{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T22:58:56Z","timestamp":1790031536847,"version":"4.0.1"},"reference-count":54,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives:<\/jats:title>\n The aim of this study was to assess three-dimensionally the upper airway changes following functional appliance treatment in growing Class II patients.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n Pre-and post-treatment Cone beam computed tomography scans of 20 patients (age range: 9 to 12; mean: 11.4 \u00b1 1.0 years) were retrieved from the list of patients previously treated with functional appliances in the Postgraduate Clinic at the Section of Orthodontics, Aarhus University, Denmark. Total and partial volumes of the upper airway (ie, lower nasopharynx, velopharynx, and oropharynx) were calculated. To rule out the effect of growth, the changes in the functional appliance group were compared to an age-matched Class I group of 18 patients (age range: 8 to 14; mean: 11.8 \u00b1 1.4 years).<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n In the functional appliance group, all the partial and total volumes were significantly larger at the end of treatment when compared to the start of treatment (\n P<\/jats:italic>\n < .003). On the other hand, when comparing the changes for the total and partial volumes of the upper airway in the functional appliance group with the Class I group, a statistical difference was seen only for the oropharynx (\n P<\/jats:italic>\n = .022) and total volume (\n P<\/jats:italic>\n = .025), with the functional appliance group showing a larger volume increment.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n An increase in the upper airway volume was found after treatment with functional appliances. This difference was mainly related to the changes at the oropharynx level, which differed significantly from what was observed in the Class I group.<\/jats:p>\n <\/jats:sec>","DOI":"10.2319\/083117-587.1","type":"journal-article","created":{"date-parts":[[2018,5,29]],"date-time":"2018-05-29T08:32:31Z","timestamp":1527582751000},"page":"552-559","source":"Crossref","is-referenced-by-count":35,"title":["Three-dimensional evaluation of changes in upper airway volume in growing skeletal Class II patients following mandibular advancement treatment with functional orthopedic appliances"],"prefix":"10.2319","volume":"88","author":[{"given":"Stig","family":"Isidor","sequence":"first","affiliation":[{"name":"Former Postgraduate Student, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Di Carlo","sequence":"additional","affiliation":[{"name":"PhD Student, Department of Oral and Maxillofacial Sciences, Unit of Pediatric Dentistry, Sapienza University of Rome, Rome, Italy; and Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie A.","family":"Cornelis","sequence":"additional","affiliation":[{"name":"Associate Professor and Head, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flemming","family":"Isidor","sequence":"additional","affiliation":[{"name":"Professor, Section of Prosthetic Dentistry, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo M.","family":"Cattaneo","sequence":"additional","affiliation":[{"name":"Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-88-5-552-b01","series-title":"Am J Dis Child","first-page":"541","article-title":"Glossoptosis due to atresia and hypotrophy of the mandible","volume":"48","author":"Robin \n P.","year":"1934","unstructured":"Robin \n P. \n \n \n Glossoptosis due to atresia and hypotrophy of the mandible. Am J Dis Child. 1934; 48:541\u2013547."},{"key":"i0003-3219-88-5-552-b02","series-title":"Am Rev Respir Dis","first-page":"624","article-title":"Effect of anterior mandibular positioning on obstructive sleep apnea","volume":"147","author":"Clark \n GT,","year":"1993","unstructured":"Clark \n GT, \n \n \n Arand \n D, \n \n \n Chung \n E, \n \n \n Tong \n D. \n \n \n Effect of anterior mandibular positioning on obstructive sleep apnea. Am Rev Respir Dis. 1993; 147:624\u2013629."