Korean J Orthod.  2017 Nov;47(6):344-352. 10.4041/kjod.2017.47.6.344.

Effects of bodily retraction of mandibular incisors versus mandibular setback surgery on pharyngeal airway space: A comparative study

• Keum BT
• Choi SH
• Choi YJ
• Baik HS
• Lee KJ

• KMID: 2392181
• DOI: http://doi.org/10.4041/kjod.2017.47.6.344

Abstract

OBJECTIVE
The purpose of this study was to compare the changes induced in the pharyngeal airway space by orthodontic treatment with bodily retraction of the mandibular incisors and mandibular setback surgery without extraction.
METHODS
This retrospective study included 63 adult patients (32 men and 31 women). Thirty-three patients who had been treated via four-bicuspid extraction and bodily retraction of the mandibular incisors (incisor retraction, IR group) were compared with 30 patients who had been treated via mandibular setback surgery (MS group) without extraction. Lateral cephalograms were acquired and analyzed before (T1) and after treatment (T2).
RESULTS
The superior pharyngeal airway space did not change significantly in either group during treatment. The middle pharyngeal airway space decreased by 1.15 ± 1.17 mm and 1.25 ± 1.35 mm after treatment in the IR and MS groups, respectively, and the decrease was comparable between the two groups. In the MS group, the inferior pharyngeal airway space (E-IPW) decreased by 0.88 ± 1.67 mm after treatment (p < 0.01). The E-IPW was larger in the MS group than in IR group at T1, but it did not differ significantly between the two groups at T2. No significant correlation was observed between changes in the pharyngeal airway space and the skeletal and dental variables in each group.
CONCLUSIONS
The middle pharyngeal airway space decreased because of the posterior displacement of the mandibular incisors and/or the mandibular body. The E-IPW decreased only in the MS group because of the posterior displacement of only the mandibular body.

Keyword

Bodily retraction; Miniscrew; Mandibular setback surgery; Pharyngeal airway space

MeSH Terms

Adult
Humans
Incisor*
Male
Retrospective Studies

Figure

• 

  Figure 1 Flow diagram illustrating sample selection. IR, Incisor retraction; IMPA, incisor mandibular plane angle.

• 

  Figure 2 A, Cephalometric landmarks and planes. S, sella; N,nasion; A, point A; B, point B; Po, porion; Or, orbitale; PNS, posterior nasal spine; Go, gonion; Me, menton; H, the most anterosuperior point of the hyoid bone; U, tip of the uvula; E, tip of the epiglottis; U1, center of resistance of U1; L1, center of resistance of L1; HRP, horizontal reference plane–the Frankfort horizontal plane; VRP, vertical reference plane—passes through the sella, perpendicular to the HRP; SPW, superior pharyngeal wall, point of intersection of the posterior pharyngeal wall and perpendicular line drawn from the PNS; MPW, middle pharyngeal wall, point of intersection of the posterior pharyngeal wall and perpendicular line drawn from the U; IPW, inferior pharyngeal wall, point of intersection of the posterior pharyngeal wall and perpendicular line drawn from the E. B, Skeletal measurements. 1, A-VRP, perpendicular distance from the VRP to point A (mm); 2, A-HRP, perpendicular distance from the HRP to point A (mm); 3, B-VRP, perpendicular distance from the VRP to point B (mm); 4, B-HRP, perpendicular distance from the HRP to point B (mm); 5, H-VRP, perpendicular distance from the VRP to point H (mm); 6, H-HRP, perpendicular distance from the HRP to point H (mm); 7, PNS-HRP, perpendicular distance from the HRP to the PNS (mm). C, Dental and pharyngeal airway space measurements. 1, U1-VRP, perpendicular distance from the VRP to U1 (mm); 2, U1-HRP, perpendicular distance from the HRP to U1 (mm); 3, L1-VRP, perpendicular distance from the VRP to L1 (mm); 4, L1-HRP, perpendicular distance from the HRP to L1 (mm); 5, U1-SN (o); 6, IMPA (o); 7, PNS-SPW, superior pharyngeal airway (mm); 8, U-MPW, middle pharyngeal airway (mm); 9, E-IPW, inferior pharyngeal airway (mm).

• 

  Figure 3 Changes in pharyngeal airway space during treatment. Blue line, before treatment; red line, after treatment. NS, Not significant; IR, incisor retraction; MS, mandibular setback surgery. *p < 0.05; †p < 0.01; ‡p < 0.001.

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