Assessment of functional indicators in children with class II Malocclusion with normal, and impaired external respiratory function assessed with spirometry
DOI:
https://doi.org/10.33295/1992-576X-2022-5-6-46Keywords:
class II malocclusion, distal occlusion, impaired external breathing, cephalometric, spirometerAbstract
Background. Class II malocclusion is one of the most common problems in orthodontic practice and is accompanied by certain morphological, functional, and aesthetic changes: a violation of the dynamic balance of muscles of a peri-oral area and tongue, which affects many functions of the child: there are disorders of external breathing, speech, chewing and swallowing functions. Among vital functions, breathing can be called one of the most important, because the exchange ofair between a living being, and the external atmosphere is necessary to meet the metabolic needs of the body. During the respiratory process, the tissues of the oral cavity are the first structures that come into contact with the air moving to the upper respiratory tract. Thus, a malocclusion, especially in Class II with retrognathia mandible, can lead to narrowing of the upper respiratory tract. And these changes, in turn, can adversely affect lung function. Therefore, the correction of retrognathia mandible in Class II Malocclusion by functional appliances can have a beneficial effect on the functions of the lower respiratory tract.
Objective. Study of functional (cephalometric and spirometric indicators) in patients aged 7–13 years with skeletal class II malocclusion with normal and impaired function of external breathing.
Research methods. Cephalometric analysis of the assessment of the position of the jaws and upper respiratory tract (nasopharynx, oropharynx and hypopharynx) by the McNamara method. Spirometric analysis to assess lung function.
Results. The conducted study did not reveal a correlation between the types of jaw growth profile and the volume of the upper respiratory tract in all experimental groups compared to patients in the control group. We also found a low correlation between the nasopharyngeal respiratory function and the position of the lower jaw in different types of class II malocclusion, while changes in the position of the lower jaw significantly affect the volume of the oropharynx and hypopharynx. We found a worsening of the results of FVC, FEV1, IT%(FEV1/FVC) PEF and FEF25–75% in children with narrowing of the upper airways (I-1 and II-1 subgroups) compared to all I-2 and II-2 subgroups and control group (p < 0.05), In addition, a non-significant (p > 0.05) decrease in spirometric measurements was noted in children without narrowing of the upper respiratory tract (I-2, II-2 subgroups) compared to control group.
Conclusions. In order to determine the effectiveness of orthodontic treatment of class II malocclusion, it is necessary to conduct a cephalometric and spirometric study before and after the treatment to determine its effectiveness.
Downloads
References
Choi J.K., Hur Y.K., Lee J.M., Clark G.T. Effects of mandibular advancement on upper airway dimension and collapsibility in patients with obstructive sleep apnea using dynamic upper airway imaging during sleep // Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. - 2010; 109: 712-9. https://doi.org/10.1016/j.tripleo.2009.11.034
Ambjшrnsen E., Valderhaug J., Norheim P.W., Flшystrand F. Assessment of an additive index for plaque accumulation on complete maxillary dentures // Acta Odontol. Scand. - 1982; 40: 203 8. https://doi.org/10.3109/00016358209019813
Katyal V., Kennedy D., Martin J. et al. Paediatric sleep-disordered breathing due to upper airway obstruction in the orthodontic setting:a review // Aust. Orthod. J.; 29 (2): 184-192. PMID: 24380139.
