Measuring Airway Changes After Treatment With The Maxillary Skeletal Expander Using Three Dimension Cone Beam Computed Tomography And Computational Fluid Dynamic Analysis PDF Download

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Measuring Airway Changes After Treatment with the Maxillary Skeletal Expander Using Three Dimension Cone Beam Computed Tomography and Computational Fluid Dynamic Analysis

Measuring Airway Changes After Treatment with the Maxillary Skeletal Expander Using Three Dimension Cone Beam Computed Tomography and Computational Fluid Dynamic Analysis
Author: Zachary Philip Hollander
Publisher:
Total Pages: 38
Release: 2021
Genre:
ISBN:

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Transverse maxillary deficiency is a common skeletal malocclusion that is diagnosed when the maxilla is narrow in relation to the mandible. The malocclusion develops during growth and usually does not correct without treatment. Some health problems thought to be associated with a narrow maxilla include narrowing of the pharyngeal airway and the nasal cavity and increased nasal resistance. In short, problems that make it more difficult to breath. Adult patients seeking an alternative to surgical expansion can now turn to bone-borne expanders utilizing Temporary Anchorage Devices (TADs) such as the maxillary skeletal expander (MSE) which is able to orthopedically expand the maxilla transversely at any age. A preliminary study performed at UCLA suggested that patients treated with MSE had improvement in airway volume and airflow immediately following expansion. This study investigated the effects of MSE on airway improvement using three-dimensional cone beamed computed tomography (CBCT) to measure volume changes in the upper airway and a computational fluid dynamic model (CFD) to evaluate the changes in airflow for sixteen patients at the UCLA Orthodontics Clinic at two timepoints: pre-expansion (T0) and post-expansion (T1). Treatment with the MSE caused a statistically significant increase in the volume of the airway after expansion as compared with the control group. Furthermore, CFD analysis showed that treatment with the MSE caused a statistically significant reduction in the airway resistance. The airway resistance of the MSE group was no longer statistically different from the control group after expansion. There was no correlation between the volume increase and the decrease in airway resistance. Overall, there was a significant increase in total airway volume, oropharyngeal volume, nasopharyngeal volume, and nasal cavity volume with MSE treatment immediately after expansion, but there was no correlation between volume increase and the improvement in breathing metrics, namely airway resistance. These results suggest that treatment of maxillary constriction using the MSE appliance may show positive effects in improvement of the upper airway volumes and reduction of the upper airway resistance.


Orthodontics in Obstructive Sleep Apnea Patients

Orthodontics in Obstructive Sleep Apnea Patients
Author: Su-Jung Kim
Publisher: Springer Nature
Total Pages: 141
Release: 2019-10-16
Genre: Medical
ISBN: 303024413X

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This well-illustrated book is an up-to-date guide to orthodontic diagnosis, treatment planning, and treatment delivery in patients with obstructive sleep apnea (OSA). The aim is to present the latest knowledge on the important contribution that orthodontic modalities can now make in the management of a disorder that has generally been the preserve of sleep doctors. This book comprises three parts of general understanding of OSA and medical approaches, orthodontic diagnostic process, and orthodontic treatment application. In particular, the treatment parts are subdivided into six chapters depending on the patient’s phenotype and age groups. The readers will come to realize how many modalities are available beyond the previously well-known options, and how important orthodontic contributions are for the treatment of OSA patients. The book will be an excellent resource providing well-organized diagnostic and therapeutic protocols from orthodontic point of view and will also be of value to other practitioners with an interest in OSA.


Alveolar Bone and Airway Changes in Different Maxillary Expansion Treatments

Alveolar Bone and Airway Changes in Different Maxillary Expansion Treatments
Author: Dennis Wang
Publisher:
Total Pages: 0
Release: 2020
Genre:
ISBN:

