THE IMPACT OF ORTHODONTIC PATHOLOGY AND THERAPY ON THE CONDITION OF THE UPPER AIRWAY
DOI:
https://doi.org/10.35220/2523-420X/2024.1.16Keywords:
pharyngeal airway space, orthodontic pathology, functional orthodontic appliances, orthognathic surgery, rapid palatal expansion, type of jaw growth, McNamara analysisAbstract
The aim of the study. To analyze the scientific literature on radiological methods most commonly used to diagnose the width of the upper airway and the impact of orthodontic pathology and therapy on the linear parameters of the pharynx. Materials and methods. The online search was conducted in the Medline-Pubmed Internet database of published scientific studies on methods of diagnostics and changes in the linear dimensions of the upper airway in orthodontic pathology and after orthodontic treatment. Outline of the main material. One of the most well-known methods for assessing airway width is the McNamara cephalometric method. The hyoid bone and its muscles play a key role in regulating the pharyngeal airway and maintaining head posture. The position of the hyoid bone and tongue can be considered determinants of the volume of the pharyngeal airway. Scientific studies have shown a correlation between skull growth types and upper airway width, namely a larger nasopharyngeal width in brachycephalic individuals with skeletal class 1 and a smaller pharyngeal width in individuals with hyperdivergent jaw growth. The airways are the smallest in adults with anterior position of the mandibular condyles. The distal position of the mandible is associated with a reduced oropharyngeal airway. Functional orthodontic treatment leads to an increase in the size of the airway, and removable appliances are more effective than fixed appliances. Using the RME appliance to rapidly expansion the upper jaw reduces nasal congestion, elevates the tongue and widens the upper airway. Mandibular set back reduces the width of the airway, while surgical mesial advancement of the mandible increases this dimension. In adult patients with bimaxillary protrusion, treatment with the extraction of four premolars and maximum anchorage of the posterior teeth results in a decrease in the volume of the upper airway. If mesial movement of the posterior teeth occurs during treatment, this leads to an increase in airway volume. Conclusions. The synchronization of ideal occlusion and facial growth is possible with correct tongue position and nasal breathing. Therefore, orthodontic treatment protocols should not only normalize occlusion and facial aesthetics, but also take into account the need to improve the pharyngeal airway space.
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