Effect of airway and tongue in facial morphology of prepubertal Class I, II children

Yong-In Hwang; Kyu-Hong Lee; Kee-Joon Lee; Sang-Cheol Kim; Hyung-Jun Cho; Se-Hwan Cheon; Yang-Ho Park

doi:10.4041/kjod.2008.38.2.74

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Hwang, Lee, Lee, Kim, Cho, Cheon, and Park: Effect of airway and tongue in facial morphology of prepubertal Class I, II children

Original Article

Korean Journal of Orthodontics

Korean Journal of Orthodontics 2008; 38(2): 74-82.

Published online: 30 April 2008

DOI: https://doi.org/10.4041/kjod.2008.38.2.74

Effect of airway and tongue in facial morphology of prepubertal Class I, II children

Yong-In Hwang, DDS^a, Kyu-Hong Lee, DDS^a, Kee-Joon Lee, DDS, MSD, PhD^b, Sang-Cheol Kim, DDS, MSD, PhD^c, Hyung-Jun Cho, DDS, MSD^d, Se-Hwan Cheon, DDS, MSD^e, Yang-Ho Park, DDS, MSD, PhD^f

^aResident, Department of Orthodontics, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Korea.

^bAssistant Professor, Department of Orthodontics, School of Dentistry, Yonsei University, Korea.

^cProfessor, Department of Orthodontics, School of Dentistry, Wonkwang University, Korea.

^dGraduate Student, Department of Orthodontics, Graduate School of Hallym University, Korea.

^eFull-time lecturer, Department of Orthodontics, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Korea.

^fAssociate Professor, Department of Orthodontics, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Korea.

Corresponding author: Yang-Ho Park. Department of Orthodontics, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Gil-Dong 445, Gangdong-Gu, Seoul 134-701, Korea. +82 2 2225 2969; dentpark64@hanmail.net

Received 5 November 2007 Revised 27 February 2008 Accepted 29 February 2008

Abstract

Objective

This study examined the craniofacial morphology of young patients in their prepubertal stage showing class I, II malocclusion, by analyzing lateral cephalograms, and analyzed its relationship with tongue position, tongue space, and airway space in order to ascertain the effects of nasopharyngeal airway and tongue morphology on the form of the malocclusion.

Methods

Seventy-six patients aging from 9 to 11 were divided into two groups depending on the ANB difference on the lateral cephalogram: Experimental group (Cl II malocclusion group) showing 0 ≤ ANB difference < 4.0; Control group (Cl I malocclusion group) showing 0 ≤ ANB difference < 4.0. The tongue space, space between palate and tongue, nasopharyngeal airway space and craniofacial morphology were compared between the two groups.

Results

Tongue space, palate-tongue space, nasopharyngeal airway space showed no significant differences between class I and class II malocclusion groups. Hyperdivergent faces were associated with smaller nasopharyngeal airway space. Longer anterior facial height and posterior facial height were associated with larger tongue space, and greater anterior facial height were associated with lower tongue position. Smaller nasopharyngeal airway space showed smaller tongue space.

Conclusions

Tongue space and nasopharyngeal airway space showed no significant differences between class I malocclusion group and class II malocclusion group. Only anterior facial height and posterior facial height had an influence on tongue space and nasopharyngeal airway space.

Keywords: Tongue, Nasopharyngeal airway, Malocclusion, Cephalometric analysis

Figures and Tables

Fig 1

Landmarks and reference lines used in this study. Ar (Articulare), intersection between posterior cranial base surface and posterior border of condylar head and neck; Pt (Pterygoid point), the posterior point of the pterygopalatine fossa; ANS (anterior nasal spine), Anterior point of the maxilla; PNS (posterior nasal spine), Posterior point of the palatine bone; Me (Menton), the inferior point of the symphysis; Pm (Protuberance menti), the most superior point where the heavy cortical bone of the symphysis ends; Xi, midpoint of the ramus (Ricketts analysis); Rp, intersection between the posterior border of the ramus and the palatal plane; H1, intersection between posterior border of tongue and hyoid bone; H2, the most anterior point of the hyoid bone; T, the most anterior point of the outline of tongue; Palatal plane, a line passing through ANS and PNS.

Fig 2

Spatial measurements used in this study. 1. Tongue space, area formed by superior and posterior border of tongue and T, Me, H2 and H1; 2. Palate-tongue space, space between tongue and palate from the line perpendicular to the palatal plane at the incisive foramen to the line perpendicular to the palatal plane at the PNS; 3. Nasopharyngeal airway space, area formed by Ar-Pt-PNS-Rp.

Fig 3

Anterior-posterior measurements used in this study. 4, A to N perpend, distance between A point and nasion perpendicular; 5, Facial convexity, angle formed by nasion, A point and pogonion; 6, Pog to N perpend, distance between pogonion and nasion perpendicular.

Fig 4

Vertical measurements used in this study. 7, anterior facial height (AFH), distance between nasion and menton; 8, posterior facial height (PFH), distance sella and gonion; 9, PFH/AFH; 10, cant of occlusal plane, an angle betweenthe FH plane and occlusal plane; 11, angle between facial plane and mandibular plane; 12, lower facial height, angle formed by ANS-Xi-Pm point.

Fig 5

Dental measurements used in this study. 13, Overbite; 14, overjet; 15, interincisal angle.

Table 1

Distribution of subjects by ANB difference

SD, Standard deviation.

Table 2

Comparison of measurements between male and female

^*p < 0.05; ^†p < 0.01; SD, standard deviation.

Table 3

Comparison of measurements between Class I and Class II

^*p < 0.05; ^†p < 0.01; SD, standard deviation.

Table 4

Correlation coefficients between the measurements

^*p < 0.05; ^†p < 0.01.

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