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Table of Contents
ORIGINAL ARTICLE
Year : 2021  |  Volume : 9  |  Issue : 3  |  Page : 83-85

A study to measure nasopharyngeal airway space in different facial morphological patterns between both genders


1 Department of Orthodontics and Dentofacial Orthopedics, Rural Dental College, PIMS, Loni, Ahmednagar, Maharashtra, India
2 Department of Orthodontics and Dentofacial Orthopedics, C.K.S. Teja Institute of Dental Sciences and Research, Tirupati, Andhra Pradesh, India
3 Satish Dental Clinic, Madanpalli, Chittoor, Andhra Pradesh, India

Date of Submission02-Jul-2021
Date of Acceptance20-Jul-2021
Date of Web Publication09-Sep-2021

Correspondence Address:
Dr. Vijaysinh Ramchandra Tanpure
Department of Orthodontics and Dentofacial Orthopedics, Rural Dental College, PIMS, Ahmednagar, Maharashtra.
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/INJO.INJO_27_21

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  Abstract 

Background: Studies in the past have assessed relation between airway and type of malocclusion and found no association between rhinomanometric measures of airway adequacy and type of malocclusion or craniofacial morphology. Hence, the present study was undertaken to test whether there is any association between pharyngeal airway and type of malocclusion. Materials and Methods: The subjects were divided into three groups based on skeletal pattern with 20 subjects in each group: Group 1 with Class I skeletal pattern, Group 2 with Class II skeletal pattern, and Group 3 with Class III skeletal pattern. All the cephalograms were taken in natural head position. Results: When compared between males and females among these groups, significant differences were observed in Group 1 in the following parameters: lower airway thickness (PNS-Ba), upper airway thickness (PNS-AD2), and upper airway thickness (PNS-H), and the total nasopharyngeal area was more in males than in females and differences were statistically significant. Conclusion: It was concluded that significant differences were observed in Group 1 in the following parameters: lower airway thickness (PNS-Ba), upper airway thickness (PNS-AD2), and upper airway thickness (PNS-H), and the total nasopharyngeal area was more in males than in females and differences were statistically significant.

Keywords: Malocclusion, nasopharyngeal airway space, orthodontics


How to cite this article:
Tanpure VR, Kalavani S V, Palagiri FB, Bhagyalakshmi K, Devaki SB. A study to measure nasopharyngeal airway space in different facial morphological patterns between both genders. Int J Oral Care Res 2021;9:83-5

How to cite this URL:
Tanpure VR, Kalavani S V, Palagiri FB, Bhagyalakshmi K, Devaki SB. A study to measure nasopharyngeal airway space in different facial morphological patterns between both genders. Int J Oral Care Res [serial online] 2021 [cited 2021 Nov 29];9:83-5. Available from: https://www.ijocr.org/text.asp?2021/9/3/83/325838




  Introduction Top


Cephalometric radiography is a vital clinical tool in orthodontics for evaluating craniofacial complex, determination of morphology and growth, diagnosis of anomalies, forecasting future relationships, planning treatment, and evaluating the results of growth and the effects of treatment. The lateral cephalogram provides information regarding skeletal, dental, and soft tissue morphology as well as relationships between these structures. The influence of airway obstruction on developmental pattern of face has always been controversial.[1],[2],[3],[4],[5] Studies in the past have assessed the relation between airway and type of malocclusion and found no association between rhinomanometric measures of airway adequacy and type of malocclusion or craniofacial morphology.[6],[7],[8],[9],[10],[11] Hence, the present study was undertaken to test whether there is any association between pharyngeal airway and type of malocclusion and difference between males and females.


  Materials and Methods Top


The sample comprised 60 subjects with an age range of 18–25 years. The subjects were screened from the Orthodontic Department of CKS Teja Institute of Dental Science and Research, Tirupati, Andhra Pradesh, India. The subjects were divided into three groups based on the skeletal pattern with 20 subjects in each group: Group 1 with Class I skeletal pattern, Group 2 with Class II skeletal pattern, and Group 3 with Class III skeletal pattern. Each group consisted of equal number of males and females. All procedures performed in the study were conducted in accordance with the ethics standards given in 1964 Declaration of Helsinki, as revised in 2013. The study proposal was submitted for approval and clearance was obtained from the Ethical Committee of our institution. A written informed consent was obtained from each participant. All the cephalograms were taken in natural head position (NHP). A modified mirror method was used to obtain NHP. A mirror was placed about 3 ft front from the floor level. To obtain a true vertical, a plumb line was created by suspending a weight of 4 kg on a 0.016 in. wire hung from the ceiling, 9 ft in front of the mirror. The subject stands to the left of the plumb line looking into the mirror. A Kavo light source (12 V) was fixed 7 ft 6 in. to the right wall, at a height of 5 ft 3 in. The rod can move only in a vertical direction to adjust the level of the light source depending on subject’s head height. The light casts a shadow of the wire on the right side of subject’s face, just distal to the lateral canthus of the eye. The light does not have any horizontal movement, thus preventing a shift of the wire shadow in a horizontal direction as this could alter the true vertical reference. The subject was asked to maintain the self-balanced position of the head by tilting the head backward and forward with decreasing amplitude to find the most natural position in between. After determining the self-balanced neural position, the subject was asked to look into his/her own eyes in the mirror. At this junction, two points were marked using a pen along the wire shadow on the right side of subject’s face: one near the lateral canthus of the eye and the other at the lower border of the mandible. These areas were selected for placing the markers as no important cephalometric landmarks are located here. The marker gave radiopaque shadows on the lateral cephalogram. All cephalometric tracings were done by a single calibrated examiner. Inter-group comparisons were performed using analysis of variance test. If P-value (level of significance) was significant, then a post hoc Turkey’s test was done to check which two groups were statistically different from each other. A P-value of less than 0.05 is set to be statistically significant.


