Copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Cone beam computed tomographic evaluation of pharyngeal airway in North Indian children with different skeletal patterns
Anuraj Singh Kochhar, Maninder Singh Sidhu, Ritasha Bhasin, Gulsheen Kaur Kochhar, Himanshu Dadlani, Jagpreet Sandhu, Bobby Virk
Anuraj Singh Kochhar, Former Orthodontist, Max Hospital, Gurgaon 122001, India
Maninder Singh Sidhu, Department of Orthodontics, Faculty of Dental Sciences, SGT University, Gurugram 122001, India
Ritasha Bhasin, Faculty of Dentistry, University of Toronto, Toronto M5G 1G6, Canada
Gulsheen Kaur Kochhar, Department of Pediatric and Preventive Dentistry, National Dental College and Hospital, Derabassi 140507, Punjab, India
Himanshu Dadlani, Department of Periodontology, Kalka Dental College, Uttar Pradesh 210507, India
Himanshu Dadlani, Senior Consultant, Department of Dental Surgery, Max Hospital, Gurgaon 122001, India
Jagpreet Sandhu, Formerly at Department of Orthodontics, Genesis Institute of Dental Sciences, Punjab 152001, India
Bobby Virk, Chief Orthodontist, Smile With Braces, Puyallup, WA 98371, United States
Author contributions: Kochhar AS contributed conceptualization, data curation, and formal analysis; Sidhu MS contributed investigation and methodology; Bhasin R contributed software, supervision, and validation; Kochhar GK contributed visualization, and wrote review and edited; Dadlani H contributed data curation, and wrote original draft preparation; Sandhu J contributed Project administration and resources; Virk B contributed methodology and validation; all authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved for by our Institutional Review Board (Approval No. SGTDC/PPL/Com./E.C). Dated 14/08/2010.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.
Data sharing statement: No additional data are available. The original anonymous dataset is available on request from the corresponding author.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Himanshu Dadlani, MDS, Professor, Department of Periodontology, Kalka Dental College, Meerut, Uttar Pradesh 210507, India. himdent@hotmail.com
Received: November 24, 2020
Peer-review started: November 24, 2020
First decision: December 21, 2020
Revised: December 27, 2020
Accepted: January 28, 2021
Article in press: January 28, 2021
Published online: February 28, 2021
ARTICLE HIGHLIGHTS
Research background
Diminished airway associated with obstructive sleep apnea tends to be typical in patients with Angle class II malocclusion, displaying retrognathic mandible and sagittal discrepancy. Early diagnosis and evaluation of the functional factors in growing children with skeletal discrepancy and features of adenoid hypertrophy (adenoid faces) might be pivotal to restore proper craniofacial growth and treatment outcome stability.
Research motivation
A lot of data has been published related to the identification of airway in the general population, even comparing different cone beam computed tomography machines for the same. However, there is a paucity of data on tomographic evaluation of airways in different skeletal patterns, which is often challenging due to their morphology and plays a vital role in their treatment planning.
Research objectives
Comparing the airway volumes in patients with mandibular retrognathism and those with the normal anteroposterior skeletal relationship.
Research methods
Cone-beam computed tomography volume scans, and lateral cephalograms, 3-dimensional airway volume and cross-sectional areas of 120 healthy children which were done for orthodontic assessment was evaluated. The subjects were divided into 2 groups based on the angle formed between point A, Nasion and Point B (ANB) values and cephalometric variables (such as anterior and posterior facial height, gonial angle etc.) airway volumes, and cross-sectional measurements were compared using independent t tests. Pearson’s correlation coefficient test was used to detect any relationship of different parts of the airway and between airway volume and 2-dimensional cephalometric variables.
Research results
Means and standard deviations for cephalometric, cross-sectional, and volumetric variables were compared. ANB, mandibular body length, facial convexity was statistically highly significant whereas condylion to point A, nasal airway and total airway volume were statistically significant. The nasal airway volume and the superior pharyngeal airway volume had a positive correlation, nasal airway was correlated to middle and total airway superior had a relation with middle, inferior and total airway, middle was related to all other airways, inferior was also related to all the airways except nasal. Lateral cephalometric values were positively correlated with the airway volume with Frankfurt Mandibular Plane Angle and facial convexity showed significant correlations with total airway volume. Additionally, ANB angle was significantly correlated with total airway volume and superior airway.
Research conclusions
Position of the mandible has positive correlation with the airway volume. Retrognathic mandible showed decreased overall airway in patients. Facial convexity and length of the mandible also influence the airway.
Research perspectives
The current study gives direction for future research on a larger cohort related to mandibular position and airway, linking the two for timely maxillo-facial orthopedic treatment interventions.