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Objectives: To evaluate the long-term effects on the airway and bone in patients that have undergone BA, TA and control with 3D cone beam computed tomography (CBCT) analysis. Materials and Methods: 180 CBCTs were analyzed for 60 patients at pretreatment (T1), post expansion (T2), and post-treatment (T3). Patients were divided into three groups, bone anchored expansion (BA), tooth anchored expansion (TA) and a control group. For the airway portion of the study, the nasal cavity, nasopharyngeal, oropharyngeal and laryngopharyngeal, and total airway volumes were measured. Total airway area, minimal cross-sectional area, maxillary intermolar, external maxillary and palatal widths were also examined. For the bone portion of the study, intermolar width, palatal width, molar angulation, vertical bone height, and buccal bone thickness at the alveolar crest and root apex were measured. Results: Both BA and TA caused a significant increase in the airway parameters short-term but when examining long-term results, there were no significant differences in the airway parameters between the three groups except for the nasopharyngeal volume and palatal width parameters.. Both BA and TA resulted in significant increases in the intermolar width, molar angulation, palatal width, vertical bone height and buccal bone thickness at the root apex short-term. Long-term examination showed similar trends to that seen in the short term for both BA and TA groups. However, in the control group, there were significant increases in the intermolar width and decrease in the buccal bone thickness at the root apex. When comparing the end results with pre-treatment measurements, there was still a significant decrease in the vertical bone heights in the BA and TA groups. Conclusions: There were significant increases in the total airway volume and area, minimal cross-sectional area with BA and TA immediately post-expansion but by post-treatment, the changes seen in the airway and bone parameters in the BA and TA groups were similar to the changes seen in the control group. The only differences seen long-term were that the BA group led to a significant increase in the nasopharyngeal volume and that the BA and TA groups led to significant decreases in the vertical bone heights.


Dental Sleep Medicine, An Issue of Sleep Medicine Clinics

Dental Sleep Medicine, An Issue of Sleep Medicine Clinics
Author: Jamison Spencer
Publisher: Elsevier Health Sciences
Total Pages: 137
Release: 2018-11-14
Genre: Medical
ISBN: 0323643353

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This issue of Sleep Medicine Clinics focuses on Dental Sleep Medicine and includes topics on: Clinical Evaluation for Oral Appliance Therapy; Bruxism and Obstructive Sleep Apnea; Obstructive Sleep Apnea's Connections with Clinical Dentistry; Avoiding and Managing with Oral Appliance Therapy Side Effects; Predicting outcomes with Oral Appliance Therapy; Oral Appliance Therapy and Temporomandibular Disordres; Dental Sleep Medicine in the Military; and Pediatric Considerations in Dental Sleep Medicine


Rapid Maxillary Expansion

Rapid Maxillary Expansion
Author: Donald J. Timms
Publisher:
Total Pages: 152
Release: 1981
Genre: Medical
ISBN:

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Three-Dimensional Comparison of the Upper Airway in Various Types of Dentofacial Deformities

Three-Dimensional Comparison of the Upper Airway in Various Types of Dentofacial Deformities
Author: Mei-Man Chong
Publisher: Open Dissertation Press
Total Pages:
Release: 2017-01-26
Genre:
ISBN: 9781361303313

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This dissertation, "Three-dimensional Comparison of the Upper Airway in Various Types of Dentofacial Deformities" by Mei-man, Chong, 臧薇敏, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Objectives 1. To define the normative airway of Chinese population using three-dimensional imaging and computer analysis 2. To evaluate the upper airway differences in patients with normal facial profile and those with skeletal class III deformity 3. To evaluate the differences in upper airway models among patients with different dentofacial deformities and describe the role of computational fluid dynamics (CFD) in the human upper airway Materials and Methods Part I: Three-Dimensional Analysis of the Normative Upper Airway in Chinese This was a cross-sectional observational study. Cone beam computerized tomography (CBCT) scans of one hundred patients were analyzed. Computer analysis of the different upper airway parameters were studied including airway length and volume, as well as airway dimensions at the axial level of the soft palate, hard palate, base of tongue, and epiglottis. The most constricted airway location was identified and correlation analysis with variables of interest was done. Part II: A Cone Beam Computerized Tomography Study of Airway in Skeletal Class I and Class III Cone-beam computed tomography (CBCT) records of 200 patients were used to evaluate the upper airway dimensions. This sample consisted of patients with normal facial profile (Class I) and those demonstrating skeletal class III deformities. Computer analysis of the upper airway parameters such as airway length, airway volume, airway anterior-posterior and cross-sectional area dimensions at the hard palate, soft palate, base of tongue and epiglottis were performed. The most constricted airway sites were identified. Part III: Computational fluid dynamics study of upper airway in different dentofacial deformities Cone-beam computed tomography records of 12 patients were used to evaluate the upper airway. This sample consisted of facial skeletal Class I, II and III subjects. The upper airway models were constructed to allow CFD simulations in the airway from the epiglottis to the hard palate. Cross-sectional area, pressure, velocity and resistance were measured based on the reconstructed meshed models. Results Part I: Three-Dimensional Analysis of the Normative Upper Airway in Chinese In 100 subjects (40 males, 60 females) aged 16-40 years with normal facial profile, we found that the most constricted site occurs at the level of the soft palate. This surface area of this site was found to be linearly correlated to the airway volume, suggesting a significant relationship between the most constricted area and the total airway volume. Gender differences were found in airway length, volume, and in the dimensions at the base of tongue and epiglottis region. The mean airway length was 54.12 mm + 6.19 for males and 49.25 mm + 4.86 for females; airway volume of 15.09 cm3 + 4.92 for males and 13.12 cm3 + 4.72 for females. Part II: A Cone Beam Computerized Tomography Study of Airway in Skeletal Class I and Class III The sample consisted of 100 Class I (41 males, 59 females) with a mean age of 25.4 years and 100 Class III (38 males, 62 females) with a mean age of 23.5 years. Gender differences were noted in the airway length, airway volume and dimensions at the base of tongue and epiglottis for both groups. Males showed longer airway length, larger airway volume, larger airway dimensions at the base of tongue and epiglottis co