  Results Top


When compared between males and females among these groups, significant differences was observed in Group 1 in the following parameters: lower airway thickness (PNS-Ba), upper airway thickness (PNS-AD2), upper airway thickness (PNS-H), and the total nasopharyngeal area was more in males than in females and differences were statistically significant [Graph 1][Graph 2][Graph 3][Graph 4].
Graph 1: (M/F) Lower airway thickness (PNS-Ba)

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Graph 2: (M/F) Upper airway thickness (PNS-AD2)

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Graph 3: (M/F) Upper airway thickness (PNS-H)

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Graph 4: (M/F) Nasopharyngeal area (Np)

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  Discussion Top


In our study, we found that there was no statistically significant relationship between different skeletal groups and nasopharyngeal soft-tissue characteristics, except for two measurements, i.e., aerial and adenoidal areas of Group 2 and Group 3. Our findings are similar to those of Sosa et al.,[7] in which statistically significant relationships were not found between the pharyngeal structures and the ANB angles of the subjects with class I and class II, division 1 malocclusions. Similarly, Solow et al.[8] and Wenzel et al.[11] could find no relationship between the pharyngeal size and the measurements regarding the anteroposterior jaw relationship. Also, Ceylan and Oktay[1] in their study concluded that a number of postural changes can occur and these can involve the structures of head and neck regions in response to the changes in sagittal jaw relationship. The size of the pharyngeal airway does not change appreciably.


  Conclusion Top


It was concluded that significant differences were observed in Group 1 in the following parameters: lower airway thickness (PNS-Ba), upper airway thickness (PNS-AD2), upper airway thickness (PNS-H), and the total nasopharyngeal area was more in males than in females and differences were statistically significant.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Ceylan I, Oktay H. A study on the pharyngeal size in different skeletal patterns. Am J Orthod Dentofacial Orthop 1995;108:69-75.  Back to cited text no. 1
    
2.
Meredith GM. The airway and dentofacial development. Ear Nose Throat J 1987;66:190-5.  Back to cited text no. 2
    
3.
Rubin RM. Mode of respiration and facial growth. Am J Orthod 1980;78:504-10.  Back to cited text no. 3
    
4.
Subtenly J. The significance of adenoid tissue in orthodontia. Angle Orthodont1954;24:235-50.  Back to cited text no. 4
    
5.
Ricketts RM. Respiratory obstruction syndrome. Am J Orthod 1968;54:495-507.  Back to cited text no. 5
    
6.
Kim YJ, Hong JS, Hwang YI, Park YH. Three-dimensional analysis of pharyngeal airway in preadolescent children with different anteroposterior skeletal patterns. Am J Orthod Dentofacial Orthop 2010;137:306.e1-11; discussion 306-7.  Back to cited text no. 6
    
7.
Sosa FA, Graber TM, Muller TP. Postpharyngeal lymphoid tissue in angle class I and class II malocclusions. Am J Orthod 1982;81:299-309.  Back to cited text no. 7
    
8.
Solow B, Siersbaek-Nielsen S, Greve E. Airway adequacy, head posture, and craniofacial morphology. Am J Orthod 1984;86:214-23.  Back to cited text no. 8
    
9.
Warren DW, Lehman MD, Hinton VA. Analysis of simulated upper airway breathing. Am J Orthod 1984;86:197-206.  Back to cited text no. 9
    
10.
Cooke MS, Wei SH. The reproducibility of natural head posture: A methodological study. Am J Orthod Dentofacial Orthop 1988;93:280-8.  Back to cited text no. 10
    
11.
Wenzel A, Williams S, Ritzau M. Relationships of changes in craniofacial morphology, head posture, and nasopharyngeal airway size following mandibular osteotomy. Am J Orthod Dentofacial Orthop 1989;96:138-43.  Back to cited text no. 11
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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   Abstract
  Introduction
   Materials and Me...
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