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Upper airway changes following single-step or stepwise advancement using the Functional Mandibular Advancer

Veränderungen im Bereich der oberen Luftwege nach einzeitiger bzw. schrittweiser Vorverlagerung mit dem Functional Mandibular Advancer

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

Abstract

Objectives

Purpose of the present study was to determine and compare possible changes in the dimensions of the pharyngeal airway, morphology of the soft palate, and position of the tongue and hyoid bone after single-step or stepwise mandibular advancement using the Functional Mandibular Advancer (FMA).

Patients and methods

The sample included 51 peak-pubertal Class II subjects. In all, 34 patients were allocated to two groups using matched randomization: a single-step mandibular advancement group (SSG) and a stepwise mandibular advancement group (SWG). Both groups were treated with FMA followed by fixed appliance therapy; the remaining 17 subjects who underwent only fixed appliance therapy constituted the control group (CG). The study was conducted using pre- and posttreatment lateral cephalometric radiographs. Data were analyzed by paired t test, one-way analysis of variance, and Pearson’s correlation coefficient.

Result

In the SWG and SSG, although increases in nasopharyngeal airway dimensions were not significant compared with those in the CG, enlargements in the oropharyngeal airway dimensions at the level of the soft palate tip and behind the tongue, and decreases in soft palate angulation, were significant. Tongue height increased significantly only in the SWG. Compared with the CG, while forward movement of the hyoid was more prominent in SSG and SWG, the change in the vertical movement of the hyoid was not significant. No significant difference between SWG and SSG was observed in pharyngeal airway, soft palate, tongue or hyoid measurements.

Conclusions

The mode of mandibular advancement in FMA treatment did not significantly affect changes in the pharyngeal airway, soft palate, tongue, and hyoid bone.

Zusammenfassung

Zielsetzung

Ziel der Arbeit war die Überprüfung möglicher Veränderungen hinsichtlich der Dimensionen der pharyngealen Luftwege, der Morphologie des weichen Gaumens sowie der Position von Zunge und Os hyoideum nach einzeitiger bzw. mehrschrittiger Unterkiefervorverlagerung mittels Functional Mandibular Advancer (FMA).

Patienten und Methoden

Das Studienkollektiv bestand aus 51 Klasse-II-Patienten im pubertären Wachstumsmaximum. Insgesamt 34 Patienten wurden mittels gematchter Randomisierung 2 Gruppen zugeteilt: Gruppe 1 mit einschrittiger (“single-step mandibular advancement group”, SSG) und Gruppe 2 mit schrittweiser Unterkiefervorverlagerung (“stepwise mandibular advancement group”, SWG). In beiden Gruppen wurde mit FMA und anschließender festsitzender Apparatur behandelt. Die 17 Patienten, die nur mit einer festsitzenden Apparatur behandelt wurden, dienten als Kontrollgruppe (“control group”, CG). Untersucht wurden Fernröntgenseitenbilder vor und nach Behandlung; die Evaluierung der Daten erfolgte mit gepaartem t-Test, einfaktorieller Varianzanalyse und dem Korrelationskoeffizienten nach Pearson.

Ergebnisse

Die Erweiterungen im Bereich des Nasopharyngealraums waren nach SWG und SSG im Vergleich zu CG nicht signifikant. Vergrößerungen des oropharyngealen Luftwegs auf Höhe der Spitze des weichen Gaumens und hinter der Zunge sowie die Verringerungen der Angulierung des weichen Gaumens erwiesen sich als signifikant. Nur in der SWG-Gruppe änderte sich die Höhe der Zunge signifikant. Während die Bewegung des Os hyoideum nach anterior im Vergleich zur CG in den Gruppen SSG und SWG deutlicher war, erwies sich die Änderung in der vertikalen Bewegung des Os hyoideus als nicht signifikant. Zwischen den Gruppen SWG und SSG wurden keine signifikanten Unterschiede im Hinblick auf den pharyngealen Raum, den weichen Gaumen, die Zunge oder das Hyoid beobachtet.

Schlussfolgerung

Die Art der Unterkiefervorverlagerung mit der FMA-Apparatur hatte keinen signifikanten Effekt in Hinblick auf  den pharyngealen Luftweg, weichen Gaumen, Zunge und Os hyoideum.

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Author information

Authors and Affiliations

  1. Department of Orthodontics, Faculty of Dentistry, Ege University, 35080, Bornova, Izmir, Turkey

    Isil Aras & Aynur Aras

  2. Cihangir Mah. Kaptan Sokak Avcılar, Istanbul, Turkey

    Aylin Pasaoglu

  3. Dentege ADSM, Sair Esref Bulvarı No:90, Alsancak, Izmir, Turkey

    Sultan Olmez

  4. Dent Ekol ADSM, Mavisehir, Cigli, Izmir, Turkey

    Idil Unal

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  1. Isil Aras
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  2. Aylin Pasaoglu
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  3. Sultan Olmez
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  4. Idil Unal
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  5. Aynur Aras
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Correspondence to Isil Aras.

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Conflict of interest

I Aras, A. Pasaoglu, S. Olmez, I. Unal, and A. Aras declare that there are no competing interests. 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. Informed consent was obtained from all individual participants included in the study.

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

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  • DOI: https://doi.org/10.1007/s00056-016-0062-0

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