Changes in 3D Midfacial Parameters after Biomimetic Oral Appliance Therapy in Adults

Abstract

Background/objectives/aims: Controversy exists regarding maxillary bone changes in nongrowing adults. However, previous studies have relied on two-dimensional (2D) cephalo metric analyses, which may be unable to capture three-dimen sional (3D) pheno mena. In this study, we investigated 2D and 3D parameters to test the null hypothesis that maxillary bone volume cannot be changed in nongrowing adults that had been diagnosed with mid facial underdevelopment. Methods: After obtaining informed consent, we undertook 3D cone beam computed tomography scans of 11 consecutive, adult patients prior to and after biomimetic, oral appliance therapy. The mean treatment time was 18.4 months ± 2.5 using the DNA appliance® system. The intramolar width and 3D volume of the midface was calculated prior to and after the mid facial redevelopment protocol. The findings were subjected to statistical analysis. Results: The mean intramolar increased from 33.5 mm ± 3.4 prior to treatment to 35.8 mm ± 2.9 after appliance therapy (p = 0.0003). Similarly, the mean midfacial bone volume was 17.4 cm3 ± 3.9 prior to treatment and increased to 19.1 cm3 ± 2.6 after appliance therapy (p = 0.0091). Conclusion: These data support the notion that maxillary bone width and volume can be changed in nongrowing adults. Furthermore, midfacial redevelopment may provide a potentially-use ful method of managing adults diagnosed with obstructive sleep apnea, using biomimetic, oral appliances.