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Cited by 13Orthodontics and Dentofacial OrthopedicsTemporomandibular Joint DisordersNasal Surgery and Airway Studies

The effect of different functional appliances on the sagittal pharyngeal airway dimension in skeletal class II: a retrospective study

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Elfouly, Dina, Dumu, Emmanuel, Madian, Ahmed M., Eid, Farah Y.·2024·Scientific Reports
DOI 10.1038/s41598-024-69717-5PMC PMC11339275
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Abstract

The aim of this study was to compare the changes in the sagittal pharyngeal airway dimension (SPAD) in adolescents with Class II mandibular retrusion treated with Invisalign Mandibular Advancement (IMA), prefabricated Myobrace (MB), and Twin block (TB). For this retrospective study, the pre-treatment and post-treatment lateral cephalograms of 60 patients who underwent myofunctional treatment, using either one of the tested appliances were gathered from the files of treated patients. Changes in the SPAD were measured in each group, and comparisons were carried out between the three study groups. Additionally, sagittal skeletal measurements were carried out. Comparisons of the study variables at T0 and T1 between the three groups were performed using one-way ANOVA, while comparisons of the difference (T1–T0) were performed using Kruskal Wallis test. A significant SPAD increase has been reported using the three tested appliances (p < 0.05), with the least change documented with MB use (p < 0.05). Significant antero-posterior improvements have been found with IMA, MB, and TB with an increase in the SNB°, and a decrease in ANB° and Wits appraisal (p < 0.05). Non-significant FMA° changes have been observed post-treatment in the three test groups (p > 0.05). The IMA, MB, and TB generated significant SPAD and sagittal changes, with both IMA and TB surpassing MB in the airway area improvement post-treatment. Moreover, the three tested Class II functional appliances did not affect the vertical dimension.

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Crossref · 10.1038/s41598-024-69717-5

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  • Studies using cephalometry and cone beam computed tomography have demonstrated structural airway enlargement following mandibular advancement, although findings vary across appliance types and populations.

    “Studies using cephalometry and cone beam computed tomography (CBCT) have demonstrated structural airway enlargement following mandibular advancement, although findings vary across appliance types and populations [12–14, 41, 43]”

    From Long-Term Changes Following Orthopedic Mandibular Advancement Therapy in Pediatric Obstructive Sleep Apnea: a 7-Year Follow-up Study (2026) · cites this paper as [43]

    The Results (Measurement of the Sagittal Pharyngeal Airway Dimension; page not supplied) report significant airway enlargement after all three mandibular-advancement appliances, with a smaller increase for Myobrace than for the other two. The Methods and Discussion specify that this study used two-dimensional lateral cephalograms, not CBCT. The paper therefore supports the cephalometric finding and variation by appliance, but not the claim's CBCT or population-variation components. (LLM, conf=0.85)

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  • Studies incorporating polysomnography alongside structural assessment to evaluate functional outcomes of mandibular advancement in children are more limited in number.

    “In contrast, studies incorporating polysomnography alongside structural assessment to evaluate functional outcomes of mandibular advancement in children are more limited in number [20–22, 42–45]”

    From Long-Term Changes Following Orthopedic Mandibular Advancement Therapy in Pediatric Obstructive Sleep Apnea: a 7-Year Follow-up Study (2026) · cites this paper as [43]

    The Methods describe lateral cephalometric assessment of airway dimensions in children aged 9–12, but do not describe polysomnography. The Introduction and Discussion discuss structural airway studies without comparing how many studies also measured functional outcomes with polysomnography. Our copy therefore does not establish the claimed relative scarcity. (LLM, conf=0.73)

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Research works printed but not linked: 4

  1. [16]Anastasi, G. & Dinnella, A. Myobrace System: A no-braces approach to malocclusion and a myofunctional therapy device. Orthodontics 2014, 5 (2014).
  2. [29]Clark, W. J. Twin block functional therapy. Applications in dentofacial orthopaedics. Orthodontics 1995, 856 (1995).
  3. [50]Ferreira, F. Novel approaches for class II malocclusion treatment using myofunctional orthodontics therapy: A systematic review. Int. J. Dent. Oral Sci. 4, 503–507 (2017).
  4. [52]Blackham, S. S. A study of short-term skeletal, dental, and soft tissue effects of Class II malocclusions treated with InvisalignⓇ with Mandibular Advancement Feature or Twin Block appliance compared with historical controls: Doctoral dissertation, University of British Columbia (2020).

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Authors
Elfouly, D., Dumu, E., Madian, A. M., & Eid, F. Y.
Affiliations
Alexandria University (EG)
Corresponding author
Eid, Farah Y.
ORCID
Elfouly, Dina
Venue
Scientific Reports
Publisher
Springer Science and Business Media LLC
Published
2024-08-21
Volume
14
Issue
1
Pages
19410-19410
ISSN
2045-2322 (ISSN-L)
DOI
10.1038/s41598-024-69717-5
PMC
PMC11339275
OpenAlex
W4401757499
Cited by
13
References
47
Citations by year
2026: 6 · 2025: 7
FWCI
5.44
Type
journal article
Language
en
Open access
Licence
Locations
  • Scientific Reports (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Alexandria University
Topics
  • Health Sciences › Dentistry › Orthodontics › Orthodontics and Dentofacial Orthopedics
  • Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
  • Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
Keywords
Class II malocclusion, functional orthodontic appliances, mandibular retrusion, airway space, adolescents
MeSH terms
Adolescent, Cephalometry, Female, Humans, Male, Malocclusion, Angle Class II, Pharynx, Retrospective Studies, Treatment Outcome, Orthodontic Appliances, Functional, Mandibular Advancement

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