{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T19:43:55Z","timestamp":1783194235106,"version":"3.54.6"},"reference-count":56,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective:<\/jats:title>\n To compare the three-dimensional (3D) morphology of the upper airway in skeletal Class III patients with and without mandibular asymmetry and to investigate the possible underlying correlations between the morphology of the upper airway and mandibular deviation.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n Cone-beam computed tomography images of 54 subjects with skeletal Class III malocclusion (ANB angle \u2264 0.4\u00b0, Wits \u2264 \u22125.5\u00b0) were taken and 3D upper airway models were reconstructed using Dolphin 3D software. According to the distance (d) from symphysis menti to the sagittal plane, all subjects were divided into a symmetry group (d \u2264 2 mm) and an asymmetry group (d \u2265 4 mm). Based on the severity of mandibular deviation, the asymmetry group was divided into subgroup I (4 mm \u2264d <10 mm) and subgroup II (d \u2265 10 mm). Cross-sectional linear distances, areas, and volumetric variables of the upper airway were measured in the 3D airway model.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Width of the inferior limit of the glossopharynx (P3W), cross-sectional area of the anterior limit of the nasal airway (P5S), and height of the glossopharynx (GPH) in the asymmetry group were significantly larger than in the symmetry group. As for subjects with severe mandibular deviation in subgroup II (d \u2265 10 mm), volume of the glossopharynx (GPV), total volume of the pharynx (TPV), length of the inferior limit of the velopharynx (P2L), and ratio of length to width of the inferior limit of the velopharynx (P2L\/P2W) showed significantly negative correlations with mandibular deviation (\n r<\/jats:italic>\n > 0.7,\n P <<\/jats:italic>\n .05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n \n In Class III subjects with severe mandibular asymmetry, the pharyngeal airway showed a tendency toward constriction and presented a more elliptical shape as mandibular deviation became more severe (\n P<\/jats:italic>\n < .01).\n <\/jats:p>\n <\/jats:sec>","DOI":"10.2319\/120116-866.1","type":"journal-article","created":{"date-parts":[[2017,4,18]],"date-time":"2017-04-18T12:38:12Z","timestamp":1492519092000},"page":"526-533","source":"Crossref","is-referenced-by-count":14,"title":["Three-dimensional analysis of upper airway morphology in skeletal Class III patients with and without mandibular asymmetry"],"prefix":"10.2319","volume":"87","author":[{"given":"Xi","family":"Wen","sequence":"first","affiliation":[{"name":"Postgraduate Student, Department of Orthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology; Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, People's Republic of China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Postgraduate Student, Department of Orthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology; Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, People's Republic of China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuqi","family":"Qin","sequence":"additional","affiliation":[{"name":"Postgraduate Student, Department of Orthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology; Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, People's Republic of China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Franchi","sequence":"additional","affiliation":[{"name":"Professor, Department of Orthodontics, University of Florence, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Gu","sequence":"additional","affiliation":[{"name":"Professor, Department of Orthodontics; National Engineering Laboratory for Digital and Material Technology of