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Effects of Twin-Block with an expanding device on the upper airway in growing children with skeletal class II malocclusion—a retrospective study based on the consistency of three-dimensional and two-dimensional data

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Abstract

Objectives

Skeletal class II malocclusion is one of the most common malocclusions. Among the functional appliances for skeletal class II malocclusion, the Twin-Block appliance with a maxillary expander is effective in repositioning the mandible forward. In this study, we focused our efforts on investigating the effects of Twin-Block appliances with maxillary expanders on the upper airway in growing children with skeletal class II malocclusion by tracing and measuring lateral cephalograms after evaluating the consistency of three-dimensional CBCT data and two-dimensional lateral cephalogram data.

Materials and methods

A total of 102 patients ranging from 9 to 15 years old (11.37 ± 2.80, male/female ratio = 1:1) with skeletal class II malocclusion were selected to evaluate the consistency of CBCT data and lateral cephalogram data. The strongly and moderately correlated segments were then selected to study the effects of Twin-Block with a maxillary expander on the upper airway in 66 growing children with skeletal class II malocclusion (11.31 ± 1.23 years old, male/female ratio = 1:1) by lateral cephalograms.

Results

The results showed a strong significant correlation in the nasopharynx (r = 0.708) and moderate significant correlations in the overall upper airway (r = 0.641), palatopharynx (r = 0.553), and glossopharynx (r = 0.575) but a weak correlation in the hypopharynx (r = 0.323). The corresponding determination coefficient (R2) was also determined by scatter plot analysis. Moreover, compared with the pretreatment data (T1), the total area of the upper airway and the areas of the nasopharynx, palatopharynx, and glossopharynx after functional treatment (T2) increased statistically and significantly.

Conclusions

Lateral cephalograms can reflect the volume of the nasopharynx and oropharynx in skeletal class II children to a certain extent, while Twin-Block appliances with maxillary expanders can widen the volume of the nasopharynx and oropharynx significantly.

Clinical relevance

The lateral cephalogram is reliable for analyzing the nasopharynx, palatopharynx, and glossopharynx in orthodontic clinical practice. Twin-Block appliances with maxillary expanders have a positive effect on skeletal class II patients with airway stenosis.

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Data Availability

All relevant data are within the manuscript and its Additional files.

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Acknowledgements

We would like to thank Dr. Xiaoxi Wei and Dr. Zhi Mao at Jilin University for their excellent technical assistance and scientific input.

Funding

This study was supported by the National Natural Science Foundation of China [82100956] and the Natural Science Foundation of Jilin Province, China [YDZJ202301ZYTS432].

Author information

Authors and Affiliations

  1. Department of Orthodontics, Hospital of Stomatology, Jilin University, Changchun, Jilin, People’s Republic of China

    Feng Mao, Chenmeng Lu, Nan Liu, Zhiqing Liu, Yi Zhang, Huichuan Qi & Min Hu

  2. Department of Orthodontics, Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao, Shandong, People’s Republic of China

    Chenmeng Lu

  3. Department of Orthodontics, Suzhou Stomatological Hospital, Suzhou, Jiangsu, People’s Republic of China

    Nan Liu

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Contributions

Feng Mao executed the study, collected the data, and wrote the manuscript; Chenmeng Lu, Nan Liu, and Zhiqing Liu collected and analyzed the data; Yi Zhang edited the manuscript; Huichuan Qi and Min Hu conceived and designed the study, interpreted the data, and approved the manuscript.

Corresponding authors

Correspondence to Huichuan Qi or Min Hu.

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Ethics approval and consent to participate

All participants were written informed consents. The experimental designs and protocols were approved by the Institutional Review Board of Jilin University (JLUIRB-2022–59).

Competing interests

The authors declare no competing interests.

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Mao, F., Lu, C., Liu, N. et al. Effects of Twin-Block with an expanding device on the upper airway in growing children with skeletal class II malocclusion—a retrospective study based on the consistency of three-dimensional and two-dimensional data. Clin Oral Invest 28, 4 (2024). https://doi.org/10.1007/s00784-023-05388-2

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