Analogue simulation of pharyngeal airflow response to Twin Block treatment in growing patients with Class II1 and mandibular retrognathia

Li, Liang; Wu, Wei; Yan, Guijun; Liu, Li; Liu, Hong; Li, Guojv; Li, Jing; Liu, Dongxu

doi:10.1038/srep26012

Cited by 13 publications

(8 citation statements)

References 32 publications

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“…Radiographic computer tomography (CT) provides a more accurate estimate of the UA volume and more detail compared with teleradiography (Abdelkarim, ; Iwasaki et al, ; Li et al, ; Maspero et al, ). However, the patient, and in this case the growing child, becomes exposed to higher radiation contrary to the ALARA principle and is difficult to justify from a research ethics perspective (Ali et al, ; Ghodke et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…The TB appliance is a functional device used for early treatment of children with Class II malocclusion that advances the jaw and stimulates jaw growth (Burhan & Nawaya, ; Clark, ; Sharma et al, ; Ysla et al, ). The appliance was developed by William J Clark in 1970 in Scotland and is currently one of the most common and popular functional appliances due to its effectiveness in correcting skeletal Class II malocclusion (Abdelkarim, ; Al‐Anezi, ; Brunharo et al, ; Burhan & Nawaya, ; Elfeky & Fayed, ; Ghodke et al, ; Li et al, ; Schaefer et al, ; Sharma et al, ; SuchitaTarvade et al, ; Verma et al, ; Zhang et al, ). The appliance is well accepted by patients and can produce rapid changes (Al‐Anezi, ; Elfeky & Fayed, ; Li et al, ; Li et al, ; Quintero & Mariaca, ; Zhang et al, ).…”

Section: Methodsmentioning

confidence: 99%

“…The use of functional appliances to correct mandibular retrognathia is very common among orthodontists and is increasingly recommended as a treatment option for obstructive sleep apnoea (OSA; Abdelkarim, ; Ali et al, , ; Caridi & Galluccio, ; Elfeky & Fayed, ; Maspero et al, ; Zhang et al, ). Previous studies have reported improvements in UA dimensions after functional therapy (Elfeky & Fayed, ; Ghodke et al, ; Maspero et al, ; Pavoni et al, ), with Twin Block (TB) being one of the most common and popular functional appliances due to its effectiveness in correcting skeletal Class II malocclusion (Abdelkarim, ; Al‐Anezi, ; Brunharo, Quintão, Almeida, Motta, & Barreto, ; Burhan & Nawaya, ; Elfeky & Fayed, ; Ghodke et al, ; Li et al, ; Schaefer, McNamara, Franchi, & Baccetti, ; Sharma, Sachdev, Singla, & Kirtaniya, ; SuchitaTarvade, Yamyar, Choudhari, & Biday, ; Verma, Tandon, Nagar, Singh, & Singh, ; Zhang et al, ).…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of changes in the upper airway after Twin Block treatment in patients with Class II malocclusion

Entrenas

González-Chamorro

Álvarez-Abad

et al. 2019

Clinical & Exp Dental Res

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The purpose of this prospective case control study is to describe in growing patients with mandibular hypoplasia, treatment outcomes following functional therapy in terms of volumetric changes in nasopharynx and oropharynx, that is, upper and lower pharynx. We recruited 60 study participants aged between 8 and 12 years having mandibular Class II malocclusion and a reduced upper airway (UA) size, as determined by McNamara cephalometric analyses. Forty patients received Twin Block treatment, whereas the remaining 20 patients did not receive treatment, thus constituting the control group. The control group included patients who did not start treatment after their first visit but returned for a consultation one or 2 years later. All patients underwent an initial teleradiography examination of the skull and a final teleradiography examination to measure changes using McNamara cephalometric analysis of the UA. Pretreatment and posttreatment changes were assessed using Student's t test for independent samples with a significance level of 0.05. Both anatomical structures analyzed—the upper pharynx (nasopharynx) and lower pharynx (oropharynx)—showed significant increases after treatment regardless of whether the patients were boys or girls. The controls showed a decrease in UA size on average after approximately 2 years of growth. A clear relationship exists between the mandibular advancement achieved with TB treatment and an increased UA size. Therefore, the appliance is considered suitable for improving the respiratory quality of growing patients with a decreased UA size.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of changes in the upper airway after Twin Block treatment in patients with Class II malocclusion

