The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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A study on the correlation between airway space and facial morphology in Class III malocclusion children with nasal obstruction

비폐쇄를 보이는 III급 부정교합아동의 기도 공간 형태와 안모 골격 형태와의 상관관계 연구

  • Jung, Ho-Lim (Department of Orthodontics, School of Dentistry, Dankook University) ;
  • Chung, Dong-Hwa (Department of Orthodontics, School of Dentistry, Dankook University) ;
  • Cha, Kyung-Suk (Department of Orthodontics, School of Dentistry, Dankook University)
  • 정호림 (단국대학교 치과대학 교정학 교실) ;
  • 정동화 (단국대학교 치과대학 교정학 교실) ;
  • 차경석 (단국대학교 치과대학 교정학 교실)
  • Published : 2007.06.30
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Abstract

Objective: The aim of this study was assessment of the relationship between airway space and facial morphology in Class III children with nasal obstruction. Methods: For this study, 100 Class III children (50 boys and 50 girls) were chosen. All subjects were refered to ENT, due to nasal obstruction. Airway space measurements and facial morphology measurements were measured on lateral cephalometric radiograph. Pearson correlation analysis was used to assess the relationship between airway space and facial morphology Results: Ramal height, SNA, SNB, PFH, FHR and facial plane angle were positively related to upper PAS, and sum of saddle angle, articular angle, and genial angle, SN-GoGn, Y-axis to SN and FMA negatively related to upper PAS. Genial angle, FMA were positively related to lower PAS, and articular angle, facial depth, PFH and FHR negatively related to lower PAS. PCBL, ramal height, Mn. body length, Mn. body length to ACBL, facial depth, facial length, PFH and AFH were positively related to tonsil size. Sum of saddle angle, articular angle, genial angle, facial length, AFH, FMA and LFH were positively related to tongue gap, and IMPA and overbite was negatively related to tongue gap. Upper PAS, related to size of adenoid tissue, was mainly related to posterior facial dimension following a vertical growth pattern of face and mandibular rotation. Lower PAS and tonsil size, related to anterior-posterior tongue base position, were significantly related to each other. Lower PAS was related to growth pattern of mandible, and tonsil size was related to size of mandible and horizontal growth pattern of face. Tongue gap was related to anterior facial dimension following a vertical growth pattern of face. Conclusion: Significant relationship exists between airway space and facial morphology.

본 연구는 비폐쇄를 보이는 III급 부정교합아동에서, 기도 공간의 형태와 안모 골격 형태 사이의 상관관계를 평가하였다. III급 부정교합을 보이며, 비폐쇄 소견을 보여 이비인후과로 의뢰된 환아 100명의 초진 측모 두부 규격 방사선 사진에서 상 인두기도 공간(upper PAS), 하 인두기도 공간(lower PAS), 편도의 크기, 구개-혀 공간을 측정하여 기도 공간 형태를 분석하였으며, 통상적인 계측점을 사용하여 안면 골격 분석을 시행하여 기도 공간 형태 계측항목과 안면 골격분성 항목간의 상관관계를 연구하여 다음과 같은 결과를 얻었다. Upper PAS는 ramal height, SNA, SNB, PFH, FHR, facial plane angle 항목과 양의 상관관계를 보였으며, saddle angle, articular angle, gonial angle의 sum, SN-GoGn, Y-axis to SN, FMA 항목과 음의 상관관계를 보였다. Lower PAS는 genial angle, FMA와 양의 상관관계를 보였으며, articular angle, facial depth, PFH, FHR와 음의 상관관계를 보였다. 편도의 크기는 PCBL, ramal height, Mn. body length, Mn. body length to ACBL, facial depth, facial length, PFH, AFH와 양의 상관관계를 보였다. 구개-혀 공간은 saddle angle, articular angle, genial angle의 합, facial length, AFH, FMA, LFH와 양의 상관관계를 보였으며, IMPA, overbite와 음의 상관관계를 보였다.

