Three-Dimensional Evaluation of the Upper Airway in Children of Skeletal Class III
Jingjing Zhang1, Weitao Liu, Weiran Li
1Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.
Insights
Skeletal Class III in children impacts upper airway dimensions, with high-angle growth patterns leading to smaller airways. Maxillary and mandibular discrepancies also affect the nasopharynx.
Area of Science:
- Orthodontics
- Pediatric Dentistry
- Craniofacial Imaging
Background:
- Skeletal Class III malocclusion is associated with craniofacial abnormalities.
- Understanding the relationship between craniofacial structures and upper airway dimensions is crucial for diagnosis and treatment planning in growing children.
- Previous studies have primarily focused on 2D analyses, limiting comprehensive understanding.
Purpose of the Study:
- To investigate the 3D relationship between upper airway size and craniofacial structures in growing children with skeletal Class III.
- To compare upper airway dimensions based on sagittal and vertical skeletal patterns.
- To analyze correlations between craniofacial dimensions and upper airway size.
Main Methods:
- Cone beam computed tomography (CBCT) images of 47 growing children (mean age 9.6 years) with skeletal Class III were analyzed.
- Craniofacial structures and upper airway dimensions were measured using DOLPHIN 11.7 software.
- Statistical analysis included Mann-Whitney U, Kruskal-Wallis, and Spearman correlation tests.
Main Results:
- The nasopharynx was significantly affected in children with insufficient maxilla and overdeveloped mandible.
- Children with a high angle (vertical skeletal pattern) exhibited smaller upper airway dimensions compared to normal and low angle groups.
- Skeletal transverse dimension showed correlations with velopharynx, hypopharynx, and total airway height.
Conclusions:
- Skeletal Class III malocclusion, particularly vertical growth patterns and sagittal discrepancies, influences upper airway dimensions in growing children.
- CBCT 3D analysis provides valuable insights into the complex interplay between craniofacial morphology and airway patency.
- Findings highlight the importance of considering airway evaluation in orthodontic treatment planning for skeletal Class III patients.
Abstract:
The present study was aimed to investigate the relationship of the upper airway size and craniofacial structures in 3 dimensions in growing children of skeletal Class III. Forty-seven children (19 boys and 28 girls, 9.6 ± 1.3 years of age, range 8.0-12.4 years) were selected. Twenty-three children with normal vertical development were divided into groups of insufficient maxilla and overdeveloped mandible for the airway comparison between different sagittal skeletal patterns. Thirty-two children with the same sagittal development were divided into groups of low angle, normal angle, and high angle for the comparison between different vertical skeletal developments. The upper airway and craniofacial structures were measured in cone beam computed tomography images using DOLPHIN 11.7 software. Mann-Whitney U test and Kruskal-Wallis test were used to analyze the airway differences between groups. Spearman correlated analysis was done between the upper airway size and the craniofacial pattern in the transverse dimension. The results showed that the nasopharynx was the only affected airway part between groups of insufficient maxilla and overdeveloped mandible (P <0.05). The high angle group showed smaller upper airway compared with the groups of normal angle and low angle (P <0.05). The skeletal transverse dimension was correlated with the height of velopharynx, hypopharynx, and total airway with small gender differences.
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