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KJO Korean Journal of Orthodontics

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Korean J Orthod

Published online December 10, 2020

Copyright © The Korean Association of Orthodontists.

Effect of extraction treatment on upper airway dimension in patients with bimaxillary skeletal protrusion relative to their vertical skeletal pattern

Ha-Nul Cho, MSDa; Hyun Joo Yoon, MSDb; Jae Hyun Park, PhDc, Young-Guk Park, PhDd, Su-Jung Kim, PhDe*

a Graduate student, Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
b Graduate student, Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
c Professor and Chair, Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, AZ, USA; and International Scholar, Graduate School of Dentistry, Kyung Hee University, Seoul, Korea.
d Professor, Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea.
e Professor and Department Chair, Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea.

Correspondence to:Dr. Su-Jung Kim, Professor and Department Chair, Department of Orthodontics, School of Dentistry, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea.
Tel: +82-2-958-9390, E-mail: ksj113@khu.ac.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective: To investigate the dimensional changes of regional pharyngeal airway spaces after premolar extraction treatment in bimaxillary skeletal protrusion (BSP) patients according to their vertical skeletal pattern, and further to identify dentoskeletal risk factors to predict posttreatment pharyngeal changes.
Materials and Methods: Fifty-five BSP adults treated with microimplants anchorage after four premolar extractions were included in this retrospective study. The subjects were divided into two groups according to the mandibular plane steepness (FH-MP): hyperdivergent (FH-MP≥30°) and nonhyperdivergent groups (FHMP< 30°). The control group comprised twenty untreated adults with skeletal Class I normodivergent pattern and favorable facial profile. Treatment changes of cephalometric variables were evaluated and compared between the groups. The association between posttreatment changes in the dentoskeletal and upper airway variables were analyzed using linear regression analysis.
Results: The BSP patients showed no significant decrease in the pharyngeal dimensions to the lower level than that of the control group, except for middle airway space (MAS, P<.01). The upper airway variable representing greater decrease in the hyperdivergent group than in the nonhyperdivergent group was the MAS (P<.01). Posttreatment change of FH-MP had negative correlation with the change of MAS (β= -0.42, P<.01) and inferior airway space (IAS, β=-0.52, P<.01) as a result of multivariable regression analysis adjusted for sagittal skeletal relationship.
Conclusions: Decreased pharyngeal dimension after treatment in BSP patients showed no significant difference from normal range of pharyngeal dimension. However, glossopharyngeal airway space may be susceptible to the treatment changes if the vertical dimension is increased in hyperdivergent BSP patients.

Keywords: Airway, Cephalometrics, bimaxillary skeletal protrusion, vertical skeletal pattern

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Korean J Orthod

Published online December 10, 2020

Copyright © The Korean Association of Orthodontists.

Effect of extraction treatment on upper airway dimension in patients with bimaxillary skeletal protrusion relative to their vertical skeletal pattern

Ha-Nul Cho, MSDa; Hyun Joo Yoon, MSDb; Jae Hyun Park, PhDc, Young-Guk Park, PhDd, Su-Jung Kim, PhDe*

a Graduate student, Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
b Graduate student, Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
c Professor and Chair, Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, AZ, USA; and International Scholar, Graduate School of Dentistry, Kyung Hee University, Seoul, Korea.
d Professor, Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea.
e Professor and Department Chair, Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea.

Correspondence to:Dr. Su-Jung Kim, Professor and Department Chair, Department of Orthodontics, School of Dentistry, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea.
Tel: +82-2-958-9390, E-mail: ksj113@khu.ac.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective: To investigate the dimensional changes of regional pharyngeal airway spaces after premolar extraction treatment in bimaxillary skeletal protrusion (BSP) patients according to their vertical skeletal pattern, and further to identify dentoskeletal risk factors to predict posttreatment pharyngeal changes.
Materials and Methods: Fifty-five BSP adults treated with microimplants anchorage after four premolar extractions were included in this retrospective study. The subjects were divided into two groups according to the mandibular plane steepness (FH-MP): hyperdivergent (FH-MP≥30°) and nonhyperdivergent groups (FHMP< 30°). The control group comprised twenty untreated adults with skeletal Class I normodivergent pattern and favorable facial profile. Treatment changes of cephalometric variables were evaluated and compared between the groups. The association between posttreatment changes in the dentoskeletal and upper airway variables were analyzed using linear regression analysis.
Results: The BSP patients showed no significant decrease in the pharyngeal dimensions to the lower level than that of the control group, except for middle airway space (MAS, P<.01). The upper airway variable representing greater decrease in the hyperdivergent group than in the nonhyperdivergent group was the MAS (P<.01). Posttreatment change of FH-MP had negative correlation with the change of MAS (β= -0.42, P<.01) and inferior airway space (IAS, β=-0.52, P<.01) as a result of multivariable regression analysis adjusted for sagittal skeletal relationship.
Conclusions: Decreased pharyngeal dimension after treatment in BSP patients showed no significant difference from normal range of pharyngeal dimension. However, glossopharyngeal airway space may be susceptible to the treatment changes if the vertical dimension is increased in hyperdivergent BSP patients.

Keywords: Airway, Cephalometrics, bimaxillary skeletal protrusion, vertical skeletal pattern