Korayem M.M., Witmans M., MacLean J. et al. Craniofacial morphology in pediatric patients with persistent obstructive sleep apnea with or without positive airway pressure therapy: a cross-sectional comparison with controls // Am. J. Orthod. Dentofacial Orthop. - 2013; 144 (1): 78-85. PMID: 23810049. https://doi.org/10.1016/j.ajodo.2013.02.027
Pirilд-Parkkinen K., Lopponen H., Nieminen P. et al. Cephalometric evaluation of children with nocturnal sleep disordered breathing // Eur. J. Orthod. - 2010;(6): 662-671. PMID: 20305055. https://doi.org/10.1093/ejo/cjp162
Kirjavainen M., Kirjavainen T. (2007). Upper airway dimensions in Class II malocclusion. Effects of headgear treatment // Angle Orthod. - 77: 1046-1053. https://doi.org/10.2319/081406-332
Jena A.K., Singh S.P., Utreja A.K. (2010). Sagittal mandibular development effects on the dimensions of the awake pharyngeal airway passage // Angle Orthod.: 1061-1067. https://doi.org/10.2319/030210-125.1
Ozbek M.M., Miyamoto K., Lowe A.A., Fleetham J.A. (1998). Natural head posture, upper airway morphology and obstructive sleep apnoe a severity in adults // Eur. J. Orthod. - 20: 133-143. https://doi.org/10.1093/ejo/20.2.133
Katyal V., Pamula Y., Martin A.J. et al. Craniofacial and upper airway morphology in Paediatric sleep-disordered breathing and changes in quality of life with rapid maxillary expansion // Am. J. Orthod. Dentofacial Orthop. - 2013; 143 (1): 20-30. PMID: 23273357.
Pupneja P., Utreja A., Singh S. et al. Effects of twin-block appliance treatment on pulmonary functions in class II malocclusion subjects with retrognathic mandibles // J. Orthod. Endod. - 2015; 1 (6): 1-5.
Lundy Braun, breathing race into the machine: the surprising career of the spirometer from Plantation to genetics, inventing the Spirometer, Published by the University of Minnesota Press, 2014; 3-7 p. https://doi.org/10.5749/minnesota/9780816683574.001.0001
Holdenberh Yu.M. Klinika ta diahnostyka zakhvoriuvan orhaniv dykhannia: navch. posib. / Yu.M. Holdenberh, I.M. Shchulipenko, A.E. Petrov. - Poltava: TOV «Firma Tekhservis». - 2007. - 454 s.
Brazzale D., Hall G., Swanney M.P. Reference values for spirometry and their use in test interpretation: A position statement from the Australian and New Zealand Society of Respiratory Science // Respirology. - 2016; 21 (7): 1201-9. https://doi.org/10.1111/resp.12855
Marina Malanda N., Lopez de Santa Maria E., Gutierrez A., Bayon J.C., Garcia L., Galdiz J.B. Telemedicine spirometry training and quality assurance program in primary care centers of a public health system // Telemed. J. E. Health. - 2014; 20: 388-392. https://doi.org/10.1089/tmj.2013.0111
World Health Organization. The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization // Soc. Sci Med. - 1995; 41: 1403-9. https://doi.org/10.1016/0277-9536(95)00112-K
Jose N.P., Shetty S., Mogra S., Shetty V.S., Rangarajan S., Mary L. Evaluation of hyoid bone position and its correlation with pharyngeal airway space in different types of skeletal malocclusion // Contemp. Clin. Dent. - 2014; 5: 187-189. https://doi.org/10.4103/0976-237X.132313
American Thoracic Society. Standardization of spirometry - 2005 // Eur. Respir. J. - 2005; 26: 319-38.
Tepedino M., Illuzzi G., Laurenziello M., Perillo L., Taurino A.M., Cassano M. et al. Craniofacial morphology in patients with obstructive sleep apnea: cephalometric evaluation // Braz. J. Otorhinolaryngol. - 2020.
Lakshmi K.B., Yelchuru S.H., Chandrika V., Lakshmikar O.G., Sagar V.L., Reddy G.V. Comparison between growth patterns and pharyngeal widths in different skeletal malocclusions in South Indian Population // J. Int. Soc. Prevent. Communit. Dent. - 2018; 8: 224-8. https://doi.org/10.4103/jispcd.JISPCD_77_18
Dalmau E., Zamora N., Tarazona B., Gandia J.L., Paredes V. A Comparative Study of the Pharyngeal Airway Space, Measured with Cone Beam ComputedTomography, Between Patients with Different Craniofacial Morphologies // Journal of Cranio-Maxillofacial Surgery (2015) https://doi.org/10.1016/j.jcms.2015.06.016