{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T16:05:23Z","timestamp":1780070723025,"version":"3.54.0"},"reference-count":54,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Objective:<\/jats:bold>\n                    To introduce new 3-D imaging techniques to characterize shape and volume changes of the oropharyngeal space after bilateral sagittal split osteotomy (BSSO) advancement.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Materials and Methods:<\/jats:bold>\n                    Longitudinal cone-beam computed tomography (CBCT) scans were obtained for 20 patients undergoing BSSO advancement at three time points (T1 = presurgery, T2 = splint removal, and T3 = 1 year after surgery). Segmentation of the airway was performed using the following boundaries: hard palate\/posterior nasal spine superiorly and lower border of C3 to the base of the epiglottis inferiorly. For shape measurements, point-based correspondent models and mean latitude axis were obtained for all the data using SPHARM-PDM software. All 3-D correspondent models were rigidly registered using Procrustes alignment. Absolute distance maps and corresponding vector maps were calculated to show shape and vector differences between each correspondent point. Mean latitude axis is a new imaging method to calculate minimum cross-sectional areas along the long axis of the airway independent of head position\/alignment.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    The airway volume increased (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; .01) after BSSO advancement (2973.9 mm\n                    <jats:sup>3<\/jats:sup>\n                    \u00b1 27882.0) and was stable (\u2212439.9 mm\n                    <jats:sup>3<\/jats:sup>\n                    \u00b1 3308.8) 1 year post-op. 3-D color maps and semitransparency overlays showed more lateral than anteroposterior expansion of the airway after BSSO advancement. Mean latitude axis was used to measure minimum cross-sectional area, showing a statistically significant increase (52.7 mm\n                    <jats:sup>2<\/jats:sup>\n                    \u00b1 46.7) (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; .01) after surgery and remained stable (\u221210.3 mm\n                    <jats:sup>2<\/jats:sup>\n                    \u00b1 43.3) 1 year after surgery.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    SPHARM-PDM and mean latitude axis are useful tools to assess airway shape change. BSSO advancement produces a significant increase in pharyngeal airway volume and minimum cross-sectional area. The airway space increased more transversely than anteroposteriorly.\n                  <\/jats:p>","DOI":"10.2319\/110815-753.1","type":"journal-article","created":{"date-parts":[[2016,5,3]],"date-time":"2016-05-03T13:02:58Z","timestamp":1462280578000},"page":"943-948","source":"Crossref","is-referenced-by-count":6,"title":["The use of SPHARM-PDM and mean latitude axis to evaluate airway changes"],"prefix":"10.2319","volume":"86","author":[{"given":"Tung","family":"Nguyen","sequence":"first","affiliation":[{"name":"Associate Professor, Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ceib","family":"Phillips","sequence":"additional","affiliation":[{"name":"Professor and Assistant Dean for Graduate\/Advanced Education, School of Dentistry, University of North Carolina, Chapel Hill, NC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Paniagua","sequence":"additional","affiliation":[{"name":"Research Assistant Professor, Department of Psychiatry and Computer Science, University of North Carolina, Chapel Hill, NC."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-86-6-943-b01","series-title":"Int J Adult Orthod Orthog Surg","first-page":"97","article-title":"Prevalence of malocclusion and orthodontic treatment need in the United States: estimates from the N-HANES III survey","volume":"13","author":"Proffit \n              WR,","year":"1998","unstructured":"Proffit \n              WR, \n            \n            \n              Fields \n              HW, \n            \n            \n              Moray \n              LJ. \n            \n          \n          Prevalence of malocclusion and orthodontic treatment need in the United States: estimates from the N-HANES III survey. Int J Adult Orthod Orthog Surg. 1998;13:97\u2013106."},{"key":"i0003-3219-86-6-943-b02","series-title":"J Oral Surg","first-page":"543","article-title":"Sleep apnea syndrome: correction with surgical advancement of the mandible","volume":"38","author":"Bear \n              SE,","year":"1980","unstructured":"Bear \n              SE, \n            \n            \n              Priest \n              JH. \n            \n          \n          Sleep apnea syndrome: correction with surgical advancement of the mandible. J Oral Surg. 1980;38:543\u2013549."