Airway in twin block /certified fixed orthodontic courses by Indian dental academy

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Welcome to Indian Dental Academy …

Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.


Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients

State of the art comprehensive training-Faculty of world wide repute &Very affordable.

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  • 1. ASSESSMENT OF ORO-PHARYNGEAL AIRWAY DIMENSIONS IN SKELETAL CLASS II CASES TREATED WITH TWIN BLOCK APPLIANCE INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. INTRODUCTION  Mandibular deficiency may be a factor in reduced oropharyngeal airway dimensions and related impaired respiratory function.  Functional appliance therapy has become an accepted method for treatment of moderate and severe discrepancies of sagittal jaw relation in growing individuals.  Functional appliances posture the mandible forward in a permanent anterior position thereby altering the neuromuscular environment of the dentition and bone. www.indiandentalacademy.com
  • 3. AIMS & OBJECTIVES  To assess the changes in the OAW dimensions in Individuals with retrognathic mandible treated with Twin Block functional appliance to correct the skeletal class II during the growth period. www.indiandentalacademy.com
  • 4. REVIEW OF LITERATURE  Murat Ozbek (1998) - OAW dimensions increased significantly in treated patients, especially those with sagittally smaller and more retrognathic maxillomadibular complexes and smaller OAW dimensions.  Tourne (1991). A decreased patency of the OAW can induce some postural adaptation which secure a constant sagittal dimension at that level as in cases of mandibular retrognathism. www.indiandentalacademy.com
  • 5.  Lowe (1996) - Obstructive sleep apnea is caused by repeated obstruction of the upper airway space during sleep.  Eung Kwon Pae (1997) - Hypothesized that respiratory efficiency may be associated with anterior open bites. Under this assumption that breathing efficiency of the oropharynx and hypopharynx may pharyngeal airway length. www.indiandentalacademy.com be related to
  • 6. METHODOLOGY  Study material was obtained from the Department of Ortho, SDCH and comprised of lateral Cephalograms, HWR, questionnaires and clinical records. Sample included 10 individuals with skeletal class II cases, of which 5 individuals formed the control sample and 5 formed the experimental sample who has been treated with functional appliance. www.indiandentalacademy.com
  • 7. SELECTION CRITERIA (1) Patients of mixed dentition stage (2) ANB > 3 degrees (3) Skeletal class II case with mandibular retrognathism. (4) No respiratory complaints (5) Significant growth potential at the beginning of the treatment period. (6) Quality cephalogram at beginning and end of the treatment period. (7) Treatment by Twin Block Appliance. www.indiandentalacademy.com
  • 8. CASE REPORTS Figure 1 - Anatomic landmarks used in the study www.indiandentalacademy.com
  • 9. Figure 3 - Oral airway (OAW) measurements of the study: 1.Superior posterior airway space (SPAS): Smallest distance between the posterior border of the softpalate and the posterior pharyngeal wall; 2.middle airway space (MAS): Smallest distance between the posterior border of the tongue and the posterior pharyngeal wall, through the tip of the soft palate (p); 3.Inferior airway space (IAS): Smallest distance between the posterior border of the tongue and the posterior pharyngeal wall; Oropharyngeal crosssectional area (ORO): The cross-sectional area of the oropharynx between the ANS-PNS line and a parallel line through epiglottis (shaded area). www.indiandentalacademy.com
  • 10. CASE 1 Master Navin Pretreatment SPAS - 9 mm MAS - 11 mm IAS - 9 mm ORO - 1088.68mm2 Posttreatment SPAS - 11 mm MAS - 13 mm IAS - 12 mm www.indiandentalacademy.com ORO - 1319.16mm2
  • 11. CASE2 Miss.Pheeba Mathew Pretreatment SPAS - 12 mm MAS - 11 mm IAS - 14 mm ORO - 1672.57mm2 Posttreatment www.indiandentalacademy.com SPAS - 14 mm MAS - 13 mm IAS - 16 mm ORO - 1913.47mm2
  • 12. Ashok Raja Pretreatment SPAS - 12 mm MAS - 10 mm IAS - 6 mm ORO - 1069.83 mm2 CASE 3 Posttreatment www.indiandentalacademy.com SPAS - 14 mm MAS - 13 mm IAS - 9 mm ORO - 1303.03mm2
  • 13. CASE 4 Thasreen Pretreatment Posttreatment SPAS - 15 mm MAS - 11 mm IAS - 10 mm ORO - 1282.29 MM2 SPAS - 18 mm MAS - 13 mm IAS - 12 mm ORO - 1428.56 MM2 www.indiandentalacademy.com
  • 14. Prakash Pretreatment SPAS - 12 mm MAS - 10 mm IAS - 6 mm ORO - 1069.83 mm2 CASE 5 Posttreatment www.indiandentalacademy.com SPAS - 14 mm MAS - 13 mm IAS - 9 mm ORO - 1303.03mm2
  • 15. RESULTS Control Group Experimental Group SPAS 12mm 13mm 10mm 12mm MAS 11mm 11mm 11mm 13mm IAS 14mm 13mm 9mm 12mm 1672mm2 1713,47mm2 1282.29mm2 1428.56mm2 ORO (Area) www.indiandentalacademy.com
  • 16. DISCUSSION  Significant changes in the oropharyngeal airway dimension were noted in our study, which revealed an increase in cross section area by 202.25mm2 in OAW dimension compared to other study by Ozbek at el. which revealed increase in Cross section area by 153.90mm2. The appliance used for correcting skeletal class II was Clark's Twin Block appliance.  Ozbek stated that functional orthopaedic treatment of growing patients who have skeletal patterns with deficient mandible may lead to increased OAW dimensions, thereby reducing the risk of respiratory problems in the future. www.indiandentalacademy.com
  • 17. CONCLUSION  Our study revealed a significant increase in the OAW dimensions in retrognathic mandible class II individuals treated with Twin Block Appliance.. study The cephalometric using modified Pancherz's analysis revealed an increase of 2-3mm in OAW dimensions among the samples selected. Increase in OAW dimension may lead to correction of problems such as snoring, upper airway resistance syndrome and obstructive sleep apnea syndrome www.indiandentalacademy.com
  • 18. ACKNOWLEDGEMENT My sincerest and heartful thanks to, Prof. Dr. Rajagopal, MDS (Prof & HOD) Prof. Dr. Venkatesan, Prof. Dr. Shyamala Chandrasekar, Prof. Dr. Umashankar, Dr. Karthikeyan www.indiandentalacademy.com And all my staffs and colleagues
  • 19. www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com