Computational Fluid Dynamics Analysis of Upper Airway Changes after Protraction Headgear and Rapid Maxillary Expansion Treatment

  • Haoran Xu 1School of Energy and Power Engineering, Shandong University, Jinan, 250061, China
Keywords: Computational fluid dynamics; protraction headgear; rapid maxillary expansion; maxillary skeletal deficiency
Article ID: 52

Abstract

Clinically, it is common for Class III patients with maxillary skeletal deficiency, which may result in a variety of adverse consequences. Protraction headgear and rapid maxillary expansion (PE) is an effective treatment, but its effect on upper airway hydrodynamics has not been reported. The main purpose of this study was to evaluate the changes of the flow in the upper airway after PE by computational fluid dynamics (CFD). The sample includes fifteen patients (6 males, 9 females, age 11.00 ± 1.00) and the paired T-test was used to analyze the differences between the measured data before and after treatment. The maximum flow velocity decreased from 8.42 ± 0.16 m/s to 6.98 ± 0.36 m/s (p < 0.05), and the maximum shear force decreased from 3.72 ± 1.48 Pa to 2.13 ± 0.18 Pa. The maximum negative pressure decreased from −101.78 ± 33.60 Pa to 58.15 ± 9.16 Pa, only the changes of velopharynx and glossopharynx were statistically significant; while the maximum resistance decreased from 140.88 ± 68.68 Pa/mL/s to 45.95 ± 22.96 Pa/mL/s. PE can effectively reduce the airflow resistance of the upper airway and the probability of airway collapse, thus improving the patient’s ventilation function.

References

1. Hardy, D. K., Cubas, Y. P., Orellana,M. F. (2012). Prevalence of angle class III malocclusion: A systematic review and meta-analysis. Open Journal of Epidemiology, 2(4), 75–82. https://doi.org/10.4236/ojepi.2012.24012
2. Vaida, L. L., Moca, A. E., Negrutiu, B. M., Precup, A. L., Bumbu, B. A. et al. (2019). Correction of Class III malocclusions through morphological changes of the maxilla using the protraction face mask by three different therapeutic approaches. Romanian Journal of Morphology and Embryology, 60(2), 605–615.
3. Ming, Y., Hu, Y., Li, Y., Yu, J., He, H. et al. (2018). Effects of maxillary protraction appliances on airway dimensions in growing class III maxillary retrognathic patients: A systematic review and meta-analysis. International Journal of Pediatric Otorhinolaryngology, 105, 138–145. https://doi.org/10.1016/j.ijporl.2017.12.013
4. Suga, H., Iwasaki, T., Mishima, K., Nakano, H., Ueyama, Y. et al. (2021). Evaluation of the effect of oral appliance treatment on upper-airway ventilation conditions in obstructive sleep apnea using computational fluid dynamics. Cranio, 39(3), 209–217. https://doi.org/10.1080/08869634.2019.1596554
5. Celikoglu, M., Bayram, M., Sekerci, A. E., Buyuk, S. K., Toy, E. (2014). Comparison of pharyngeal airway volume among different vertical skeletal patterns: A cone-beam computed tomography study. Angle Orthod, 84(5), 782–787. https://doi.org/10.2319/101013-748.1
6. Zimmerman, J. N., Vora, S. R., Pliska, B. T. (2019). Reliability of upper airway assessment using CBCT. European Journal of Orthodontics, 41(1), 101–108. https://doi.org/10.1093/ejo/cjy058
7. Sujir, N., Desai, A., Ahmed, J., Nambiar, S., Saha, A. (2022). Cone beam computed tomography (CBCT) in the assessment of the airway: A review. Journal of Positive School Psychology, 6(7), 3658–3663.
8. Faizal, W. M., Ghazali, N. N. N., Khor, C. Y., Badruddin, I. A., Zainon, M. Z. et al. (2020). Computational fluid dynamics modelling of human upper airway: A review. Computer Methods and Programs in Biomedicine, 196, 105627. https://doi.org/10.1016/j.cmpb.2020.105627
9. Chen, S., Wang, J., Xi, X., Zhao, Y., Liu, H. et al. (2021). Rapid maxillary expansion has a beneficial effect on the ventilation in children with nasal septal deviation: A computational fluid dynamics study. Front Pediatr, 9, 718735.
https://doi.org/10.3389/fped.2021.718735
10. Feng, X., Chen, Y., Hellen-Halme, K., Cai, W., Shi, X. (2021). The effect of rapid maxillary expansion on the upper airway’s aerodynamic characteristics. BMC Oral Health, 21(1), 123. https://doi.org/10.1186/
s12903-021-01488-1
11. Yanagisawa-Minami, A., Sugiyama, T., Iwasaki, T., Yamasaki, Y. (2020). Primary site identification in children with obstructive sleep apnea by computational fluid dynamics analysis of the upper airway. Journal of Clinical
Sleep Medicine, 16(3), 431–439.
12. Ghosh, R. P., Bianchi, M., Marom, G., Rotman, O. M., Kovarovic, B. et al. (2019). Patient-specific computational approach for trans catheter aortic valve replacement (TAVR): Pre-procedural planning for enhancing performance
and clinical outcomes. Molecular & Cellular Biomechanics, 16(Suppl.2), 12–14. https://doi.org/10.32604/mcb. 2019.07379
13. Rana, S. S., Kharbanda, O. P., Agarwal, B. (2020). Influence of tongue volume, oral cavity volume and their ratio on upper airway: A cone beam computed tomography study. Journal of Oral Biology and Craniofacial Research,
10(2), 110–117.
14. Iwasaki, T., Takemoto, Y., Inada, E., Sato, H., Suga, H. et al. (2014). The effect of rapid maxillary expansion on pharyngeal airway pressure during inspiration evaluated using computational fluid dynamics. International
Journal of Pediatric Otorhinolaryngology, 78(8), 1258–1264.
15. Chen, S., Wang, J., Liu, D., Lei, L., Wu, W. et al. (2021). Open oral cavity has little effects on upper airway aerodynamics in children with obstructive sleep apnea syndrome: A computational fluid dynamics study based
on patient-specific models. Journal of Biomechanics, 121, 110383.
16. Bates, A. J., Doorly, D. J., Cetto, R., Calmet, H., Gambaruto, A. M. et al. (2015). Dynamics of airflow in a short inhalation. Journal of the Royal Society Interface, 12(102), 20140880.
17. Hahn, I., Scherer, P. W., Mozell, M. M. (1993). Velocity profiles measured for airflow through a large-scale model of the human nasal cavity. Journal of Applied Physiology, 75(5), 2273–2287.
18. Stéphano, J., Mauroy, B. (2021).Wall shear stress distribution in a compliant airway tree. Physics of Fluids, 33(3),
031907.
Published
2023-06-21
How to Cite
Xu, H. (2023). Computational Fluid Dynamics Analysis of Upper Airway Changes after Protraction Headgear and Rapid Maxillary Expansion Treatment. Molecular & Cellular Biomechanics, 20(1), 15-22. Retrieved from https://ojs.sin-chn.com/index.php/mcb/article/view/52
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