},{"key":"i0003-3219-88-5-552-b03","series-title":"Angle Orthod","first-page":"907","article-title":"Short-term anteroposterior treatment effects of functional appliances and extraoral traction on class II malocclusion. A meta-analysis","volume":"77","author":"Antonarakis \n GS,","year":"2007","unstructured":"Antonarakis \n GS, \n \n \n Kiliaridis \n S. \n \n \n Short-term anteroposterior treatment effects of functional appliances and extraoral traction on class II malocclusion. A meta-analysis. Angle Orthod. 2007;77:907\u2013914."},{"key":"i0003-3219-88-5-552-b04","series-title":"Angle Orthod","first-page":"327","article-title":"Oropharyngeal airway dimensions and functional-orthopedic treatment in skeletal Class II cases","volume":"68","author":"Ozbek \n MM,","year":"1998","unstructured":"Ozbek \n MM, \n \n \n Memikoglu \n TU, \n \n \n Gogen \n H, \n \n \n Lowe \n AA, \n \n \n Baspinar \n E. \n \n \n Oropharyngeal airway dimensions and functional-orthopedic treatment in skeletal Class II cases. Angle Orthod. 1998;68:327\u2013336."},{"key":"i0003-3219-88-5-552-b05","series-title":"J Ind Orthod Soc","first-page":"439","article-title":"Computed tomographic evaluation of three- dimensional changes in pharyngeal airway in class II division 1 patients treated with Twin Block Appliance","volume":"48","author":"Temani \n P,","year":"2014","unstructured":"Temani \n P, \n \n \n Jain \n P, \n \n \n Chaudhary \n S, \n \n \n Rathee \n P, \n \n \n Pachori \n Y, \n \n \n Temani \n R. \n \n \n Computed tomographic evaluation of three- dimensional changes in pharyngeal airway in class II division 1 patients treated with Twin Block Appliance. J Ind Orthod Soc. 2014;48:439\u2013445."},{"key":"i0003-3219-88-5-552-b06","series-title":"J Orthodont Sci","first-page":"54","article-title":"Effect of functional appliances on the airway dimensions in patients with skeletal class II malocclusion: A systematic review","volume":"6","author":"Kannan \n A,","year":"2017","unstructured":"Kannan \n A, \n \n \n Sathyanarayana \n HP, \n \n \n Padmanabhan \n S. \n \n \n Effect of functional appliances on the airway dimensions in patients with skeletal class II malocclusion: A systematic review. J Orthodont Sci. 2017;6:54\u201364."},{"key":"i0003-3219-88-5-552-b07","series-title":"Angle Orthod","first-page":"440","article-title":"Changes in upper airway width associated with Class II treatments (headgear vs activator) and different growth patterns","volume":"81","author":"Godt \n A,","year":"2011","unstructured":"Godt \n A, \n \n \n Koos \n B, \n \n \n Hagen \n H, \n \n \n Goz \n G. \n \n \n Changes in upper airway width associated with Class II treatments (headgear vs activator) and different growth patterns. Angle Orthod. 2011;81:440\u2013446."},{"key":"i0003-3219-88-5-552-b08","series-title":"Controversies in Orthodontics","first-page":"45","article-title":"Dentofacial morphology and breathing: a century of controversy","author":"Warren \n DW,","year":"1990","unstructured":"Warren \n DW, \n \n \n Spalding \n P. \n \n \n Dentofacial morphology and breathing: a century of controversy. InMelsen B. Controversies in Orthodontics. Chicago, IL: Quintessence Publishing; 1990:45\u201376."},{"key":"i0003-3219-88-5-552-b09","series-title":"Am J Orthod","first-page":"505","article-title":"The reliability of head film measurements. 2. Conventional angular and linear measures","volume":"60","author":"Baumrind \n S,","year":"1971a","unstructured":"Baumrind \n S, \n \n \n Frantz \n RC. \n \n \n The reliability of head film measurements. 2. Conventional angular and linear measures. Am J Orthod. 1971a;60:505\u2013517."},{"key":"i0003-3219-88-5-552-b10","series-title":"Am J of Orthod","first-page":"111","article-title":"The reliability of head film measurements. 1. Landmark identification","volume":"60","author":"Baumrind \n S,","year":"1971b","unstructured":"Baumrind \n S, \n \n \n Frantz \n RC. \n \n \n The reliability of head film measurements. 1. Landmark identification. Am J of Orthod. 1971b; 60:111\u2013127."