The relationship between upper airway width and facial growth changes in orthodontic treatment of growing children

Yoon-Ji Kim; Gyoo-Suk Bok; Kyu-Hong Lee; Yong-In Hwang; Yang-Ho Park

doi:10.4041/kjod.2009.39.3.168

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Kim, Bok, Lee, Hwang, and Park: The relationship between upper airway width and facial growth changes in orthodontic treatment of growing children

Original Article

Korean Journal of Orthodontics

Korean Journal of Orthodontics 2009; 39(3): 168-176.

Published online: 30 June 2009

DOI: https://doi.org/10.4041/kjod.2009.39.3.168

The relationship between upper airway width and facial growth changes in orthodontic treatment of growing children

Yoon-Ji Kim, DDS^a, Gyoo-Suk Bok, DDS, MSD^b, Kyu-Hong Lee, DDS, MSD^c, Yong-In Hwang, DDS, MSD^a, Yang-Ho Park, DDS, MSD, PhD^d

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

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

^cPublic Health Doctor, Korea.

^dAssociate 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, 445, Gil-dong, Gangdong-gu, Seoul 134-701, Korea. +82 2 2225 2969; dentpark64@hanmail.net

Received 17 February 2009 Revised 6 May 2009 Accepted 11 May 2009

Abstract

Objective

The purpose of this study was to evaluate how airway changes influence facial growth during puberty in Korean children.

Methods

Thirty-six patients aged 9 to 11 (mean age: 10.7 years) were selected. Cephalograms and hand-wrist x-rays were taken at pre-treatment (T1) and post-treatment (T2). The sample was divided into narrow (5.2 - 8.6 mm, AW-Narrow), medium (8.9 - 11.5 mm, AW-Medium), and wide (11.7 - 16.0 mm, AW-Wide) groups according to the airway width at T1. Cephalometric measurements at T1, T2 and growth from T1 to T2 were compared between groups.

Results

The degree of increase in airway size in each group was 4.55 mm, 3.84 mm and 1.94 mm in the AW-Narrow, AW-Medium, and AW-Wide groups, respectively. Moreover, the differences were statistically significant. The significant smallest posterior facial height was found in the AW-Narrow group at T1. For the growth values from T1 to T2, the AW-Narrow group showed significantly larger values of PFH/AFH, facial axis, ANS (T1 - T2), and Gn (T1 - T2) than the AW-Medium group.

Conclusions

The compensational changes in the airway width and facial growth were found in the narrow group. Surgical approach of the airway to prevent unfavorable facial growth in these years of age should be carried out, but with careful deliberation because these problems may be improved naturally.

Keywords: Airway, Facial growth, Pubertal growth, Posterior facial height (PFH)

Figures and Tables

Fig. 1

A and B, Airway width, anteroposterior measurements and cervical vertebral maturation by the concavity depth of the 4th cervical vertebra¹⁹ used in this study. 1. Upper airway width: The shortest distance between the posterior border of the soft palate and anterior border of adenoid; 2. A point-N perpend: distance from point A to the line perpendicular to FH plane passing through nasion; 3. N-A-Pog angle: angle formed by nasion, A point and pogonion; 4. Pog-N perpend: distance from pogonion to the line perpendicular to FH plane passing through nasion; 5. Facial Axis: angle formed by N-Ba line and Gn-Pt line; 6. Anterior facial height (AFH): distance between nasion and menton; 7. Posterior facial height (PFH): distance between sella and gonion; 8. PFH/AFH: ratio of PFH to AFH; 9. FMA: angle formed by FH plane and mandibular plane. C, Superimposition of lateral cephalograms taken between T1 (Initial) and T2 (Debonding) show the direction of growth of maxilla and mandible. 10. Angle between N-Ba line and the direction of growth of Gn; 11. Angle between N-Ba line and the direction of growth of ANS; 12. Angle between the direction lines of ANS(s) and Gn(s).

Table 1

Difference between male and female at T1 and T2 stage

NS, Not significant; SD, standard deviation.

Table 2

Mean, standard deviation of the measurements and t-test between the groups at T1 and T2 stage

^*p < 0.05. AW-Narrow, group of children whose upper airway width is between 5.2 mm and 8.6 mm; AW-Medium, group of children whose upper airway width is between 8.9 mm and 11.5 mm; AW-Wide, group of children whose upper airway width is between 11.7 mm and 16.0 mm.

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