Entrenas

González-Chamorro

Álvarez-Abad

et al. 2019

Clinical & Exp Dental Res

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“…A Cexpander is a type of tissue bone-borne maxillary expander which consists of four miniscrews and an acrylic body. A great deal of research has verified that the C-expander, without surgical assistance, is still considered to be an effective treatment modality for maxillary skeletal deficiency in late adolescents and young adults [13][14][15][16]. However, the previous studies of the C-expander were limited to the effect of opening the midpalatal area, but the morphological and dynamic effects of C-expander on the nasal airway have not been reported.…”

Section: Introductionmentioning

confidence: 99%

Computational Fluid Dynamics Analysis of Nasal Airway Changes after Treatment with C-Expander

Wang

Liu

et al. 2021

Applied Bionics and Biomechanics

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The use of the C-expander is an effective treatment modality for maxillary skeletal deficiencies which can cause ailments and significantly reduce life expectancy in late adolescents and young adults. However, the morphological and dynamic effects on the nasal airway have not been reported. The main goal of this study was to evaluate the nasal airway changes after the implementation of a C-expander. A sample of nine patients (8 females, 1 male, age range from 15 to 29 years) was included. The morphology parameters and nasal airway ventilation parameters of pretreatment and posttreatment were measured. All study data were normally distributed. A paired t -test was used to evaluate the changes before and after treatment. After expansion, the mean and standard deviation values of intercanine maxillary width (CMW) and intermolar maxillary width (MMW) increased from 35.75 ± 2.48 mm and 54.20 ± 3.17 mm to 37.87 ± 2.26 mm ( P < 0.05 ) and 56.65 ± 3.10 mm ( P < 0.05 ), respectively. The nasal cavity volume increased from 20320.00 ± 3468.25 mm3 to 23134.70 ± 3918.84 mm3 ( P < 0.05 ). The nasal pressure drop decreased from 36.34 ± 3.99 Pa to 30.70 ± 3.17 Pa ( P < 0.05 ), while the value of the maximum velocity decreased from 6.50 ± 0.31 m/s to 5.85 ± 0.37 m/s ( P < 0.05 ). Nasal resistance dropped remarkably from 0.16 ± 0.14 Pa/ml/s to 0.08 ± 0.06 Pa/ml/s ( P < 0.05 ). The use of C-expander can effectively broaden the area and volume of the nasal airway, having a positive effect in the reduction of nasal resistance and improvement of nasal airway ventilation. For patients suffering from maxillary width deficiency and respiratory disorders, a C-expander may be an alternative method to treat the disease.

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“…Many studies have demonstrated that orthodontic treatment causes morphological or functional changes of upper airway34. Therefore, detailed evaluation of the upper airway is essential for orthodontic diagnosis and planning.…”

mentioning

confidence: 99%

Computational fluid dynamics simulation of the upper airway response to large incisor retraction in adult class I bimaxillary protrusion patients

Zhe

Liu

et al. 2017

Sci Rep

Self Cite

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The changes of the upper airway after large retraction of the incisors in adult class I bimaxillary protrusion patients were assessed mainly focused on the anatomic variation and ignored the functional changes. This study aimed to investigate the changes of the upper airway in adult class I bimaxillary protrusion patients after extraction treatment using the functional images based on computational fluid dynamics (CFD). CFD was implemented after 3D reconstruction based on the CBCT of 30 patients who have completed extraction treatment. After treatment, pressure drop in the minimum area, oropharynx, and hypopharynx increased significantly. The minimum pressure and the maximum velocity mainly located in the hypopharynx in pre-treatment while they mostly occured in the oropharynx after treatment. Statistically significant correlation between pressure drop and anatomic parameters, pressure drop and treatment outcomes was found. No statistical significance changes in pressure drop and volume of nasopharynx was found. This study suggested that the risk of pharyngeal collapsing become higher after extraction treatment with maximum anchorage in bimaxillary protrusion adult patients. Those adverse changes should be taken into consideration especially for high-risk patients to avoid undesired weakening of the respiratory function in clinical treatment.

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Analogue simulation of pharyngeal airflow response to Twin Block treatment in growing patients with Class II1 and mandibular retrognathia

Cited by 13 publications

References 32 publications

Evaluation of changes in the upper airway after Twin Block treatment in patients with Class II malocclusion

Evaluation of changes in the upper airway after Twin Block treatment in patients with Class II malocclusion

Computational Fluid Dynamics Analysis of Nasal Airway Changes after Treatment with C-Expander

Computational fluid dynamics simulation of the upper airway response to large incisor retraction in adult class I bimaxillary protrusion patients

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