},{"key":"i0003-3219-88-5-552-b11","series-title":"Orthod Craniofac Res","first-page":"96","article-title":"An analysis of different approaches to the assessment of upper airway morphology: a CBCT study","volume":"13","author":"Lenza \n MG,","year":"2010","unstructured":"Lenza \n MG, \n \n \n Lenza \n MM, \n \n \n Dalstra \n M, \n \n \n Melsen \n B, \n \n \n Cattaneo \n PM. \n \n \n An analysis of different approaches to the assessment of upper airway morphology: a CBCT study. Orthod Craniofac Res. 2010;13:96\u2013105."},{"key":"i0003-3219-88-5-552-b12","series-title":"World J Orthod","first-page":"269","article-title":"The use of cone-beam computed tomography in an orthodontic department in between research and daily clinic","volume":"9","author":"Cattaneo \n PM,","year":"2008","unstructured":"Cattaneo \n PM, \n \n \n Melsen \n B. \n \n \n The use of cone-beam computed tomography in an orthodontic department in between research and daily clinic. World J Orthod. 2008;9:269\u2013282."},{"key":"i0003-3219-88-5-552-b13","series-title":"Int J Oral Maxillofac Surg","first-page":"1227","article-title":"Cone-beam computerized tomography imaging and analysis of the upper airway: a systematic review of the literature","volume":"40","author":"Guijarro-Martinez \n R,","year":"2011","unstructured":"Guijarro-Martinez \n R, \n \n \n Swennen \n GR. \n \n \n Cone-beam computerized tomography imaging and analysis of the upper airway: a systematic review of the literature. Int J Oral Maxillofac Surg. 2011;40:1227\u20131237."},{"key":"i0003-3219-88-5-552-b14","series-title":"Dentomaxillofac Radiol","first-page":"20140282","article-title":"CBCT in orthodontics: assessment of treatment outcomes and indications for its use","volume":"44","author":"Kapila \n SD,","year":"2015","unstructured":"Kapila \n SD, \n \n \n Nervina \n JM. \n \n \n CBCT in orthodontics: assessment of treatment outcomes and indications for its use. Dentomaxillofac Radiol. 2015;44:20140282."},{"key":"i0003-3219-88-5-552-b15","series-title":"Orthod Craniofac Res","first-page":"1","article-title":"The relationship between upper airways and craniofacial morphology studied in 3D. A CBCT study","volume":"18","author":"Di Carlo \n G,","year":"2015","unstructured":"Di Carlo \n G, \n \n \n Polimeni \n A, \n \n \n Melsen \n B, \n \n \n Cattaneo \n PM. \n \n \n The relationship between upper airways and craniofacial morphology studied in 3D. A CBCT study. Orthod Craniofac Res. 2015;18:1\u201311."},{"key":"i0003-3219-88-5-552-b16","series-title":"Acta Genetica et Statistica Medica","first-page":"313","article-title":"Standard error and medicine","volume":"1","author":"Dahlberg \n G.","year":"1949","unstructured":"Dahlberg \n G. \n \n \n Standard error and medicine. Acta Genetica et Statistica Medica. 1949;1:313\u2013321."},{"key":"i0003-3219-88-5-552-b17","series-title":"Semin Orthod","first-page":"132","article-title":"Effects of mandibular advancement device (MAD) on airway dimensions assessed with cone-beam computed tomography","volume":"15","author":"Haskell \n JA,","year":"2009","unstructured":"Haskell \n JA, \n \n \n McCrillis \n J, \n \n \n Haskell \n BS, \n \n \n Scheetz \n JP, \n \n \n Scarfe \n WC, \n \n \n Farman \n AG. \n \n \n Effects of mandibular advancement device (MAD) on airway dimensions assessed with cone-beam computed tomography. 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Am J Orthod Dentofacial Orthop. 2010;137:S50. e1\u20139, discussionS50\u201352."},{"key":"i0003-3219-88-5-552-b21","series-title":"Am J Orthod Dentofacial Orthop","first-page":"468","article-title":"Comparison of airway space with conventional lateral headfilms and 3-dimensional reconstruction from cone-beam computed tomography","volume":"135","author":"Aboudara \n C,","year":"2009","unstructured":"Aboudara \n C, \n \n \n Nielsen \n I, \n \n \n Huang \n JC, \n \n \n Maki \n K, \n \n \n Miller \n AJ, \n \n \n Hatcher \n D. \n \n \n Comparison of airway space with conventional lateral headfilms and 3-dimensional reconstruction from cone-beam computed tomography. Am J Orthod Dentofacial Orthop. 2009;135:468\u2013479."