Stomatology; Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, People's Republic of China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-87-4-526-b01","series-title":"Am J Orthod Dentofacial Orthop","first-page":"20","article-title":"Craniofacial and upper airway morphology in pediatric sleep-disordered breathing: systematic review and meta-analysis","volume":"143","author":"Katyal \n V,","year":"2013","unstructured":"Katyal \n V, \n \n \n Pamula \n Y, \n \n \n Martin \n AJ, \n \n \n Daynes \n CN, \n \n \n Kennedy \n JD, \n \n \n Sampson \n WJ. \n \n \n Craniofacial and upper airway morphology in pediatric sleep-disordered breathing: systematic review and meta-analysis. Am J Orthod Dentofacial Orthop. 2013;143:20\u201330."},{"key":"i0003-3219-87-4-526-b02","series-title":"J Am Dent Assoc","first-page":"269","article-title":"Craniofacial morphological characteristics in children with obstructive sleep apnea syndrome: a systematic review and meta-analysis","volume":"144","author":"Flores-Mir \n C,","year":"2013","unstructured":"Flores-Mir \n C, \n \n \n Korayem \n M, \n \n \n Heo \n G, \n \n \n Witmans \n M, \n \n \n Major \n MP, \n \n \n Major \n PW. \n \n \n Craniofacial morphological characteristics in children with obstructive sleep apnea syndrome: a systematic review and meta-analysis. J Am Dent Assoc. 2013;144:269\u2013277."},{"key":"i0003-3219-87-4-526-b03","series-title":"Int J Pediatr Otorhi","first-page":"1167","article-title":"Comparison of cephalometric patterns in mouth breathing and nose breathing children","volume":"78","year":"2014","unstructured":"Chung Leng Mu\u00f1oz I, Beltri Orta P. Comparison of cephalometric patterns in mouth breathing and nose breathing children. Int J Pediatr Otorhi. 2014;78:1167\u20131172."},{"key":"i0003-3219-87-4-526-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"301","article-title":"Three-dimensional analysis of pharyngeal airway in preadolescent children with different anteroposterior skeletal patterns","volume":"137","author":"Kim \n Y,","year":"2010","unstructured":"Kim \n Y, \n \n \n Hong \n J, \n \n \n Hwang \n Y, \n \n \n Park \n Y. \n \n \n Three-dimensional analysis of pharyngeal airway in preadolescent children with different anteroposterior skeletal patterns. 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Orthod Craniofac Res. 2014;17:38\u201348."},{"key":"i0003-3219-87-4-526-b06","series-title":"PLoS ONE","first-page":"e135273","article-title":"Three-dimensional evaluation of the upper airway morphological changes in growing patients with skeletal Class III malocclusion treated by protraction headgear and rapid palatal expansion: a comparative research","volume":"10","author":"Chen \n X,","year":"2015","unstructured":"Chen \n X, \n \n \n Liu \n D, \n \n \n Liu \n J, \n \n \n Wu \n Z, \n \n \n Xie \n Y, \n \n \n Li \n L, \n \n et al. \n Three-dimensional evaluation of the upper airway morphological changes in growing patients with skeletal Class III malocclusion treated by protraction headgear and rapid palatal expansion: a comparative research. PLoS ONE. 2015;10:e135273."},{"key":"i0003-3219-87-4-526-b07","series-title":"J Craniomaxillofac Surg","first-page":"107","article-title":"Changes in tongue and hyoid position, and posterior airway space following mandibular setback surgery","volume":"33","author":"Kawakami \n M,","year":"2003","unstructured":"Kawakami \n M, \n \n \n Yamamoto \n K, \n \n \n Fujimoto \n M, \n \n \n Ohgi \n K, \n \n \n Inoue \n M, \n \n \n Kirita \n T. \n \n \n Changes in tongue and hyoid position, and posterior airway space following mandibular setback surgery. J Craniomaxillofac Surg. 2003;33:107\u2013110."