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Korean J Orthod
Copyright © The Korean Association of Orthodontists.
Su-Ji Yoon a; Il-Hyung Yang b, Su-Jung Kim c, Seung-Hak Baek d
a Graduate student (PhD), Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea (tnwl437@naver.com; +82-10-6250-1847; ORCID: 0009-0007-7147-8078)
b Dept. of Orthodontics, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Republic of Korea (drortho@snu.ac.kr; +82-2-2072-4701; ORCID: 0000-0001-6398-4607)
c Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Republic of Korea (ksj113@khu.ac.kr; +82-10-9967-2545; ORCID: 0000-0001-8500-5246)
d Professor, Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea (drwhite@snu.ac.kr; +82-2-6256-3238; ORCID: 0000-0002-6586-9503)
Correspondence to:Dr. Seung-Hak Baek, Department of Orthodontics, School of Dentistry, Seoul National University, Daehakro 101, Jongro-gu, Seoul, 03080, Republic of Korea; e-mail: drwhite@snu.ac.kr Tel: +82-2-6256-3238; Fax: +82-2-2072-3817.
Objective: To investigate the change in the upper airway (UA) dimension in growing patients with Pierre-Robin sequence (PRS).
Methods: The subjects were 23 PRS patients, who did not undergo growth modification therapy or surgical intervention. Lateral cephalograms were taken longitudinally at mean ages of 8.81 years (T0) and 14.05 years (T1). Based on the SNB value at T0 (criteria: -2 SD), they were divided into the very retrusive mandible group (Group-1; n=13) and the moderately retrusive mandible group (Group-2; n=10). The skeletal and UA variables at T0 and T1 as well as the amounts of change (T0-T1) were investigated statistically.
Results: Group-1 showed a more retrusive maxilla and mandible (SNA, p<0.01; SNB, p<0.001), a more hyperdivergent pattern (FHR, p<0.05), and a more backward-positioned hyoid bone (H-PTV, p<0.05) at T0 and exhibited a more retrusive maxilla and mandible (SNA, SNB, all p<0.01), a less forward-positioned tongue (TT-PTV, p<0.05) and a more obtuse soft palate angle (SPA, p<0.05) at T1 than Group-2. However, at T0, Group-1 had a larger pharyngeal UA space (SPAS, IPAS, all p<0.05) than Group-2, which might indicate the existence of compensatory response to maintain the UA patency. During T0-T1, Group-1 showed increases in the distance between hyoid bone and symphysis (ΔH-RGN, p<0.001), tongue length (ΔTGL, p<0.01), and pharyngeal UA spaces (ΔSPAS, ΔPNS-ad2, all p<0.001).
Conclusions: In growing PRS patients with a severely retrusive mandible, the UA dimension increased due to forward growth of the mandible, repositioning of the tongue and hyoid bone, and the existence of compensatory response.
Keywords: upper airway, Pierre-Robin sequence
Korean J Orthod
First Published Date November 14, 2024
Copyright © The Korean Association of Orthodontists.
Su-Ji Yoon a; Il-Hyung Yang b, Su-Jung Kim c, Seung-Hak Baek d
a Graduate student (PhD), Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea (tnwl437@naver.com; +82-10-6250-1847; ORCID: 0009-0007-7147-8078)
b Dept. of Orthodontics, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Republic of Korea (drortho@snu.ac.kr; +82-2-2072-4701; ORCID: 0000-0001-6398-4607)
c Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Republic of Korea (ksj113@khu.ac.kr; +82-10-9967-2545; ORCID: 0000-0001-8500-5246)
d Professor, Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea (drwhite@snu.ac.kr; +82-2-6256-3238; ORCID: 0000-0002-6586-9503)
Correspondence to:Dr. Seung-Hak Baek, Department of Orthodontics, School of Dentistry, Seoul National University, Daehakro 101, Jongro-gu, Seoul, 03080, Republic of Korea; e-mail: drwhite@snu.ac.kr Tel: +82-2-6256-3238; Fax: +82-2-2072-3817.
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.
Objective: To investigate the change in the upper airway (UA) dimension in growing patients with Pierre-Robin sequence (PRS).
Methods: The subjects were 23 PRS patients, who did not undergo growth modification therapy or surgical intervention. Lateral cephalograms were taken longitudinally at mean ages of 8.81 years (T0) and 14.05 years (T1). Based on the SNB value at T0 (criteria: -2 SD), they were divided into the very retrusive mandible group (Group-1; n=13) and the moderately retrusive mandible group (Group-2; n=10). The skeletal and UA variables at T0 and T1 as well as the amounts of change (T0-T1) were investigated statistically.
Results: Group-1 showed a more retrusive maxilla and mandible (SNA, p<0.01; SNB, p<0.001), a more hyperdivergent pattern (FHR, p<0.05), and a more backward-positioned hyoid bone (H-PTV, p<0.05) at T0 and exhibited a more retrusive maxilla and mandible (SNA, SNB, all p<0.01), a less forward-positioned tongue (TT-PTV, p<0.05) and a more obtuse soft palate angle (SPA, p<0.05) at T1 than Group-2. However, at T0, Group-1 had a larger pharyngeal UA space (SPAS, IPAS, all p<0.05) than Group-2, which might indicate the existence of compensatory response to maintain the UA patency. During T0-T1, Group-1 showed increases in the distance between hyoid bone and symphysis (ΔH-RGN, p<0.001), tongue length (ΔTGL, p<0.01), and pharyngeal UA spaces (ΔSPAS, ΔPNS-ad2, all p<0.001).
Conclusions: In growing PRS patients with a severely retrusive mandible, the UA dimension increased due to forward growth of the mandible, repositioning of the tongue and hyoid bone, and the existence of compensatory response.
Keywords: upper airway, Pierre-Robin sequence
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