Analysis of Upper Airway Functional and Dentofacial Changes During Non-surgical Maxillary Expansion in Adults

Analysis of Upper Airway Functional and Dentofacial Changes During Non-surgical Maxillary Expansion in Adults
Author: Nikoo Habibnia
Publisher:
Total Pages: 0
Release: 2022
Genre: Maxillary expansion
ISBN:

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Introduction: This analysis is part of an ongoing retrospective secondary pilot study on a randomized clinical trial. The purpose of this research project was to evaluate the effect of none-surgical maxillary expansion techniques on upper airway dimension and function, and skeletal and dental changes, using two different maxillary expanders: Moon and Dresden expanders. Methods: A sample of thirteen patients were randomly allocated to either group A or group B. Patients in group A (N=5) received orthodontic treatment using an appliance called Dresden expander. Patients in group B (N=8) received orthodontic treatment using the Moon expander. Two sets of records were taken for each patient; before starting treatment (T0) and after maxillary expansion completed (T1). Records consisted of the following: clinical charting and diagnostic exams, intra-oral and extraoral photos, cone beam computer tomography (CBCT), nasal obstruction symptom evaluation (NOSE) questionnaires, and peak nasal inspiratory flow (PNIF). The changes on the upper airway dimension and function were evaluated using CBCT scans (using Dolphin software), PNIF (objective measurement), and NOSE questionnaire (subjective measure). The skeletal and dental changes were evaluated using various skeletal and dental landmarks in CBCT using Avizo software. For upper airway changes and skeletal and dental changes, one-way repeated measure mixed ANOVA tests and paired sample t-tests were conducted. Results: For upper airway changes, from T0 to T1, no statistically significant differences were found between the Moon and the Dresden expander groups for nasopharynx volume (NPV), oropharynx volume (OPV), oropharynx minimal cross-sectional area (OPMCA), PNIF with both nostrils (PNIFBN), PNIF with left nostril blocked (PNIFLB), and PNIF with right nostril blocked (PNIFRB), and NOSE questionnaires. Also, both expanders showed to have no significant effect on upper airway dimensions and function. For skeletal and dental changes, Moon expander resulted in buccal displacement of pulp chamber of tooth # 1.6, 2.6, and 2.4 (p0.05). Conclusion: The effect of microimplant-assisted rapid palatal expansion (MARPE) appliances on upper airway dimension and function in adults is yet to be determined and future randomized controlled clinical trial studies with larger sample size are needed. In terms of skeletal and dental changes, the only statistically significant change was in the Moon expander group in transverse (X) direction for pulp chamber of upper first molars and upper left first premolar. However, such changes may not be clinically significant. No significant differences were found between the two appliance designs in this analysis.


Effects of Rapid Maxillary Expansion on Upper Airway

Effects of Rapid Maxillary Expansion on Upper Airway
Author: Yoon Hwan Chang
Publisher:
Total Pages:
Release: 2011
Genre: Airway (Medicine)
ISBN:

