Volumetric changes in pharyngeal airway in Class II division 1 patients treated with Forsus-fixed functional appliance: A three-dimensional cone-beam computed tomography study

OBJECTIVE: Recent years have witnessed a renewed interest to determine a quantifiable relationship between mandibular advancement performed with an orthodontic appliance and the resulting airway volume. The study was conducted to evaluate the volumetric changes in pharyngeal airway space using cone-beam computed tomography (CBCT) in Class II division 1 patients with retrognathic mandible treated by Forsus-fixed functional appliance and to compare them with their pretreatment findings. MATERIALS AND METHODS: Thirty patients with Class II division 1 malocclusion of age group 10–17 years were selected randomly and evaluated for changes in pharyngeal airway volume with and without Forsus-fixed functional appliance. Patients in each group underwent CBCT scan of head and neck region at pretreatment stage and 6 months after the initial scan. Institutional approval for the project was obtained from the Ethical Committee. Volumetric changes of upper (oropharynx) and lower (hypopharynx) pharyngeal airways were measured on scanogram using computer software and intragroup comparisons were done. RESULTS: There was a statistically significant increase in the volume of both hypopharynx and oropharynx and also total airway volume in patients treated with Forsus-fixed functional appliance. Three-dimensional reconstruction of the airway also demonstrates a considerable increase in pharyngeal airway space. CONCLUSION: Forsus-fixed functional appliance can be a promising appliance for improving pharyngeal airway volume in Class II division 1 patients with retrognathic mandible thus preventing obstructive sleep apnea and other respiratory problems in future. However, the long-term implications of this treatment modality need further consideration and a longer period of follow-up.