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The aim of our study was to evaluate the effect of treatment with a maxillary protraction appliance on the development of the craniofacial structures and to describe the correlation between the skeletal changes and the sagittal airway dimension associated with tongue, soft palate, and hyoid bone position in skeletal Class III children. A total of 40 patients with Class III malocclusions were evaluated by the use of lateral cephalograms. Pretreatment and posttreatment cephalometric radiographs were analyzed; linear and angular measurements were performed by the same orthodontist. The effect of treatment with a maxillary protraction appliance on the development of the craniofacial structures were evaluated by Student's T test and the correlation between treatment changes in craniofacial morphology and those in upper airway, tongue, soft palate, and hyoid position was evaluated by Pearson's correlation test. A significant increase in maxillary forward growth, inhibition of mandibular forward growth, and clockwise rotation of the mandible were observed. The statistical analysis revealed that maxillary growth had a significant positive effect on the superior upper airway sagittal dimension. The nasopharyngeal airway dimensions can be improved in the short term with maxillary protraction in skeletal Class III children.

Introduction: Facial growth changes the position of the jaws (in particular vertical position of the maxilla and antero-posterior position of the mandible) and may, in turn, modify the position of the tongue and the hyoid bone, thus, generating modifications of the upper airway space. In the present paper, effects on upper airway space and tongue position of a new functional appliance, the swallowing occlusal contact intercept appliance (SOCIA) have been investigated., Materials and Methods: Retrospective cephaolmetric study of twenty-four children (mean age 9.46±1.60) with hyperdivergent Class II malocclusion with mandibular retrusion and atypical deglutition, was performed on radiographs taken before and after 24 months treatment with "SOCIA" appliance. The variables considered in this study, and analysed by means of a Paired t-test with a 5% level of significance, included the distance between the base of epiglottis (EB) and the tip of the tongue (TT), the distance from the tongue dorsum to EB-TT (TGH), the distance between the posterior nasal spine PNS and EB (VAL), SPAS, MAS and IAS (i.e. superior, medium and inferior pharyngeal airspace width)., Results: Our findings showed a significant increase in tongue length (TT-EB) and tongue height (TGH); thus, confirming the reposition of the tongue from a lower posture to its physiological position onto the palatal spot. These modifications of the tongue posture had effects on the upper airway space. The most important modifications were observed in SPAS, with a significant 5.9 mm increase. Some increase was found also for MAS (0.83 mm) and IAS (1.1 mm) but without statistical significance. A significant increase (7.75 mm) was also found for VAL, probably as a result of the augmentation of posterior facial height., Conclusions: SOCIA appliance is capable to improve tongue position and the superior posterior airway space, and, consequently, to improve deglutition, phonation and respiratory function., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)