},{"key":"i0003-3219-88-5-552-b22","series-title":"J Oral Maxillofac Res","first-page":"e1","article-title":"Effect of head and tongue posture on the pharyngeal airway dimensions and morphology in three-dimensional imaging: a systematic review","volume":"7","author":"Gurani \n SF,","year":"2016","unstructured":"Gurani \n SF, \n \n \n Di Carlo \n G, \n \n \n Cattaneo \n PM, \n \n \n Thorn \n JJ, \n \n \n Pinholt \n EM. \n \n \n Effect of head and tongue posture on the pharyngeal airway dimensions and morphology in three-dimensional imaging: a systematic review. 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Am J Orthod Dentofacial Orthop. 2014;146:776\u2013785."},{"key":"i0003-3219-88-5-552-b25","series-title":"Eur J Orthod","first-page":"418","article-title":"Treatment effects of removable functional appliances in patients with Class II malocclusion: a systematic review and meta-analysis","volume":"37","author":"Koretsi \n V,","year":"2015","unstructured":"Koretsi \n V, \n \n \n Zymperdikas \n VF, \n \n \n Papageorgiou \n SN, \n \n \n Papadopoulos \n MA. \n \n \n Treatment effects of removable functional appliances in patients with Class II malocclusion: a systematic review and meta-analysis. Eur J Orthod. 2015;37:418\u2013434."},{"key":"i0003-3219-88-5-552-b26","series-title":"Angle Orthod","first-page":"955","article-title":"Pangrazio Kulbersh V, Al-Qawasmi R. Changes in the oropharyngeal airway of Class II patients treated with the mandibular anterior repositioning appliance","volume":"86","author":"Rizk \n S,","year":"2016","unstructured":"Rizk \n S, \n \n \n Pangrazio Kulbersh V, Al-Qawasmi R. Changes in the oropharyngeal airway of Class II patients treated with the mandibular anterior repositioning appliance. 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Eur J Orthod. 201638:516\u2013524."},{"key":"i0003-3219-88-5-552-b01","series-title":"Am J Dis Child","first-page":"541","article-title":"Glossoptosis due to atresia and hypotrophy of the mandible","volume":"48","author":"Robin \n P.","year":"1934","unstructured":"Robin \n P. \n \n \n Glossoptosis due to atresia and hypotrophy of the mandible. Am J Dis Child. 1934; 48:541\u2013547."},{"key":"i0003-3219-88-5-552-b02","series-title":"Am Rev Respir Dis","first-page":"624","article-title":"Effect of anterior mandibular positioning on obstructive sleep apnea","volume":"147","author":"Clark \n GT,","year":"1993","unstructured":"Clark \n GT, \n \n \n Arand \n D, \n \n \n Chung \n E, \n \n \n Tong \n D. \n \n \n Effect of anterior mandibular positioning on obstructive sleep apnea. Am Rev Respir Dis. 1993; 147:624\u2013629."},{"key":"i0003-3219-88-5-552-b03","series-title":"Angle Orthod","first-page":"907","article-title":"Short-term anteroposterior treatment effects of functional appliances and extraoral traction on class II malocclusion. A meta-analysis","volume":"77","author":"Antonarakis \n GS,","year":"2007","unstructured":"Antonarakis \n GS, \n \n \n Kiliaridis \n S. \n \n \n Short-term anteroposterior treatment effects of functional appliances and extraoral traction on class II malocclusion. A meta-analysis. Angle Orthod. 2007;77:907\u2013914."},{"key":"i0003-3219-88-5-552-b04","series-title":"Angle Orthod","first-page":"327","article-title":"Oropharyngeal airway dimensions and functional-orthopedic treatment in skeletal Class II cases","volume":"68","author":"Ozbek \n MM,","year":"1998","unstructured":"Ozbek \n MM, \n \n \n Memikoglu \n TU, \n \n \n Gogen \n H, \n \n \n Lowe \n AA, \n \n \n Baspinar \n E. \n \n \n Oropharyngeal airway dimensions and functional-orthopedic treatment in skeletal Class II cases. Angle Orthod. 1998;68:327\u2013336."},{"key":"i0003-3219-88-5-552-b05","series-title":"J Ind Orthod Soc","first-page":"439","article-title":"Computed tomographic evaluation of three- dimensional changes in pharyngeal airway in class II division 1 patients treated with Twin Block Appliance","volume":"48","author":"Temani \n P,","year":"2014","unstructured":"Temani \n P, \n \n \n Jain \n P, \n \n \n Chaudhary \n S, \n \n \n Rathee \n P, \n \n \n Pachori \n Y, \n \n \n Temani \n R. \n \n \n Computed tomographic evaluation of three- dimensional changes in pharyngeal airway in class II division 1 patients treated with Twin Block Appliance. J Ind Orthod Soc. 2014;48:439\u2013445."