Keywords

References

  1. Moyers RE. Handbook of orthodontics. (Korean translation) Seoul: ScienceBook Center; 1991. p.151-162
  2. Korean Academy of Pediatric Dentistry. Dentistry for the child and adolescent. Seoul: Shinheung International; 1999. p.309-310
  3. Moss ML, Salentijn L. The primary role of functional matrices in facial growth. Am J Orthod 1969;55:566-77 https://doi.org/10.1016/0002-9416(69)90034-7
  4. Butler GE, Mckie M, Ratcliffe SG. The cyclical nature of prepubertal growth. Ann Hum Biol 1990; 17: 177-98 https://doi.org/10.1080/03014469000000952
  5. Ogura JH, Dammkoehler R, Nelson JR, Kawasaki M, Togawa K. Nasal obstruction and the mechanics of breathing. Physiologic relationships and the effects of nasal surgery. Arch Otolaryngol 1966;83:135-50 https://doi.org/10.1001/archotol.1966.00760020137010
  6. Miller AJ. Electromyography of craniofacial musculature during oral respiration in the rhesus monkey (Macaca mulatta). Arch Oral Biol 1978;23: 145-52 https://doi.org/10.1016/0003-9969(78)90210-8
  7. Warren DW. Aerodynamic studies of upper airway: Implications for growth, breathing and speech In McNamara JA, editor. Nasorespiratory Function and Craniofacial Growth. Ann Arbor: The University of Michigan; 1979
  8. Howard CC. Inherent growth and its influence on malocclusion. J Am Dent Assoc 1932;19:642-51
  9. Forum on the tonsil and adenoid problem in orthodontics. Questions and answer. Am J Orthod 1968;54:508-14 https://doi.org/10.1016/0002-9416(68)90219-4
  10. Schendel SA, Eisenfeld J, Bell WH, Epker BN, Mishelevich DJ. The long face syndrome: vertical maxillary excess. Am J Orthod 1976; 70:398-408 https://doi.org/10.1016/0002-9416(76)90112-3
  11. Woodside DG, Linder-Aronson S. The channelization of upper and lower anterior face heights compared to population standard in males between ages 6 and 20 years. Eur J Orthod 1979;1:25-40 https://doi.org/10.1093/ejo/1.1.25
  12. Harvold EP, Vargervik K, Chierici G. Primate experiments on oral sensation and dental malocclusions. Am J Orthod 1973;63:494-508 https://doi.org/10.1016/0002-9416(73)90162-0
  13. Behlfelt K, Linder-Aronson S, Neander P. Posture of the head, the hyoid bone and the tongue in children with and without enlarged tonsils. Eur J Orthod 1990;12:458-67 https://doi.org/10.1093/ejo/12.4.458
  14. Hellsing E, Forsberg CM, Linder-Aronson S, Sheikholeslam A. Changes in postural EMG activity in the neck and masticatory muscles following obstruction of the nasal airways. Europ J Orthod 1986;8:247-53 https://doi.org/10.1093/ejo/8.4.247
  15. Linder-Aronson S. Adenoids. Their effect on mode of breathing and nasal airflow and their relationship to characteristics of the facial skeleton and the dentition. A biometric, rhino-manometic and cephalometro-radiographic study on children with and without adenoids. Acta Otolaryngol Suppl. 1970;265:1-132
  16. Meredith GM. The airway and dentofacial development. Ear Nose Throat J 1987;66:190-5
  17. Cha KS. Orthodontic diagnosis. Seoul: Kukje Dental Publishing; 1995. p.102-103
  18. Handelman CS, Osbome G. Growth of the nasopharynx and adenoid development from one to eighteeen years. Angle Orthod 1976;46: 243-59
  19. Diamond O. Tonsils and adenoids: Why the dilemma? Am J Orthod 1980;78:495-503 https://doi.org/10.1016/0002-9416(80)90300-0
  20. Holmberg H, Linder-Aronson S. Cephalometric radiographs as a means of evaluating the capacity of the nasal and nasopharyngeal airway. Am J Orthod 1979;76:479-90 https://doi.org/10.1016/0002-9416(79)90252-5
  21. McNamara JA Jr. A method of cephalometric evaluation. Am J Orthod 1984;86:449-69 https://doi.org/10.1016/S0002-9416(84)90352-X
  22. Hemingsson G, Isberg A. Influence of tonsils on velopharyngeal movements in children with craniofacial anomalies and hypemasality. Am J Orthod Dentofacial Orthop 1988;94:253-61 https://doi.org/10.1016/0889-5406(88)90035-2
  23. Subtelny JD. The significance of adenoid tissue in orthodontia. Angle Orthod 1954;24:59-69
  24. Gwyme EE. Discussion on upper respiratory clinic for children. Proc Roy Soc Med 1945;38:535-43
  25. Emslie RD, Massler M, Zwemer JD. Mouth breathing. I. Etiology and effects; a review. J Am Dent Assoc. 1952;44:506-21 https://doi.org/10.14219/jada.archive.1952.0099
  26. Goldman JL, Bachman AL. Soft tissue roentgenography of the nasopharynx for adenoids. Laryngoscope 1958;68: 1288-3 12 https://doi.org/10.1002/lary.5540680714
  27. O'Ryan FS, Gallagher DM, LaBanc JP, Epker BN. The relation between nasorespiratory function and dentofacial morphology : a review. Am J Orthod 1982;82:403-10 https://doi.org/10.1016/0002-9416(82)90189-0
  28. Throw RC. Grundziige der Orthodontie. Verlag Zahnarztliches Medizinisches Schriftum. Miinchen: 1975. p.116-32
  29. Japanese Society of Pediatric Dentistry. A study on the cephalometric standards of Japanese children. Jpn J Ped Dent 1995;33:659-96
  30. Bushey RS. Adenoid obstruction of the nasopharynx. (McNamara JA Jr. Nasorespiratory function and craniofacial growth.) Ann Arbor, The University of Michigan. 1979.p. 199-232
  31. Park WS, Lee JW, Cha KS. A Study on the Changes of Pharyngeal Airway, Hyoid Bone and Head Posture Before and after Tonsillectomy in Functional Class III Malocculusion Patients. Korean J Orthod 1997;27:231-43
  32. Linder-Aronson S, Woodside DG, Lundstrom A. Mandibular growth direction following adenoidectomy. Am J Orthod 1986;89:273-84 https://doi.org/10.1016/0002-9416(86)90049-7