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Informationen aus Orthodontie & Kieferorthopädie 2020; 52(02): 98-104
DOI: 10.1055/a-1108-6725
Übersichtsartikel

Die Bedeutung des extrathorakalen Luftraumes für die Kieferorthopädie

The Relevance of the Posterior Airway Space for Orthodontics
Jan Hourfar
1   Klinik für Kieferorthopädie, Universitätsklinikum des Saarlandes, Homburg/Saar
,
Gero Kinzinger
1   Klinik für Kieferorthopädie, Universitätsklinikum des Saarlandes, Homburg/Saar
,
Jörg A. Lisson
1   Klinik für Kieferorthopädie, Universitätsklinikum des Saarlandes, Homburg/Saar
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Zusammenfassung

Der „Extrathorakale Luftraum“ findet im klinischen Alltag des Kieferorthopäden sowohl bei der Fallplanung als auch bei der Therapie kaum Beachtung. Ziel dieses Beitrages ist es deshalb, Anatomie, Historie, unterschiedliche Definitionen, bildgebende Verfahren sowie Simulationstechniken des extrathorakalen Luftraumes darzustellen. Ohne kritische Aspekte zu vernachlässigen, werden therapeutische Maßnahmen mit möglichen Auswirkungen auf den extrathorakalen Luftraum, ausgewählte Studienergebnisse sowie interdisziplinäre Implikationen aufgezeigt, auch um die Relevanz des Themas für den Kliniker hervorzuheben.

Abstract

The „Posterior Airway Space“ attracts little attention in the orthodontist’s clinical routine during treatment planning and therapy. Hence, the aim of this review is to present anatomy, history, differing definitions, imaging modalities as well as computer simulations of the posterior airway space. Without disregarding critical aspects, this review presents different treatment approaches with possible effects on the posterior airway space. Study results of some relevant publications are pointed out and interdisciplinary implications are discussed to highlight the topic’s relevance to the orthodontist.

Schlüsselwörter

Extrathorakaler Luftraum - Schlafatemstörungen - Obstruktive Schlafapnoe - Interdisziplinäre Behandlung

Key words

Posterior airway space - sleep disordered breathing - obstructive sleep apnea - interdisciplinary treatment


Publikationsverlauf

Artikel online veröffentlicht:
17. Juni 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