},{"key":"i0003-3219-86-6-943-b03","series-title":"Int J Adult Orthod Orthognath Surg","first-page":"255","article-title":"Posterior airway changes associated with mandibular advancement surgery: implications for patients with obstructive sleep apnea","volume":"5","author":"Farole \n              A,","year":"1990","unstructured":"Farole \n              A, \n            \n            \n              Mundenar \n              MJ, \n            \n            \n              Braitman \n              LE. \n            \n          \n          Posterior airway changes associated with mandibular advancement surgery: implications for patients with obstructive sleep apnea. Int J Adult Orthod Orthognath Surg. 1990; 5:255\u2013258."},{"key":"i0003-3219-86-6-943-b04","series-title":"J Oral Maxillofac Surg","first-page":"40","article-title":"Pharyngeal airway changes associated with mandibular advancement","volume":"52","author":"Yu \n              LF,","year":"1994","unstructured":"Yu \n              LF, \n            \n            \n              Pogrel \n              MA, \n            \n            \n              Ajayi \n              M. \n            \n          \n          Pharyngeal airway changes associated with mandibular advancement. 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Am J Orthod Dentofacial Orthop. 2001;120:154\u2013159."},{"key":"i0003-3219-86-6-943-b06","series-title":"J Oral Maxillofac Surg","first-page":"1256","article-title":"Maxillomandibular advancement surgery in 23 patients with obstructive sleep apnea syndrome","volume":"47","author":"Waite \n              PD,","year":"1989","unstructured":"Waite \n              PD, \n            \n            \n              Wooten \n              V, \n            \n            \n              Lachner \n              J, \n            \n            \n              Guyette \n              RF. \n            \n          \n          Maxillomandibular advancement surgery in 23 patients with obstructive sleep apnea syndrome. J Oral Maxillofac Surg. 1989;47:1256\u20131261."},{"key":"i0003-3219-86-6-943-b07","series-title":"J Oral Maxillofac Surg","first-page":"20","article-title":"Maxillary, mandibular, and hyoid advancement for treatment of obstructive sleep apnea: a review of 40 patients","volume":"48","author":"Riley \n              RW,","year":"1990","unstructured":"Riley \n              RW, \n            \n            \n              Powell \n              NB, \n            \n            \n              Guilleminault \n              C. \n            \n          \n          Maxillary, mandibular, and hyoid advancement for treatment of obstructive sleep apnea: a review of 40 patients. J Oral Maxillofac Surg. 1990;48:20\u201326."},{"key":"i0003-3219-86-6-943-b08","series-title":"J Craniofac Surg","first-page":"252","article-title":"Cephalometric study of posterior airway space in patients affected by Class II occlusion and treated with orthognathic surgery","volume":"10","author":"De Ponte \n              FS,","year":"1999","unstructured":"De Ponte \n              FS, \n            \n            \n              Brunelli \n              A, \n            \n            \n              Marchetti \n              E, \n            \n            \n              Bottini \n              DJ. \n            \n          \n          Cephalometric study of posterior airway space in patients affected by Class II occlusion and treated with orthognathic surgery. J Craniofac Surg. 1999;10: 252\u2013259."},{"key":"i0003-3219-86-6-943-b09","series-title":"Int J Oral Maxillofac Surg","first-page":"1347","article-title":"Effects of orthognathic surgery on oropharyngeal airway: a meta-analysis","volume":"40","author":"Mattos \n              CT,","year":"2011","unstructured":"Mattos \n              CT, \n            \n            \n              Vilani \n              GN, \n            \n            \n              Sant'Anna \n              EF, \n            \n            \n              Ruellas \n              AC, \n            \n            \n              Maia \n              LC. \n            \n          \n          Effects of orthognathic surgery on oropharyngeal airway: a meta-analysis. Int J Oral Maxillofac Surg. 2011;40:1347\u20131356."},{"key":"i0003-3219-86-6-943-b10","series-title":"Am J Orthod Dentofacial Orthop","first-page":"S50.e1","article-title":"Measuring the airway in 3 dimensions: a reliability and accuracy study","volume":"137","author":"El \n              H,","year":"2010","unstructured":"El \n              H, \n            \n            \n              Palomo \n              JM. \n            \n          \n          Measuring the airway in 3 dimensions: a reliability and accuracy study. Am J Orthod Dentofacial Orthop. 2010;137:S50.e1\u2013S50.e9."},{"key":"i0003-3219-86-6-943-b11","series-title":"Eur J Orthod","first-page":"256","article-title":"Accuracy and reliability of cone-beam for airway volume analysis","volume":"35","author":"Ghoneima \n              A,","year":"2013","unstructured":"Ghoneima \n              A, \n            \n            \n              Kula \n              K. \n            \n          \n          Accuracy and reliability of cone-beam for airway volume analysis. Eur J Orthod. 2013;35:256\u2013261."