},{"key":"i0003-3219-87-4-526-b08","series-title":"Am J Orthod Dentofacial Orthop","first-page":"556","article-title":"Longterm changes in pharyngeal airway morphology after mandibular setback surgery","volume":"125","author":"Saioh \n K.","year":"2004","unstructured":"Saioh \n K. \n \n \n Longterm changes in pharyngeal airway morphology after mandibular setback surgery. 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Am J Orthod Dentofacial Orthop. 2011;139:e369\u2013e376."},{"key":"i0003-3219-87-4-526-b11","series-title":"Rev Stomatol Chir Maxillofac","first-page":"374","article-title":"Mandibular asymmetry and obstructive sleep apnea syndrome [in French]","volume":"97","author":"Richter \n M,","year":"1996","unstructured":"Richter \n M, \n \n \n Mossaz \n C, \n \n \n Kehrer \n P. \n \n \n Mandibular asymmetry and obstructive sleep apnea syndrome [in French]. Rev Stomatol Chir Maxillofac. 1996;97:374\u2013382."},{"key":"i0003-3219-87-4-526-b12","series-title":"Int J Adult Orthod Orthognath Surg","first-page":"171","article-title":"The prevalence of mandibular asymmetry in the dentofacial deformities population at the University of North Carolina","volume":"12","author":"Severt \n TR,","year":"1997","unstructured":"Severt \n TR, \n \n \n Proffit \n WR. \n \n \n The prevalence of mandibular asymmetry in the dentofacial deformities population at the University of North Carolina. Int J Adult Orthod Orthognath Surg. 1997;12:171\u2013176."},{"key":"i0003-3219-87-4-526-b13","series-title":"Int J Adult Orthod Orthognath Surg","first-page":"181","article-title":"Analysis of 300 dentofacial deformities in Hong Kong","volume":"7","author":"Samman \n N,","year":"1992","unstructured":"Samman \n N, \n \n \n Tong \n AC, \n \n \n Cheung \n DL, \n \n \n Tideman \n H. \n \n \n Analysis of 300 dentofacial deformities in Hong Kong. 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Am J Orthod Dentofacial Orthop. 2013;143:20\u201330."},{"key":"i0003-3219-87-4-526-b02","series-title":"J Am Dent Assoc","first-page":"269","article-title":"Craniofacial morphological characteristics in children with obstructive sleep apnea syndrome: a systematic review and meta-analysis","volume":"144","author":"Flores-Mir \n C,","year":"2013","unstructured":"Flores-Mir \n C, \n \n \n Korayem \n M, \n \n \n Heo \n G, \n \n \n Witmans \n M, \n \n \n Major \n MP, \n \n \n Major \n PW. \n \n \n Craniofacial morphological characteristics in children with obstructive sleep apnea syndrome: a systematic review and meta-analysis. J Am Dent Assoc. 2013;144:269\u2013277."},{"key":"i0003-3219-87-4-526-b03","series-title":"Int J Pediatr Otorhi","first-page":"1167","article-title":"Comparison of cephalometric patterns in mouth breathing and nose breathing children","volume":"78","year":"2014","unstructured":"Chung Leng Mu\u00f1oz I, Beltri Orta P. Comparison of cephalometric patterns in mouth breathing and nose breathing children. Int J Pediatr Otorhi. 2014;78:1167\u20131172."},{"key":"i0003-3219-87-4-526-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"301","article-title":"Three-dimensional analysis of pharyngeal airway in preadolescent children with different anteroposterior skeletal patterns","volume":"137","author":"Kim \n Y,","year":"2010","unstructured":"Kim \n Y, \n \n \n Hong \n J, \n \n \n Hwang \n Y, \n \n \n Park \n Y. \n \n \n Three-dimensional analysis of pharyngeal airway in preadolescent children with different anteroposterior skeletal patterns. Am J Orthod Dentofacial Orthop. 2010;137:301\u2013306."},{"key":"i0003-3219-87-4-526-b05","series-title":"Orthod Craniofac Res","first-page":"38","article-title":"Three-dimensional evaluation of upper airway in patients with different anteroposterior skeletal patterns","volume":"17","author":"Zheng \n ZH,","year":"2014","unstructured":"Zheng \n ZH, \n \n \n Yamaguchi \n T, \n \n \n Kurihara \n A, \n \n \n Li \n HF, \n \n \n Maki \n K. \n \n \n Three-dimensional evaluation of upper airway in patients with different anteroposterior skeletal patterns. Orthod Craniofac Res. 2014;17:38\u201348."