  • Literatur

  • 1 Hinz R, Grabowski R, Stahl de Castrillon F. Das kieferorthopädische Risikokind: Gebissentwicklung und Funktionsstörungen – KFO-Prävention und Frühbehandlung. Zahnärztlicher Fach-Verlag (zfv), Herne, Deutschland. 2009
    PubMed
  • 2 Hofrath H. Die Bedeutung von Röntgenfern- und Abstandsaufnahme für die Diagnostik der Kieferanomalien. Fortschr Orthodont 1931; 1: 232-243
    PubMedGoogle Scholar
  • 3 Broadbent BH. A New X-Ray Technique and its Application to Orthodontia. Angle Orthod 1931; 1: 45-66
    PubMedGoogle Scholar
  • 4 Hans MG, Palomo JM, Valiathan M. History of imaging in orthodontics from Broadbent to cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2015; 148: 914-921
    CrossrefPubMedGoogle Scholar
  • 5 Subtelny JD. Width of the nasopharynx and related anatomic structures in normal and unoperated cleft palate children. Am J Orthod Dentofacial Orthop 1955; 41: 889-909
    CrossrefPubMedGoogle Scholar
  • 6 Riley R, Guilleminault C, Herran J. et al. Cephalometric analyses and flow-volume loops in obstructive sleep apnea patients. Sleep 1983; 6: 303-311
    CrossrefPubMedGoogle Scholar
  • 7 Fransson AM, Tegelberg A, Svenson BA. et al. Influence of mandibular protruding device on airway passages and dentofacial characteristics in obstructive sleep apnea and snoring. Am J Orthod Dentofacial Orthop 2002; 122: 371-379
    PubMedGoogle Scholar
  • 8 Kinzinger G, Czapka K, Ludwig B. et al. Effects of fixed appliances in correcting Angle Class II on the depth of the posterior airway space: FMA vs. Herbst appliance – a retrospective cephalometric study. J Orofac Orthop 2011; 72: 301-320
    CrossrefPubMedGoogle Scholar
  • 9 Hourfar J, Kinzinger GSM, Feifel H. et al. Effects of combined orthodontic-orthognathic treatment for class II and III correction on posterior airway space : Comparison of mono- and bignathic osteotomies. J Orofac Orthop 2017; 78: 455-465
    CrossrefPubMedGoogle Scholar
  • 10 Hourfar J, Kinzinger GS, Meissner LK. et al. Effects of two different removable functional appliances on depth of the posterior airway space : A retrospective cephalometric study. J Orofac Orthop 2017; 78: 166-175
    CrossrefPubMedGoogle Scholar
  • 11 Zheng ZH, Yamaguchi T, Kurihara A. et al. Three-dimensional evaluation of upper airway in patients with different anteroposterior skeletal patterns. Orthod Craniofac Res 2014; 17: 38-48
    CrossrefPubMedGoogle Scholar
  • 12 Alhammadi MS, Elfeky HY, Fayed MS. et al. Three-dimensional skeletal and pharyngeal airway changes following therapy with functional appliances in growing skeletal Class II malocclusion patients : A controlled clinical trial. J Orofac Orthop 2019; 80: 254-265
    CrossrefPubMedGoogle Scholar
  • 13 Romulo de Medeiros J, Ferraro Bezerra M, Gurgel Costa FW. et al. Does pterygomaxillary disjunction in surgically assisted rapid maxillary expansion influence upper airway volume? A prospective study using Dolphin Imaging 3D. Int J Oral Maxillofac Surg 2017; 46: 1094-1101
    CrossrefPubMedGoogle Scholar
  • 14 Gu M, Savoldi F, Hagg U et al. Upper Airway Changes following Functional Treatment with the Headgear Herbst or Headgear Twin Block Appliance Assessed on Lateral Cephalograms and Magnetic Resonance Imaging. ScientificWorldJournal 2019; 25: Article ID 1807257, 8 pages, doi: 10.1155/2019/1807257
    PubMed
  • 15 Eslami E, Katz ES, Baghdady M. et al. Are three-dimensional airway evaluations obtained through computed and cone-beam computed tomography scans predictable from lateral cephalograms? A systematic review of evidence. Angle Orthod 2017; 87: 159-167
    CrossrefPubMedGoogle Scholar
  • 16 Xiong H, Huang X, Li Y et al. A Method for Accurate Reconstructions of the Upper Airway Using Magnetic Resonance Images. PLoS One 2015; 10
    PubMed
  • 17 Sittitavornwong S, Waite PD, Shih AM. et al. Computational fluid dynamic analysis of the posterior airway space after maxillomandibular advancement for obstructive sleep apnea syndrome. J Oral Maxillofac Surg 2013; 71: 1397-1405
    CrossrefPubMedGoogle Scholar
  • 18 Bates AJ, Schuh A, Amine-Eddine G. et al. Assessing the relationship between movement and airflow in the upper airway using computational fluid dynamics with motion determined from magnetic resonance imaging. Clin Biomech 2019; 66: 88-96