},{"key":"i0003-3219-86-6-943-b12","series-title":"AJNR Am J Neuroradiol","first-page":"135","article-title":"Relation between CT axial cross-sectional area of the oropharynx and obstructive sleep apnea syndrome in adults","volume":"16","author":"Avrahami \n              E,","year":"1995","unstructured":"Avrahami \n              E, \n            \n            \n              Englender \n              M. \n            \n          \n          Relation between CT axial cross-sectional area of the oropharynx and obstructive sleep apnea syndrome in adults. AJNR Am J Neuroradiol. 1995;16:135\u2013140."},{"key":"i0003-3219-86-6-943-b13","series-title":"AJNR Am J Neuroradiol","first-page":"1107","article-title":"Axial CT measurements of the cross-sectional area of the oropharynx in adults with obstructive sleep apnea syndrome","volume":"17","author":"Avrahami \n              E,","year":"1996","unstructured":"Avrahami \n              E, \n            \n            \n              Solomonovich \n              A, \n            \n            \n              Englender \n              M. \n            \n          \n          Axial CT measurements of the cross-sectional area of the oropharynx in adults with obstructive sleep apnea syndrome. AJNR Am J Neuroradiol. 1996;17:1107\u20131111."},{"key":"i0003-3219-86-6-943-b14","series-title":"Am J Neuroradiol","first-page":"2624","article-title":"Evaluation of the upper airway cross-sectional area changes in different degrees of severity of obstructive sleep apnea syndrome: cephalometric and dynamic CT study","volume":"26","author":"Yucel \n              A,","year":"2005","unstructured":"Yucel \n              A, \n            \n            \n              Unlu \n              M, \n            \n            \n              Haktanir \n              A, \n            \n            \n              Acar \n              M, \n            \n            \n              Fidan \n              F. \n            \n          \n          Evaluation of the upper airway cross-sectional area changes in different degrees of severity of obstructive sleep apnea syndrome: cephalometric and dynamic CT study. Am J Neuroradiol. 2005;26: 2624\u20132629."},{"key":"i0003-3219-86-6-943-b15","series-title":"Am J Orthod Dentofacial Orthop","first-page":"188","article-title":"Reliability of upper airway linear, area, and volumetric measurements in cone-beam computed tomography","volume":"145","author":"Mattos \n              C,","year":"2014","unstructured":"Mattos \n              C, \n            \n            et al. \n          Reliability of upper airway linear, area, and volumetric measurements in cone-beam computed tomography. Am J Orthod Dentofacial Orthop. 2014;145: 188\u2013197."},{"key":"i0003-3219-86-6-943-b16","series-title":"Int J Comput Assist Radiol Surg","first-page":"617","article-title":"Outcome quantification using SPHARM-PDM toolbox in orthognathic surgery","volume":"6","author":"Paniagua \n              B,","year":"2011","unstructured":"Paniagua \n              B, \n            \n            \n              Cevidanes \n              L, \n            \n            \n              Zhu \n              H, \n            \n            \n              Styner \n              M. \n            \n          \n          Outcome quantification using SPHARM-PDM toolbox in orthognathic surgery. Int J Comput Assist Radiol Surg. 2011;6:617\u2013626."},{"issue":"2","key":"i0003-3219-86-6-943-b17","series-title":"Angle Orthod","first-page":"329","article-title":"Use of shape correspondence analysis to quantify skeletal changes associated with bone-anchored Class III correction","volume":"84","author":"Nguyen \n              T,","year":"2014","unstructured":"Nguyen \n              T, \n            \n            \n              Cevidanes \n              L, \n            \n            \n              Paniagua \n              B, \n            \n            \n              Zhu \n              H, \n            \n            \n              de Paula \n              L, \n            \n            \n              De Clerck \n              H. \n            \n          \n          Use of shape correspondence analysis to quantify skeletal changes associated with bone-anchored Class III correction. Angle Orthod. 2014;84(2):329\u2013336."},{"key":"i0003-3219-86-6-943-b18","first-page":"94130U","article-title":"Lateral ventricle morphology analysis via mean latitude axis. SPIE Medical Imaging","volume":"ii","author":"Paniagua \n              B,","year":"2015","unstructured":"Paniagua \n              B, \n            \n            \n              Lyall \n              A, \n            \n            \n              Berger \n              J-B, \n            \n            et al. \n          Lateral ventricle morphology analysis via mean latitude axis. SPIE Medical Imaging. 2015;9413. p.ii: 94130U."},{"key":"i0003-3219-86-6-943-b19","series-title":"Neurology","first-page":"2159","article-title":"Basal temporal sulcal morphology in healthy controls and patients with temporal lobe epilepsy","volume":"70","author":"Kim \n              H,","year":"2008","unstructured":"Kim \n              H, \n            \n            \n              Bernasconi \n              N, \n            \n            \n              Bernhardt \n              B, \n            \n            \n              Colliot \n              O, \n            \n            \n              Bernasconi \n              A. \n            \n          \n          Basal temporal sulcal morphology in healthy controls and patients with temporal lobe epilepsy. Neurology. 