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      Correlation Analysis between Three-Dimensional Changes in Pharyngeal Airway Space and Skeletal Changes in Patients with Skeletal Class II Malocclusion following Orthognathic Surgery

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          Abstract

          Introduction

          Studies on the pharyngeal airway space (PAS) changes using three-dimensional computed tomography (CT) have shed more light on patients with Class III than Class II malocclusion. This paper focuses on analyzing the long-term changes in the PAS and evaluating the postoperative association between these PAS and skeletal changes in patients with skeletal Class II malocclusion who have undergone orthognathic surgery.

          Methods

          The records of 21 patients with skeletal Class II malocclusion who had undergone orthognathic surgery were included. The anatomical modifications in both jaws, changes in volume, sectional area (SA), minimum sectional area (MSA), and anterior-posterior (AP) and transverse (TV) width in the airway at one month before surgery ( T0), and one month ( T1) and one year ( T2) after surgery were analyzed using CT images. The association between the skeletal and airway changes was evaluated between T0, T1, and T2.

          Results

          After surgery, the ANS, A point, and PNS demonstrated significant posterior and superior movement. The B point and the pogonion exhibited substantial anterior and superior movement. The total and inferior oropharyngeal volumes (vol 3, vol 4) notably increased, while the nasopharyngeal volume (vol 1) decreased. The anterior-posterior movement at the ANS and PNS after surgery was significantly associated with the total volume, vol 2, vol 3, SA 1, MSA, and TV width 1, while substantial association with the total volume was found at the pogonion.

          Conclusion

          Thus, an ideal treatment plan can be formulated for patients with skeletal Class II malocclusion by considering the postoperative PAS changes.

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          Most cited references45

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          Cephalometrics for you and me

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            Components of class II malocclusion in children 8-10 years of age.

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              The upper airway in sleep: physiology of the pharynx.

              The upper airway is the primary conduit for passage of air into the lungs. Its physiology has been the subject of intensive study: both passive mechanical and active neural influences contribute to its patency and collapsibility. Different models can be used to explain behavior of the upper airway, including the "balance of forces" (airway suction pressure during inspiration versus upper airway dilator tone) and the Starling resistor mechanical model. As sleep is the primary state change responsible for sleep disordered breathing (SDB) and the obstructive apnea/hypopnea syndrome (OSAHS), understanding its effects on the upper airway is critical. These include changes in upper airway muscle dilator activity and associated changes in mechanics and reflex activity of the muscles. Currently SDB is thought to result from a combination of anatomical upper airway predisposition and changes in neural activation mechanisms intrinsic to sleep. Detection of SDB is based on identifying abnormal (high resistance) breaths and events, but the clinical tools used to detect these events and an understanding of their impact on symptoms is still evolving. Outcomes research to define which events are most important, and a better understanding of how events lead to physiologic consequences of the syndrome, including excessive daytime somnolence (EDS), will allow physiologic testing to objectively differentiate between "normal" subjects and those with disease.
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                Author and article information

                Contributors
                Journal
                Biomed Res Int
                Biomed Res Int
                BMRI
                BioMed Research International
                Hindawi
                2314-6133
                2314-6141
                2022
                11 January 2022
                : 2022
                : 3995690
                Affiliations
                1Department of Orthodontics, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
                2Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
                3Department of Oral & Maxillofacial Surgery, Oral Science Research Center, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
                Author notes

                Academic Editor: Fabiano Bini

                Author information
                https://orcid.org/0000-0003-2772-0836
                https://orcid.org/0000-0002-1275-5078
                Article
                10.1155/2022/3995690
                8766181
                473dbe97-1d52-42a7-8ad1-bac6adf2931b
                Copyright © 2022 Moonhwan Kim et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 September 2021
                : 10 December 2021
                : 16 December 2021
                Categories
                Research Article

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