},{"key":"i0003-3219-87-4-526-b06","series-title":"PLoS ONE","first-page":"e135273","article-title":"Three-dimensional evaluation of the upper airway morphological changes in growing patients with skeletal Class III malocclusion treated by protraction headgear and rapid palatal expansion: a comparative research","volume":"10","author":"Chen \n X,","year":"2015","unstructured":"Chen \n X, \n \n \n Liu \n D, \n \n \n Liu \n J, \n \n \n Wu \n Z, \n \n \n Xie \n Y, \n \n \n Li \n L, \n \n et al. \n Three-dimensional evaluation of the upper airway morphological changes in growing patients with skeletal Class III malocclusion treated by protraction headgear and rapid palatal expansion: a comparative research. PLoS ONE. 2015;10:e135273."},{"key":"i0003-3219-87-4-526-b07","series-title":"J Craniomaxillofac Surg","first-page":"107","article-title":"Changes in tongue and hyoid position, and posterior airway space following mandibular setback surgery","volume":"33","author":"Kawakami \n M,","year":"2003","unstructured":"Kawakami \n M, \n \n \n Yamamoto \n K, \n \n \n Fujimoto \n M, \n \n \n Ohgi \n K, \n \n \n Inoue \n M, \n \n \n Kirita \n T. \n \n \n Changes in tongue and hyoid position, and posterior airway space following mandibular setback surgery. J Craniomaxillofac Surg. 2003;33:107\u2013110."},{"key":"i0003-3219-87-4-526-b08","series-title":"Am J Orthod Dentofacial Orthop","first-page":"556","article-title":"Longterm changes in pharyngeal airway morphology after mandibular setback surgery","volume":"125","author":"Saioh \n K.","year":"2004","unstructured":"Saioh \n K. \n \n \n Longterm changes in pharyngeal airway morphology after mandibular setback surgery. Am J Orthod Dentofacial Orthop. 2004;125:556\u2013561."},{"key":"i0003-3219-87-4-526-b09","series-title":"J Oral Maxillofac Surg","first-page":"282","article-title":"Assessment of pharyngeal airwayspace after mandibular setback surgery","volume":"58","author":"Tselnik \n M,","year":"2000","unstructured":"Tselnik \n M, \n \n \n Pogrel \n MA. \n \n \n Assessment of pharyngeal airwayspace after mandibular setback surgery. J Oral Maxillofac Surg. 2000;58:282\u2013285."},{"key":"i0003-3219-87-4-526-b10","series-title":"Am J Orthod Dentofacial Orthop","first-page":"e369","article-title":"The effect of maxillary advancement and impaction on the upper airway after bimaxillary surgery to correct Class III malocclusion","volume":"139","author":"Jakobsone \n G,","year":"2011","unstructured":"Jakobsone \n G, \n \n \n Stenvik \n A, \n \n \n Espeland \n L. \n \n \n The effect of maxillary advancement and impaction on the upper airway after bimaxillary surgery to correct Class III malocclusion. Am J Orthod Dentofacial Orthop. 2011;139:e369\u2013e376."},{"key":"i0003-3219-87-4-526-b11","series-title":"Rev Stomatol Chir Maxillofac","first-page":"374","article-title":"Mandibular asymmetry and obstructive sleep apnea syndrome [in French]","volume":"97","author":"Richter \n M,","year":"1996","unstructured":"Richter \n M, \n \n \n Mossaz \n C, \n \n \n Kehrer \n P. \n \n \n Mandibular asymmetry and obstructive sleep apnea syndrome [in French]. Rev Stomatol Chir Maxillofac. 1996;97:374\u2013382."},{"key":"i0003-3219-87-4-526-b12","series-title":"Int J Adult Orthod Orthognath Surg","first-page":"171","article-title":"The prevalence of mandibular asymmetry in the dentofacial deformities population at the University of North Carolina","volume":"12","author":"Severt \n TR,","year":"1997","unstructured":"Severt \n TR, \n \n \n Proffit \n WR. \n \n \n The prevalence of mandibular asymmetry in the dentofacial deformities population at the University of North Carolina. 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