2008;70:2159\u20132165."},{"key":"i0003-3219-86-6-943-b20","series-title":"Am J Epidemiol","first-page":"1006","article-title":"Increased prevalence of sleep-disordered breathing in adults","volume":"177","author":"Peppard \n              PE,","year":"2014","unstructured":"Peppard \n              PE, \n            \n            \n              Young \n              T, \n            \n            \n              Barnet \n              JH, \n            \n            et al. \n          Increased prevalence of sleep-disordered breathing in adults. 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J Oral Maxillofac Surg. 20122012-09-01;70:2174\u20132183."},{"key":"i0003-3219-86-6-943-b22","series-title":"Angle Orthod","first-page":"791","article-title":"Customized three-dimensional computational fluid dynamics simulation of the upper airway of obstructive sleep apnea","volume":"76","author":"Sung \n              SJ,","year":"2006","unstructured":"Sung \n              SJ, \n            \n            \n              Jeong \n              SJ, \n            \n            \n              Yu \n              YS, \n            \n            \n              Hwang \n              CJ, \n            \n            \n              Pae \n              EK. \n            \n          \n          Customized three-dimensional computational fluid dynamics simulation of the upper airway of obstructive sleep apnea. Angle Orthod. 2006;76: 791\u2013799."},{"key":"i0003-3219-86-6-943-b23","series-title":"J Appl Physiol","first-page":"104","article-title":"Computational fluid dynamics endpoints to characterize obstructive sleep apnea syndrome in children","volume":"116","author":"Wootton \n              DM,","year":"2014","unstructured":"Wootton \n              DM, \n            \n            \n              Luo \n              H, \n            \n            \n              Persak \n              SC, \n            \n            et al. \n          Computational fluid dynamics endpoints to characterize obstructive sleep apnea syndrome in children. J Appl Physiol. 2014;116:104\u2013112."},{"key":"i0003-3219-86-6-943-b24","series-title":"J Aerosol Med Pulm Drug Deliv","first-page":"51","article-title":"Change in upper airway geometry between upright and supine position during tidal nasal breathing","volume":"27","author":"Van Holsbeke \n              CS,","year":"2014","unstructured":"Van Holsbeke \n              CS, \n            \n            \n              Verhulst \n              SL, \n            \n            \n              Vos \n              WG, \n            \n            \n              De Backer \n              JW, \n            \n            \n              Vinchurkar \n              SC, \n            \n            \n              Verdonck \n              PR, \n            \n            et al. \n          Change in upper airway geometry between upright and supine position during tidal nasal breathing. 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J Laryngol Otol. 2014;128:824\u2013830."},{"key":"i0003-3219-86-6-943-b26","series-title":"J Oral Maxillofac Surg","first-page":"526","article-title":"Obstructive sleep apnea and maxillomandibular advancement: an assessment of airway changes using radiographic and nasopharyngoscopic examinations","volume":"60","author":"Li \n              KK,","year":"2002","unstructured":"Li \n              KK, \n            \n            \n              Guilleminault \n              C, \n            \n            \n              Riley \n              RW, \n            \n            \n              Powell \n              NB. \n            \n          \n          Obstructive sleep apnea and maxillomandibular advancement: an assessment of airway changes using radiographic and nasopharyngoscopic examinations. J Oral Maxillofac Surg. 2002;60:526\u2013530."},{"key":"i0003-3219-86-6-943-b27","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":"2003","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. 2003;135:468\u2013479."},{"key":"i0003-3219-86-6-943-b01","series-title":"Int J Adult Orthod Orthog Surg","first-page":"97","article-title":"Prevalence of malocclusion and orthodontic treatment need in the United States: estimates from the N-HANES III survey","volume":"13","author":"Proffit \n              WR,","year":"1998","unstructured":"Proffit \n              WR, \n            \n            \n              Fields \n              HW, \n            \n            \n              Moray \n              LJ. \n            \n          \n          Prevalence of malocclusion and orthodontic treatment need in the United States: estimates from the N-HANES III survey. Int J Adult Orthod Orthog Surg. 1998;13:97\u2013106."