Herbst appliance effects on pharyngeal airway ventilation evaluated using computational fluid dynamics

Angle Orthod. 2017 May;87(3):397-403. doi: 10.2319/080616-603.1. Epub 2017 Jan 25.

Abstract

Objective: To evaluate the effect of a Herbst appliance on ventilation of the pharyngeal airway (PA) using computational fluid dynamics (CFD).

Materials and methods: Twenty-one Class II patients (10 boys; mean age, 11.7 years) who required Herbst therapy with edgewise treatment underwent cone-beam computed tomography (CBCT) before and after treatment. Nineteen Class I control patients (8 boys; mean age, 11.9 years) received edgewise treatment alone. The pressure and velocity of the PA were compared between the groups using CFD based on three-dimensional CBCT images of the PA.

Results: The change in oropharyngeal airway velocity in the Herbst group (1.95 m/s) was significantly larger than that in the control group (0.67 m/s). Similarly, the decrease in laryngopharyngeal airway velocity in the Herbst group (1.37 m/s) was significantly larger than that in the control group (0.57 m/s).

Conclusion: The Herbst appliance improves ventilation of the oropharyngeal and laryngopharyngeal airways. These results may provide a useful assessment of obstructive sleep apnea treatment during growth.

Keywords: Computational fluid dynamics; Cone-beam computed tomography; Herbst appliance; Obstructive sleep apnea; Pharyngeal airway.

MeSH terms

  • Child
  • Computational Biology
  • Cone-Beam Computed Tomography*
  • Female
  • Humans
  • Hydrodynamics
  • Male
  • Malocclusion, Angle Class II / therapy*
  • Orthodontic Appliances, Functional*
  • Pharynx / diagnostic imaging*
  • Respiration
  • Treatment Outcome