Long-term pharyngeal airway changes after bionator treatment in adolescents with skeletal Class II malocclusions
Open accessAbstract
OBJECTIVE: The aim of this study was to evaluate long-term changes in the pharyngeal airway dimensions after functional appliance treatment in adolescents with skeletal Class II malocclusions. METHODS: Pharyngeal airway dimensions were compared between subjects with skeletal Class II malocclusions (n = 24; mean age: 11.6 ± 1.29 years) treated with a Class II bionator and age-matched control subjects with skeletal Class I occlusions (n = 24; mean age: 11.0 ± 1.21 years) using a series of lateral cephalograms obtained at the initial visit (T0), after treatment (T1), and at the completion of growth (T2). RESULTS: The length of the nasopharyngeal region was similar between adolescents with skeletal Class I and Class II malocclusions at all time points, while the lengths of the upper and lower oropharyngeal regions and the pharyngeal airway areas were significantly smaller in the skeletal Class II adolescents before treatment when compared to the control adolescents (p < 0.05). However, following treatment with a functional appliance, the skeletal Class II adolescents had increased pharyngeal airway dimensions, which became similar to those of the control subjects. CONCLUSIONS: Functional appliance therapy can increase the pharyngeal airway dimensions in growing adolescents with skeletal Class II malocclusions, and this effect is maintained until the completion of growth.
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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 [13]
The Discussion (page unavailable) reports improvements in two skeletal measures, ANB and Mx-Mn, and says they showed no relapse up to the termination of appliance treatment. It does not report an absence of significant changes in most skeletal variables during the post-treatment follow-up; its explicit long-term maintenance finding concerns pharyngeal airway dimensions. (LLM, conf=0.78)
Experimental — accuracy not yet measuredStudies 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 [13]
The Discussion and Conclusion report increased oropharyngeal airway dimensions after bionator treatment in growing adolescents with skeletal Class II malocclusions, measured using cephalometry. This paper does not report CBCT measurements or establish how findings vary across populations; those parts of the collective claim are not supported by this source alone. Page numbers are not available in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredGrowing adolescents with skeletal class II malocclusions treated with functional appliances demonstrated an increase in pharyngeal airway dimensions of the oropharyngeal region, and such changes were consistently maintained even after growth completion.
“Growing adolescents with skeletal class II malocclusions treated with functional appliances demonstrated an increase in pharyngeal airway dimensions of the oropharyngeal region, and such changes were consistently maintained even after growth completion.32, 38”
From Effectiveness of functional orthodontic appliances in obstructive sleep apnea treatment in children: literature review (2022) · cites this paper as [38]
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“…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], who documented long-term skeletal stability following growth-modifying treatments in Class II patients.”
- Authors
- Han, S., Choi, Y. J., Chung, C. J., Kim, J. Y., & Kim, K.-H.
- Affiliations
- Yonsei University (KR)
- Corresponding author
- Kim, Kyung-Ho
- Venue
- The Korean Journal of Orthodontics
- Publisher
- Korean Association of Orthodontists
- Published
- 2014
- Volume
- 44
- Issue
- 1
- Pages
- 13
- ISSN
- 1225-5610 (ISSN-L)
- 2234-7518
- 2005-372X
- PMC
- PMC3915171
- OpenAlex
- W2058015406
- Cited by
- 55
- References
- 29
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 2 · 2023: 8 · 2022: 2 · 2021: 11 · 2020: 3 · 2019: 6 · 2017: 5 · 2016: 5 · 2015: 3 · 2014: 2
- FWCI
- 7.30
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- The Korean Journal of Orthodontics (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- YUHSpace (Yonsei University Medical Library) (submittedVersion, cc-by-nc-nd)
- Topics
- Health Sciences › Dentistry › Orthodontics › Orthodontics and Dentofacial Orthopedics
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- pharyngeal airway dimensions, Class II malocclusion, Bionator, functional orthodontic appliances, adolescents, oropharyngeal airway, nasopharyngeal airway, skeletal development
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