},{"key":"i0003-3219-86-6-943-b02","series-title":"J Oral Surg","first-page":"543","article-title":"Sleep apnea syndrome: correction with surgical advancement of the mandible","volume":"38","author":"Bear \n              SE,","year":"1980","unstructured":"Bear \n              SE, \n            \n            \n              Priest \n              JH. \n            \n          \n          Sleep apnea syndrome: correction with surgical advancement of the mandible. J Oral Surg. 1980;38:543\u2013549."},{"key":"i0003-3219-86-6-943-b03","series-title":"Int J Adult Orthod Orthognath Surg","first-page":"255","article-title":"Posterior airway changes associated with mandibular advancement surgery: implications for patients with obstructive sleep apnea","volume":"5","author":"Farole \n              A,","year":"1990","unstructured":"Farole \n              A, \n            \n            \n              Mundenar \n              MJ, \n            \n            \n              Braitman \n              LE. \n            \n          \n          Posterior airway changes associated with mandibular advancement surgery: implications for patients with obstructive sleep apnea. Int J Adult Orthod Orthognath Surg. 1990; 5:255\u2013258."},{"key":"i0003-3219-86-6-943-b04","series-title":"J Oral Maxillofac Surg","first-page":"40","article-title":"Pharyngeal airway changes associated with mandibular advancement","volume":"52","author":"Yu \n              LF,","year":"1994","unstructured":"Yu \n              LF, \n            \n            \n              Pogrel \n              MA, \n            \n            \n              Ajayi \n              M. \n            \n          \n          Pharyngeal airway changes associated with mandibular advancement. 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Am J Orthod Dentofacial Orthop. 2001;120:154\u2013159."},{"key":"i0003-3219-86-6-943-b06","series-title":"J Oral Maxillofac Surg","first-page":"1256","article-title":"Maxillomandibular advancement surgery in 23 patients with obstructive sleep apnea syndrome","volume":"47","author":"Waite \n              PD,","year":"1989","unstructured":"Waite \n              PD, \n            \n            \n              Wooten \n              V, \n            \n            \n              Lachner \n              J, \n            \n            \n              Guyette \n              RF. \n            \n          \n          Maxillomandibular advancement surgery in 23 patients with obstructive sleep apnea syndrome. J Oral Maxillofac Surg. 1989;47:1256\u20131261."},{"key":"i0003-3219-86-6-943-b07","series-title":"J Oral Maxillofac Surg","first-page":"20","article-title":"Maxillary, mandibular, and hyoid advancement for treatment of obstructive sleep apnea: a review of 40 patients","volume":"48","author":"Riley \n              RW,","year":"1990","unstructured":"Riley \n              RW, \n            \n            \n              Powell \n              NB, \n            \n            \n              Guilleminault \n              C. \n            \n          \n          Maxillary, mandibular, and hyoid advancement for treatment of obstructive sleep apnea: a review of 40 patients. J Oral Maxillofac Surg. 1990;48:20\u201326."},{"key":"i0003-3219-86-6-943-b08","series-title":"J Craniofac Surg","first-page":"252","article-title":"Cephalometric study of posterior airway space in patients affected by Class II occlusion and treated with orthognathic surgery","volume":"10","author":"De Ponte \n              FS,","year":"1999","unstructured":"De Ponte \n              FS, \n            \n            \n              Brunelli \n              A, \n            \n            \n              Marchetti \n              E, \n            \n            \n              Bottini \n              DJ. \n            \n          \n          Cephalometric study of posterior airway space in patients affected by Class II occlusion and treated with orthognathic surgery. J Craniofac Surg. 1999;10: 252\u2013259."},{"key":"i0003-3219-86-6-943-b09","series-title":"Int J Oral Maxillofac Surg","first-page":"1347","article-title":"Effects of orthognathic surgery on oropharyngeal airway: a meta-analysis","volume":"40","author":"Mattos \n              CT,","year":"2011","unstructured":"Mattos \n              CT, \n            \n            \n              Vilani \n              GN, \n            \n            \n              Sant'Anna \n              EF, \n            \n            \n              Ruellas \n              AC, \n            \n            \n              Maia \n              LC. \n            \n          \n          Effects of orthognathic surgery on oropharyngeal airway: a meta-analysis. Int J Oral Maxillofac Surg. 2011;40:1347\u20131356."},{"key":"i0003-3219-86-6-943-b10","series-title":"Am J Orthod Dentofacial Orthop","first-page":"S50.e1","article-title":"Measuring the airway in 3 dimensions: a reliability and accuracy study","volume":"137","author":"El \n              H,","year":"2010","unstructured":"El \n              H, \n            \n            \n              Palomo \n              JM. \n            \n          \n          Measuring the airway in 3 dimensions: a reliability and accuracy study. 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