    CrossrefPubMedGoogle Scholar
  • 19 Thereza-Bussolaro C, Oh HS, Lagravere M. et al. Pharyngeal dimensional changes in class II malocclusion treatment when using Forsus(R) or intermaxillary elastics – An exploratory study. Int Orthod 2019; 17: 667-677
    CrossrefPubMedGoogle Scholar
  • 20 Kirjavainen M, Kirjavainen T. Upper airway dimensions in Class II malocclusion. Effects of headgear treatment. Angle Orthod 2007; 77: 1046-1053
    CrossrefPubMedGoogle Scholar
  • 21 Baccetti T, Franchi L, Mucedero M. et al. Treatment and post-treatment effects of facemask therapy on the sagittal pharyngeal dimensions in Class III subjects. Eur J Orthod 2010; 32: 346-350
    CrossrefPubMedGoogle Scholar
  • 22 Pliska BT, Tam IT, Lowe AA. et al. Effect of orthodontic treatment on the upper airway volume in adults. Am J Orthod Dentofacial Orthop 2016; 150: 937-944
    CrossrefPubMedGoogle Scholar
  • 23 Kavand G, Lagravere M, Kula K. et al. Retrospective CBCT analysis of airway volume changes after bone-borne vs tooth-borne rapid maxillary expansion. Angle Orthod 2019; 89: 566-574
    CrossrefPubMedGoogle Scholar
  • 24 Graf I, Schumann U, Neuschulz J. et al. Sleep-disordered breathing in orthodontic practice: Prevalence of snoring in children and morphological findings. J Orofac Orthop 2016; 77: 129-137
    CrossrefPubMedGoogle Scholar
  • 25 Rose EC, Germann M, Sorichter S. et al. Case control study in the treatment of obstructive sleep-disordered breathing with an intraoral protrusive appliance. J Orofac Orthop 2004; 65: 489-500
    CrossrefPubMedGoogle Scholar
  • 26 Ulusoy C, Canigur Bavbek N, Tuncer BB. et al. Evaluation of airway dimensions and changes in hyoid bone position following class II functional therapy with activator. Acta Odontol Scand 2014; 72: 917-925
    CrossrefPubMedGoogle Scholar
  • 27 Ruckschloss T, Ristow O, Berger M. et al. Relations between mandible-only advancement surgery, the extent of the posterior airway space, and the position of the hyoid bone in Class II patients: a three-dimensional analysis. Br J Oral Maxillofac Surg 2019; 57: 1032-1038
    CrossrefPubMedGoogle Scholar
  • 28 Hwang DM, Lee JY, Choi YJ. et al. Evaluations of the tongue and hyoid bone positions and pharyngeal airway dimensions after maxillary protraction treatment. Cranio 2019; 37: 214-222
    PubMedGoogle Scholar
  • 29 Riepponen A, Myllykangas R, Savolainen J. et al. Changes in posterior airway space and hyoid bone position after surgical mandibular advancement. Acta Odontol Scand 2017; 75: 73-78
    CrossrefPubMedGoogle Scholar
  • 30 Balakrishna R, Reddy M, Kashyap VM. et al. The “Rubber Band” and “Slingshot” Effects of the Posterior Airway Space in Mandibular Orthognathic Surgeries. J Maxillofac Oral Surg 2014; 13: 514-518
    CrossrefPubMedGoogle Scholar
  • 31 Antosz M. CBCT volumetric analyses have no value in assessing functional airway. Am J Orthod Dentofacial Orthop 2015; 147: 10-11
    CrossrefPubMedGoogle Scholar
  • 32 Lin X. Correlation study of increase of pharyngeal airway space after mandibular advancement, taking natural head position into consideration. Br J Oral Maxillofac Surg 2019; 57: 760-764
    CrossrefPubMedGoogle Scholar
  • 33 Moze G, Seehra J, Fanshawe T. et al. In vitro comparison of contemporary radiographic imaging techniques for measurement of tooth length: reliability and radiation dose. J Orthod 2013; 40: 225-233
    CrossrefPubMedGoogle Scholar
  • 34 Eastman TR. ALARA and digital imaging systems. Radiol Technol 2013; 84: 297-298
    PubMedGoogle Scholar
  • 35 Crosby T, Phillips J, Carbo A. et al. Use of modified barium swallow study to measure posterior airway space in obstructive sleep apnea. Acta Otolaryngol 2016; 136: 592-597
    CrossrefPubMedGoogle Scholar
  • 36 Vizzotto MB, Liedke GS, Delamare EL. et al. A comparative study of lateral cephalograms and cone-beam computed tomographic images in upper airway assessment. Eur J Orthod 2012; 34: 390-393
    CrossrefPubMedGoogle Scholar
  • 37 Proffit WR, Fields HW, Sarver DM. Contemporary Orthodontics. Elsevier; Oxford: 2007
    Google Scholar
  • 38 (DGSM) DGfSS S3-Leitlinie Nicht erholsamerSchlaf/Schlafstörungen – Kapitel „SchlafbezogeneAtmungsstörungen“. Somnologie 2017; Suppl s2: S97–S180
    PubMed