Three-dimensional cone-beam computed tomography analysis of enlargement of the pharyngeal airway by the Herbst appliance

Iwasaki, Tomonori; Takemoto, Yoshihiko; Inada, Emi; Sato, Hideo; Saitoh, Issei; Kakuno, Eriko; Kanomi, Ryuzo; Yamasaki, Yuichi

doi:10.1016/j.ajodo.2014.08.017

Cited by 66 publications

(51 citation statements)

References 33 publications

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“…8 In this study, we showed that the effect of the Herbst appliance was to enlarge the CSA of the OA. Following Herbst appliance treatment, the depth and width of the OA in the previous study, 3 which is equivalent to the OA and LA in this study, were increased by 3.05 mm and 3.80 mm, respectively. Thus, the effect of Herbst treatment differed from treatment with a mandibular advancement oral appliance in terms of the site of PA enlargement.…”

Section: Discussionsupporting

confidence: 53%

“…Accordingly, considerable attention has been paid to the influence of pharyngeal airway (PA) size and form on respiratory function during growth. 2,3 PA obstruction is believed to improve with mandibular advancement, such as that achieved by using oral appliances. 4,5 The Herbst can be used with a fixed appliance; the treatment time is shorter, minimal patient cooperation is needed, and the success rate is high.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 The Herbst can be used with a fixed appliance; the treatment time is shorter, minimal patient cooperation is needed, and the success rate is high. 6,7 Because the PA undergoes three-dimensional (3-D) expansion as a secondary effect of the Herbst appliance, 3,8 its use is expected to improve PA obstruction. Based on MRI, Schutz et al 9 reported that the PA volume increases when a Herbst with rapid maxillary expansion is used, causing relief from OSA symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Herbst appliance effects on pharyngeal airway ventilation evaluated using computational fluid dynamics

Iwasaki

Sato

Suga

et al. 2017

The Angle Orthodontist

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Objective: To evaluate the effect of a Herbst appliance on ventilation of the pharyngeal airway (PA) using computational fluid dynamics (CFD). Materials and Methods: Twenty-one Class II patients (10 boys; mean age, 11.7 years) who required Herbst therapy with edgewise treatment underwent cone-beam computed tomography (CBCT) before and after treatment. Nineteen Class I control patients (8 boys; mean age, 11.9 years) received edgewise treatment alone. The pressure and velocity of the PA were compared between the groups using CFD based on three-dimensional CBCT images of the PA. Results: The change in oropharyngeal airway velocity in the Herbst group (1.95 m/s) was significantly larger than that in the control group (0.67 m/s). Similarly, the decrease in laryngopharyngeal airway velocity in the Herbst group (1.37 m/s) was significantly larger than that in the control group (0.57 m/s). Conclusion: The Herbst appliance improves ventilation of the oropharyngeal and laryngopharyngeal airways. These results may provide a useful assessment of obstructive sleep apnea treatment during growth. (Angle Orthod. 2017;87:397-403)

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Section: Discussionsupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Herbst appliance effects on pharyngeal airway ventilation evaluated using computational fluid dynamics

Iwasaki

Sato

Suga

et al. 2017

The Angle Orthodontist

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“…Similar to the findings of the present study, Iwasaki et al found a 5000.2-mm 3 increase in OA volume after treatment with the Herbst appliance compared with a 2451.6-mm 3 increase in skeletal Class I controls. 15 Statistically significant decreases in SNA (P 5 .000) and ANB (P 5 .026) were found in the experimental group, possibly due to restriction of maxillary growth found by other investigators. 16 This "headgear effect" could have been a limiting factor in the amount of forward mandibular growth.…”

Section: Discussionsupporting

confidence: 51%

Changes in the oropharyngeal airway of Class II patients treated with the mandibular anterior repositioning appliance

Rizk¹,

Kulbersh

Al-Qawasmi

2015

The Angle Orthodontist

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Objective: To evaluate the effects of functional appliance treatment on the oropharyngeal airway volume, airway dimensions, and anteroposterior hyoid bone position of growing Class II patients. Materials and Methods: Twenty Class II white patients (mean age, 11.7 6 1.75 years) treated with the MARA followed by fixed appliances were matched to an untreated control sample by cervical vertebrae maturation stage at pretreatment (T1) and posttreatment (T2) time points. Cone beam computed tomography scans were taken at T1 and T2. Dolphin3D imaging software was used to determine oropharyngeal airway volume, dimensions, and anteroposterior hyoid bone position. Results: Multivariate ANOVA was used to evaluate changes between T1 and T2. Oropharyngeal airway volume, airway dimensions, and A-P position of the hyoid bone increased significantly with functional appliance treatment. SNA and ANB decreased significantly in the experimental group (P # .05). Changes in SNB and Sn-GoGn failed to reach statistical significance. Conclusions: Functional appliance therapy increases oropharyngeal airway volume, airway dimensions, and anteroposterior hyoid bone position in growing patients. (Angle Orthod. 2016;86:955-961.)

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“…have concluded that functional appliances do not have clinically significant skeletal effect on the mandible,[1314] though other clinical studies proved functional appliances to be effective. [1516171819202122232425262728293031323334] Hence, it can be inferred from their study that, through functional appliance therapy, no significant change occurs in the airway dimensions.…”

Section: Introductionmentioning

confidence: 99%

Effect of functional appliances on the airway dimensions in patients with skeletal class II malocclusion: A systematic review

Kannan¹,

Sathyanarayana²,

Padmanabhan³

2017

J Orthodont Sci

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OBJECTIVES:The aim of the present systematic review was to assess the effect of functional appliances on the airway dimensions in patients with skeletal Class II malocclusion.MATERIALS AND METHODS:Articles were identified through a literature survey carried out through the following databases: (1) PUBMED, (2) Google Scholar, (3) The Cochrane Library, (4) Embase, (5) Lilac, and (6) Web of Scholars. The systematic review analyzed 12 articles comprising removable functional appliances, 3 articles with fixed functional appliances, and 2 articles having both fixed and removable functional appliances.RESULTS:Qualitative assessment was done for all the 17 studies. The effect of functional appliances in the dimensions of three airway spaces – nasopharynx, oropharynx, and hypopharynx were analyzed.CONCLUSIONS:Significant increase in the dimensions of nasopharynx and oropharynx was observed with Activator. Significant increase in the nasopharynx and hypopharynx (male patients) was observed with Bionator. Insignificant increase in the oropharynx was observed with the same. Significant increase in the oropharynx and hypopharynx was observed with Twin Block. Insignificant increase in the nasopharynx was observed with the same. Significant increase was observed only in the hypopharynx for Frankel II. Decreased or insignificant change was observed with FMA, MPA IV, and Herbst appliances.

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Three-dimensional cone-beam computed tomography analysis of enlargement of the pharyngeal airway by the Herbst appliance

Cited by 66 publications

References 33 publications

Herbst appliance effects on pharyngeal airway ventilation evaluated using computational fluid dynamics

Herbst appliance effects on pharyngeal airway ventilation evaluated using computational fluid dynamics

Changes in the oropharyngeal airway of Class II patients treated with the mandibular anterior repositioning appliance

Effect of functional appliances on the airway dimensions in patients with skeletal class II malocclusion: A systematic review

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