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The purpose of this study was to use cone-beam computed tomography (CBCT) to assess changes in the volume and cross sectional areas of the upper airway in children with maxillary constriction treated by rapid maxillary expansion (RME). The study group consisted of 5 males and 9 females with mean age of 12.93 years with posterior cross bite and constricted maxilla who were treated with hyrax expander as part of their comprehensive orthodontic treatment. Pre and post RME CBCT scans were analyzed with 3D Dolphin 11.0 software to measure the retropalatal (RP) and retroglossal (RG) airway changes including volume and cross sectional areas. The transverse width changes were evaluated from the maxillary inter 1st molar and inter 1st pre molar mid lingual alveolar plate points. Pre and post RME scans were compared with paired t test and Pearson correlation test was done on data reaching significance. Only the cross sectional airway measured at posterior nasal spine (PNS) to Basion (Ba) level showed a statistically significant increase (P=0.0004). The minimal cross sectional area (MCA) was always found within the RP airway. The inter-molar and inter-premolar mid lingual alveolar plate distances increased equally by 4.76 mm and were statistically significant (P


Ultrasonography in Dentomaxillofacial Diagnostics

Ultrasonography in Dentomaxillofacial Diagnostics
Author: Kaan Orhan
Publisher: Springer Nature
Total Pages: 372
Release: 2021-03-03
Genre: Medical
ISBN: 3030621790

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This book offers a comprehensive review of the state of the art in Ultrasonography (USG) dentomaxillofacial imaging to help radiologists and dentists in their training and daily practice. The book examines the relationship between clinical features, diagnosis, and choice of minimally invasive technique for a range of dentomaxillofacial disorders and provides information on post-treatment therapy. Accurate interpretation of indications for treatment is the cornerstone of success in medicine, and as such, the book explains how the selection of imaging technique is closely linked to clinical and diagnostic aspects and how recognition of this relationship forms the foundation for optimal outcomes. In addition to examining the various modalities, the book highlights the role of the latest USG imaging techniques. Further, it discusses in detail the pathology, treatment, and prognosis of common and rare diseases, as well as congenital/developmental malformations in the dentomaxillofacial, an area that is often underestimated and largely ignored by dentists. Featuring updated high-resolution images created with state-of-the-art equipment, the book introduces readers to current imaging modalities. It also includes pathological descriptions of radiologic diagnoses to help clarify the pathophysiology of the disease, while the pearls and pitfalls of image interpretation provide a quick reference guide for practitioners. Written by leading international experts, this outstanding book is a valuable resource for both radiologists, dentists and students seeking a more in-depth appreciation of the subject and its contribution to the scientific radiology community.


Long Term Functional Breathing Improvement Following Maxillary Skeletal Expander Treatment

Long Term Functional Breathing Improvement Following Maxillary Skeletal Expander Treatment
Author: Andrew Combs
Publisher:
Total Pages: 39
Release: 2021
Genre:
ISBN:

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Maxillary transverse deficiency is a highly prevalent skeletal problem characterized by a narrow maxilla in relation to the mandible. Although the etiology is multifactorial, the malocclusion develops during facial growth and usually progresses to the permanent dentition if there is no intervention. Furthermore, serious health problems are thought to be related to the occlusal disharmony including narrowing of the pharyngeal airway and nasal cavity, increased nasal resistance, and alteration of tongue posture.In patients with the desire to avoid surgery, a new design of palatal expansion termed the Maxillary Skeletal Expander (MSE) has been utilized to achieve maxillary expansion. MSE utilizes bone borne temporary anchorage devices (TADs) to expand maxillary transverse deficient patients with an interdigitated palatal suture. A preliminary study performed at UCLA demonstrated that patients treated with MSE had significant breathing improvement immediately following skeletal expansion. This study investigated the long-term effects of MSE in airway improvement using peak nasal inspiratory flow (PNIF), peak oral inspiratory flow (POIF), and subjective measures of breathing such as the Visual Analog Scale (VAS) and Nasal Obstruction Symptom Evaluation (NOSE). We examined seventeen patients at the UCLA Orthodontics Clinic at three timepoints: pre-expansion (T0), post-expansion (T1), and post orthodontic treatment (T2). Following MSE expansion, increases in PNIF total, PNIF left, PNIF right and POIF total were found to be significantly improved at the post orthodontic timepoint T2 when compared to T0. Also, VAS total, VAS left, and VAS right were significantly improved at T2 showing a decrease in the feeling of troubled breathing. Additionally, several of the objective and subjective clinical measures positively correlate with the magnitude of expansion determined by critical landmarks on Cone beam computed tomography radiographs (CBCTs). Overall, MSE treatment produces an increased objective and subjective airway improvement that continues to remain stable post expansion. Based on the clinical improvement and correlations with CBCT data, MSE offers a non-surgical alternative to achieve skeletal expansion that may benefit patients with airway issues.