Risk factors for small pharyngeal airway dimensions in preorthodontic children: A three-dimensional study

Abstract

Objective: To analyze which parameters, gathered from standard orthodontic diagnostic material, were most relevant for identifying small pharyngeal airway dimensions in preorthodontic children.

Materials and methods: The sample was composed of 105 cone beam computed tomography scans of healthy preorthodontic children (44 boys, 61 girls; mean age, 10.7 ± 2.4 years). Airway volume and minimal cross-sectional area were three-dimensionally assessed. Cephalometric features and skeletal maturity were assessed on generated two-dimensional cephalograms. Associations were analyzed and adjusted for age, gender, and skeletal maturity by multiple regression analyses.

Results: Airway volume and minimal cross-sectional area were significantly smaller in prepubertal children (P < .001, P < .05, respectively) and positively associated with age (P < .001, P < .01, respectively). After adjustment of age, skeletal maturity and gender significant associations were found between pharyngeal airway dimensions and craniofacial morphology. Airway volume was positively associated with maxillary and mandibular width (P < .01; P < .001, respectively) and anterior face height (P < .05; P < .05, respectively). Minimal cross-sectional area was positively associated with maxillary and mandibular width (P < .01; P < .001, respectively) and negatively associated with sagittal jaw relationship (AnPg, P < .05). Mandibular width and age were the most relevant factors for airway volume (r2 = 0.36). Mandibular width and sagittal jaw relationship were the most relevant factors for minimal cross-sectional area (r2 = 0.16).

Conclusion: Pharyngeal airway dimensions were significantly associated with age, skeletal maturity, and craniofacial morphology in all three planes. Children with a reduced mandibular width and increased sagittal jaw relationship are particularly at risk of having small pharyngeal airway dimensions.

Keywords: Children; Pharyngeal airway.

Figures

Figure 1.

Flowchart of final sample size.

Figure 2.

Illustration of margins for delineations of the upper airway (hatched).

Figure 3.

Illustrations of reference points and lines (dotted) describing craniofacial morphology on lateral (A) and postero-anterior (B) cephalograms.,

Figure 4.

Airway volume in relation to skeletal maturity. NS, not significant. 1 = prepubertal, 2 = pubertal, 3 = postpubertal. * P ≤ .05; ** P ≤ .01; *** P ≤ .001.

Figure 5.

Airway minimal cross-sectional area in relation to skeletal maturity. 1 = prepubertal, 2 = pubertal, 3 = postpubertal. NS, not significant. * P ≤ .05; ** P ≤ .01; *** P ≤ .001.