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Cited by 49Orthodontics and Dentofacial OrthopedicsObstructive Sleep Apnea ResearchNasal Surgery and Airway Studies

Changes in upper airway width associated with Class II treatments (headgear vs activator) and different growth patterns

Open access
Godt, Arnim, Koos, Bernd, Hagen, Hanno, Göz, Gernot·2011·The Angle Orthodontist
DOI 10.2319/090710-525.1PMC PMC8923556
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Abstract

Objective: To investigate the upper airways for anteroposterior width against different growth patterns and for alterations during various Class II treatments. Materials and Methods: Cephalograms from three treatment groups (headgear, activator, and bite-jumping appliance) were evaluated by a single investigator at baseline and at the end of orthodontic treatment. Cephalograms were used to determine upper airway width at different levels in the anteroposterior plane. Patients in the headgear group were additionally divided into six subsets on the basis of y-axis values to assess the influence of different growth patterns. Results: Small increases in pharyngeal width were noted at all vertical level segments, both at baseline and during orthodontic treatments. No significant differences in these small increases were noted across various treatment modalities and growth patterns. Conclusion: Upper airway changes did not significantly vary with the different treatment modalities investigated in the present study. Nevertheless, reductions in pharyngeal width potentially triggering or exacerbating obstructive sleep apnea syndrome (OSAS) are always possible in the headgear phase.

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  • Studies specifically assessing long-term effects in pediatric populations remain scarce.

    “Studies specifically assessing long-term effects in pediatric populations remain scarce [12, 15, 44]”

    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 [12]

    The Introduction (page unavailable) contrasts a 1.6-year headgear study with the need to examine pharyngeal width over a full course of orthodontic treatment. The Discussion (page unavailable) says this study followed adolescents over 5.2–6.4 years. These passages support a gap in longer-term research, but they do not establish that such pediatric studies generally remain scarce. (LLM, conf=0.70)

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  • The absence of significant changes in most skeletal variables during follow-up suggests a degree of maintenance of the post-treatment skeletal configuration over time.

    “The absence of significant changes in most skeletal variables during the follow-up period suggests a degree of maintenance of the post-treatment skeletal configuration over time, which is consistent with findings reported by Han et al. [13] and Godt et al. [12]”

    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 [12]

    The Results (page unavailable) report small, statistically nonsignificant differences in skeletal parameters during Class II treatment. They do not establish an absence of skeletal changes during a post-treatment follow-up period or maintenance of the post-treatment configuration; the Methods (page unavailable) describe comparisons from before treatment through the course of treatment. (LLM, conf=0.82)

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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 [12]

    The Materials and Methods describe cephalogram-based airway measurements, and the Results report modest increases in airway width over treatment, alongside reductions during isolated headgear treatment. The Conclusions emphasize that changes and differences between treatments were small. This paper does not report CBCT measurements or establish that mandibular advancement caused the observed enlargement. (LLM, conf=0.86)

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Authors
Godt, A., Koos, B., Hagen, H., & Göz, G.
Affiliations
University of Tübingen (DE)
ORCID
Koos, Bernd
Venue
The Angle Orthodontist
Publisher
The Angle Orthodontist (EH Angle Education & Research Foundation)
Published
2011-05
Volume
81
Issue
3
Pages
440-446
ISSN
  • 0003-3219 (ISSN-L)
  • 1945-7103
DOI
10.2319/090710-525.1
PMC
PMC8923556
OpenAlex
W1969014021
Cited by
49
References
40
Citations by year
2026: 2 · 2025: 5 · 2024: 1 · 2023: 1 · 2022: 3 · 2021: 5 · 2020: 2 · 2019: 4 · 2018: 3 · 2017: 6 · 2016: 5 · 2015: 5 · 2014: 3 · 2013: 1 · 2012: 3
FWCI
3.39
Type
journal article
Language
en
Open access
Locations
  • The Angle Orthodontist (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Dentistry › Orthodontics › Orthodontics and Dentofacial Orthopedics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
Keywords
Class II malocclusion, headwear, activator appliance, growth patterns, obstructive sleep apnea, orthodontic treatment
MeSH terms
Activator Appliances, Cephalometry, Child, Extraoral Traction Appliances, Female, Humans, Male, Malocclusion, Angle Class II, Maxillofacial Development, Nasopharynx, Orthodontics, Interceptive, Vertical Dimension, Statistics, Nonparametric, Sleep Apnea, Obstructive

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