Alternative therapies in health and medicine · 2024
Analysis of the Effect of Maxillary Expansion Combined with Twin-block Appliances on Malocclusion and Related Factors of Upper Airway Sagittal Diameter Changes.
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Li Hua, Dai Jindong, Sun Guangrong
Аннотация
OBJECTIVE: To comparatively analyze the therapeutic effect of maxillary expansion combined with twin-block appliances (TBA) versus adenotonsillectomy (ATE) in the treatment of children with upper airway stenosis (UAS) complicated by malocclusion (MA), and to analyze the related factors affecting the changes of the upper airway sagittal diameter.
METHODS: From October 2020 to October 2022, 54 children with UAS complicated by class II MA were treated at Zhenjiang Stomatological Hospital and Liyang People's Hospital. They were selected as study subjects and were divided as follows a research group (RG) comprised 28 children who received treatment with maxillary expansion combined with TBA and a control group (CG) comprised another 26 children who received ATE. All the children were examined by cone beam computed tomography (CBCT) before and 3 months after treatment. Alterations in upper airway parameters, and changes in the angles of sella-nasion-superior alveolar base point A (<SNA), Sella-nasion-inferior alveolar base point B (<SNB), and point A-nasion-point B (<ANB) were observed before and after treatment. Related factors affecting the change of the upper airway sagittal diameter were analyzed.
RESULTS: After treatment, specifically including the volume (V1), the volume from the top of the airway to the PNS plane (PNSP) (V2), the volume from PNSP to the uvula tip plane (UTP) (V3), the volume from UTP to epiglottis tip plane (ETP) (V5), and SAS in the control group were enhanced, while IAS was decreased. However, children receiving orthodontic treatment had increased upper airway volume, MAS, and IAS, and decreased <ANB. Comparatively, Vnasopharynx, SAS, and <ANB were lower in the research group after treatment. According to the Logistic regression analysis, treatment modalities, quantitative staging of cervical bone age, and <ANB before treatment were independent factors affecting the upper airway sagittal diameter changes.
CONCLUSIONS: Maxillary expansion combined with TBA is effective in the treatment of UAS complicated by MA, which reserves recommendation.
METHODS: From October 2020 to October 2022, 54 children with UAS complicated by class II MA were treated at Zhenjiang Stomatological Hospital and Liyang People's Hospital. They were selected as study subjects and were divided as follows a research group (RG) comprised 28 children who received treatment with maxillary expansion combined with TBA and a control group (CG) comprised another 26 children who received ATE. All the children were examined by cone beam computed tomography (CBCT) before and 3 months after treatment. Alterations in upper airway parameters, and changes in the angles of sella-nasion-superior alveolar base point A (<SNA), Sella-nasion-inferior alveolar base point B (<SNB), and point A-nasion-point B (<ANB) were observed before and after treatment. Related factors affecting the change of the upper airway sagittal diameter were analyzed.
RESULTS: After treatment, specifically including the volume (V1), the volume from the top of the airway to the PNS plane (PNSP) (V2), the volume from PNSP to the uvula tip plane (UTP) (V3), the volume from UTP to epiglottis tip plane (ETP) (V5), and SAS in the control group were enhanced, while IAS was decreased. However, children receiving orthodontic treatment had increased upper airway volume, MAS, and IAS, and decreased <ANB. Comparatively, Vnasopharynx, SAS, and <ANB were lower in the research group after treatment. According to the Logistic regression analysis, treatment modalities, quantitative staging of cervical bone age, and <ANB before treatment were independent factors affecting the upper airway sagittal diameter changes.
CONCLUSIONS: Maxillary expansion combined with TBA is effective in the treatment of UAS complicated by MA, which reserves recommendation.