American Journal of Orthodontics and Dentofacial Orthopedics
Original articleThree-dimensional upper-airway changes associated with various amounts of mandibular advancement in awake apnea patients
Section snippets
Material and methods
Eleven adults from the Hospital of Stomatology, Tongji University, Shanghai, China, participated in this investigation (Table I). The inclusion criteria were OSA as determined by an apnea/hypopnea index (AHI) score greater than 10 per hour with whole night polysomnography (Medcare Monet, TMS International, Enschede, Netherlands) and no previous CPAP therapy or upper-airway surgery. In addition, no patients had crowns, bridges, dental implants, or ferromagnetic fillings. Their average age was
Results
High resolution images of MRI were observed and measured in all 11 patients for each mandibular position. Typical changes in the velopharynx with the various amounts of mandibular advancement are shown in Figure 3. The CSA and the transverse diameter of the velopharynx appeared to increase with mandibular protrusion.
Table II gives the changes in minimum and mean CSA for the whole upper airway and the different regions during mandibular advancement. The minimum and mean CSA of the velopharynx
Discussion
The results of this study showed that the amount of mandibular advancement increased the velopharynx caliber in awake OSA patients. The enlargement of CSA in the velopharynx is mostly attributed to the increase in the transverse diameter. Since no significant changes in the sagittal diameter of the velopharynx occurred, it may be that the cross-sectional shape of the velopharynx became an ellipse with an increasing transverse long axis after mandibular advancement. A previous study indicated
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Evaluation of upper airway volume and craniofacial volumetric structures in obstructive sleep apnoea adults: A descriptive CBCT study
2019, International OrthodonticsCitation Excerpt :Regarding the mean values of UAWV for OSA subjects, the findings in the 3D studies are disparate depending on the boundaries used to define upper airway or the methods used to measure the volume [10]. The results are often discussed in terms of cross-sectional areas and/or length of the upper airway [28,31,32] as well as treatment effects on airway volume after use of oral appliances or maxillo-mandibular advancement surgery [12,33,34]. In this investigation, the significant differences between the means of volumetric variables in both groups were found for UAWV and post-hyoid volume, where UAWV was found to be significantly smaller and post-hyoid volume significantly bigger in the OSA group.
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2014, American Journal of Orthodontics and Dentofacial OrthopedicsCitation Excerpt :Kyung et al8 reported similar statistically significant enlargements of retropalatal (3.3 mm) and retroglossal (1.4 mm) depths, and enlargement of retropalatal (2.2 mm) and retroglossal (3.3 mm) widths after 7.1 mm of forward and 7.7 mm of downward mandibular movement with a mandibular advancement oral appliance. Zhao et al34 evaluated airway changes after various amounts of mandibular advancement using a mandibular advancement oral appliance. They reported that only retropalatal airway width significantly expanded after protrusion of 6 mm or more using a mandibular advancement oral appliance.
Effects of head and body positions on 2- and 3-dimensional configuration of the oropharynx with jaw protruded: A magnetic resonance imaging study
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Supported by the National Natural Science Foundation of China (30471913, 2004).