

Bulgular: Tedavi ile
maksillada ileri yönde harekette (p<0.001) ve efektif maksilla ve mandibula
boyutlarında anlamlı artışlar ortaya çıktı (p<0.001). Mandibular düzlem
eğiminin artışı (p<0.001) ile mandibulada posterior rotasyon saptandı.
Orofaringeal alanda (OA) anlamlı düzeyde (p<0.05) ve nazofaringeal alanda
(NA) anlamlı olmayan düzeyde artışlar gözlendi. Hyoid kemik, anlamlı olmayan
düzeyde öne ve aşağıya yer değiştirdi.

Sonuç: Sınıf III
malokluzyon tedavisinde kullanılan MTTYA apareyi uygulaması ile orofaringeal
havayolu alanında olumlu yönde değişiklik gözlendi.

Anahtar Kelimeler

Angle Sınıf 3, havayolu yönetimi, maloklüzyon, ortodontik gereçler, ortodonti

Kaynakça

• Kaygisiz E, Taner L, Gungor K. Distribution of sagittal occlusal relationships in different stages of dentition. Braz Oral Res 2015;29:1-6.
• Bozkaya E, Yüksel AS, Bozkaya S. Zygomatic miniplates for skeletal anchorage in orthopedic correction of Class III malocclusion: A controlled clinical trial. Korean J Orthod 2017;47:118-29.
• Baccetti T, Franchi L, McNamara JA Jr. Treatment and posttreatment changes after rapid maxillary expansion and facemask therapy. Am J Orthod Dentofacial Orthop 2000; 118:404–413.
• Toffol LD, Pavoni C, Bacetti T, Franchi L, Cozza P. Orthopedic treatment outcomes in Class III malocclusion: a systematic review. Angle Orthod 2008;78:561–73.
• Vaughn GA, Mason B, Moon HB, Turley PK. The effects of maxillary protraction therapy with or without rapid palatal expansion: a prospective, randomized trial. Am J Orthod Dentofacial Orthop 2005;128:299–309.
• Garattini G, Levrini L, Crozzoli P, Levrini A. Skeletal and dental modifications produced by the Bionator III appliance. Am J Orthod Dentofacial Orthop 1998;114:40–4.
• Ulgen M, Firatli S. The effects of the Frankel’s function regulator on the Class III malocclusion. Am J Orthod Dentofacial Orthop 1994;105:561–7.
• Kidner G, DiBiase A, DiBiase D. Class III twin blocks: a case series. J Orthod 2003;30:197–201.
• Godt A, Zeyher C, Schatz Maier D, Göz G. Early treatment to correct Class III relations with or without facemasks. Angle Orthod 2008;78:44–9.
• Ucem TT, Ucuncu N, Yuksel S. Comparison of double plate appliance and facemask therapy in treating Class III malocclusions. Am J Orthod Dentofacial Orthop 2004;126: 672–9.
• Chun Y, Jeong SG, Row J, Yang SJ. A new appliance for orthopedic correction of Class III malocclusion. J Clin Orthod 1992;33:705–11.
• Atalay Z, Tortop T. Dentofacial effects of a modified tandem traction bow appliance. Eur J Orthod 2010;32:655–61.
• Tortop T, Kaygisiz E, Gencer D, Yuksel S, Atalay Z. Modified tandem traction bow appliance compared with facemask therapy in treating Class III malocclusions. Angle Orthod 2014;84:642-8.
• Ngan P, Hagg U, Yiu C, Merwin D, Wei SH. Soft tissue and dentoskeletal profile changes associated with maxillary expansion and protraction headgear treatment. Am J Orthod Dentofacial Orthop 1996;109:38–49.
• Kaygisiz E, Tuncer BB, Yüksel S, Tuncer C, Yildiz C. Effects of maxillary protraction and fixed appliance therapy on the pharyngeal airway. Angle Orthod 2009;79:660-7.
• Oktay H, Ulukaya E. Maxillary protraction appliance effect on the size of the upper airway passage. Angle Orthod. 2008;78:209–14.
• Hiyama S, Suda N, Ishii-Suzuki M, Tsuiki S, Ogawa M, Suzuki S, et al. Effects of maxillary protraction on craniofacial structures and upper-airway dimension. Angle Orthod 2002;72:43–7.