},{"key":"i0003-3219-88-5-552-b06","series-title":"J Orthodont Sci","first-page":"54","article-title":"Effect of functional appliances on the airway dimensions in patients with skeletal class II malocclusion: A systematic review","volume":"6","author":"Kannan \n A,","year":"2017","unstructured":"Kannan \n A, \n \n \n Sathyanarayana \n HP, \n \n \n Padmanabhan \n S. \n \n \n Effect of functional appliances on the airway dimensions in patients with skeletal class II malocclusion: A systematic review. J Orthodont Sci. 2017;6:54\u201364."},{"key":"i0003-3219-88-5-552-b07","series-title":"Angle Orthod","first-page":"440","article-title":"Changes in upper airway width associated with Class II treatments (headgear vs activator) and different growth patterns","volume":"81","author":"Godt \n A,","year":"2011","unstructured":"Godt \n A, \n \n \n Koos \n B, \n \n \n Hagen \n H, \n \n \n Goz \n G. \n \n \n Changes in upper airway width associated with Class II treatments (headgear vs activator) and different growth patterns. Angle Orthod. 2011;81:440\u2013446."},{"key":"i0003-3219-88-5-552-b08","series-title":"Controversies in Orthodontics","first-page":"45","article-title":"Dentofacial morphology and breathing: a century of controversy","author":"Warren \n DW,","year":"1990","unstructured":"Warren \n DW, \n \n \n Spalding \n P. \n \n \n Dentofacial morphology and breathing: a century of controversy. InMelsen B. Controversies in Orthodontics. Chicago, IL: Quintessence Publishing; 1990:45\u201376."},{"key":"i0003-3219-88-5-552-b09","series-title":"Am J Orthod","first-page":"505","article-title":"The reliability of head film measurements. 2. Conventional angular and linear measures","volume":"60","author":"Baumrind \n S,","year":"1971a","unstructured":"Baumrind \n S, \n \n \n Frantz \n RC. \n \n \n The reliability of head film measurements. 2. Conventional angular and linear measures. Am J Orthod. 1971a;60:505\u2013517."},{"key":"i0003-3219-88-5-552-b10","series-title":"Am J of Orthod","first-page":"111","article-title":"The reliability of head film measurements. 1. Landmark identification","volume":"60","author":"Baumrind \n S,","year":"1971b","unstructured":"Baumrind \n S, \n \n \n Frantz \n RC. \n \n \n The reliability of head film measurements. 1. Landmark identification. Am J of Orthod. 1971b; 60:111\u2013127."},{"key":"i0003-3219-88-5-552-b11","series-title":"Orthod Craniofac Res","first-page":"96","article-title":"An analysis of different approaches to the assessment of upper airway morphology: a CBCT study","volume":"13","author":"Lenza \n MG,","year":"2010","unstructured":"Lenza \n MG, \n \n \n Lenza \n MM, \n \n \n Dalstra \n M, \n \n \n Melsen \n B, \n \n \n Cattaneo \n PM. \n \n \n An analysis of different approaches to the assessment of upper airway morphology: a CBCT study. Orthod Craniofac Res. 2010;13:96\u2013105."},{"key":"i0003-3219-88-5-552-b12","series-title":"World J Orthod","first-page":"269","article-title":"The use of cone-beam computed tomography in an orthodontic department in between research and daily clinic","volume":"9","author":"Cattaneo \n PM,","year":"2008","unstructured":"Cattaneo \n PM, \n \n \n Melsen \n B. \n \n \n The use of cone-beam computed tomography in an orthodontic department in between research and daily clinic. World J Orthod. 2008;9:269\u2013282."},{"key":"i0003-3219-88-5-552-b13","series-title":"Int J Oral Maxillofac Surg","first-page":"1227","article-title":"Cone-beam computerized tomography imaging and analysis of the upper airway: a systematic review of the literature","volume":"40","author":"Guijarro-Martinez \n R,","year":"2011","unstructured":"Guijarro-Martinez \n R, \n \n \n Swennen \n GR. \n \n \n Cone-beam computerized tomography imaging and analysis of the upper airway: a systematic review of the literature. 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