• Mucedero M, Baccetti T, Franchi L, Cozza P. Effects of maxillary protraction with or without expansion on the sagittal pharyngeal dimensions in Class III subjects. Am J Orthod Dentofacial Orthop 2009;135:777-81.
• Baccetti T, Franchi L, Mucedero M, Cozza P. Treatment and post-treatment effects of facemask therapy on the sagittal pharyngeal dimensions in Class III subjects. Eur J Orthod 2010;32:346-50.
• Chen F, Terada K, Hua Y, Saito I. Effects of bimaxillary surgery and mandibular setback surgery on pharyngeal airway measurements in patients with Class III skeletal deformities. Am J Orthod Dentofacial Orthop 2007;131:372-7.
• Dalmau E, Zamora N, Tarazona B, Gandia JL, Paredes V. A comparative study of the pharyngeal airway space, measured with cone beam computed tomography, between patients with different craniofacial morphologies. J Craniomaxillofac Surg 2015;43:1438-46.
• Grauer D, Cevidanes LS, Styner MA, Ackerman JL, Proffit WR. Pharyngeal airway volume and shape from cone-beam computed tomography: relationship to facial morphology. Am J Orthod Dentofacial Orthop 2009;136:805-14.
• Oz U, Orhan K, Abe N. Comparison of linear and angular measurements using two-dimensional conventional methods and three-dimensional cone beam CT images reconstructed from a volumetric rendering program in vivo. Dentomaxillofac Radiol 2011;40:492-500.
• Zamora N, Llamas JM, Cibrián R, Gandia JL, Paredes V. Cephalometric measurements from 3D reconstructed images compared with conventional 2D images. Angle Orthod 2011;81:856-64.
• Riley RW, Powell NB. Maxillofacial surgery and obstructive sleep apnea syndrome. Otolaryngol Clin North Am1990;23:809-26.
• Akin M, Ucar FI, Chousein C, Sari Z. Effects of chincup or facemask therapies on the orofacial airway and hyoid position in Class III subjects. J Orofac Orthop 2015;76:520-30.
• Pereira-Filho VA, Monnazzi MS, Gabrielli MA, Spin-Neto R, Watanabe ER, Gimenez CM, et al. Volumetric upper airway assessment in patients with transverse maxillary deficiency after surgically assisted rapid maxillary expansion. Int J Oral Maxillofac Surg 2014;43:581-6.
• Baik HS. Clinician results of the maxillary protraction in Korean children. Am J Orthod Dentofacial Orthop 1995;108:583–92.
• Wells AP, Sarver DM, Proffit WR. Long-term efficacy of reverse headgear therapy. Angle Orthod 2006;76:915–22.
• Hagg U, Tse A, Bendeus M, Rabie AB. Long-term follow-up of early treatment with reverse headgear. Eur J Orthod 2003;25:95–102.
• Westwood PV, McNamara JA Jr, Baccetti T, Franchi L, Sarver DM. Long-term effects of Class III treatment with rapid maxillary expansion and facemask therapy followed by fixed appliances. Am J Orthod Dentofacial Orthop 2003;123:306-20.
• Sayınsu K, Isık F, Arun T. Sagittal airway dimensions following maxillary protraction: a pilot study. Eur J Orthod 2006;28:184–9.
• Kilinç AS, Arslan SG, Kama JD, Ozer T, Darı O. Effects on the sagittal pharyngeal dimensions of protraction and rapid palatal expansion in Class III malocclusion subjects. Eur J Orthod 2008;30:61–6.
• Aydemir H, Memikoğlu U, Karasu H. Pharyngeal airway space, hyoid bone position and head posture after orthognathic surgery in Class III patients. Angle Orthod 2012;82:993-1000.
• Efendiyeva R, Aydemir H, Karasu H, Toygar-Memikoğlu U. Pharyngeal airway space, hyoid bone position, and head posture after bimaxillary orthognathic surgery in Class III patients: long-term evaluation. Angle Orthod 2014;84:773-81.
• Tuncer BB, Kaygisiz E, Tuncer C, Yüksel S. Pharyngeal airway dimensions after chin cup treatment in Class III malocclusion subjects. J Oral Rehabil 2009;36:110-7.