Malocclusion or laterorhinia: Which one impacts aesthetic facial perception the most?

INTRODUCTION: This study aimed to evaluate the perception of facial attractiveness when nose and teeth, together or isolated, present different degrees of disharmony. The secondary objective was to compare the perception of laypersons with that of dentists. MATERIALS AND METHODS: This cross-sectional observational study included 112 individuals (58 laypersons and 54 dentists) that evaluated 6 manipulated images of the face of the same model, scoring their attractiveness using 10 cm Visual Analogue Scales (VAS), with least and most attractive at the left and right anchors, respectively. The images contained manipulations performed only on the nose (laterorhinia) and mouth (misaligned teeth), as follows: (1) standard photograph, with symmetrical nose + aligned teeth; (2) 2 mm nasal deviation + aligned teeth; (3) 4 mm nasal deviation + aligned teeth; (4) symmetrical nose + misaligned teeth; (5) 2 mm nasal deviation + misaligned teeth and (6) 4 mm nasal deviation + misaligned teeth. We used the repeated measures ANOVA test and Tukey's post-test for intra-group comparison of the images. The independent t-test was used for inter-group comparison of each image. RESULTS: In the laypersons' group, the highest grades were given to images with aligned teeth and the lowest to misaligned teeth (smallest mean difference = 2.88 cm). For this group, there was no statistically significant difference (P-values ranged from .988 to 1.000) between scores of the three images in which teeth were aligned (range of 7.70-7.78 cm). In the group of dentists, highest grades were given to images with aligned teeth and the lowest to misaligned teeth. Difference between images 3 and 4 was not statistically significant (P = .204). All other differences between any image of straight teeth and any image with misaligned teeth were significant and the smallest mean difference between the two groups of images was 1.87 (P = .039). However, in the images with aligned teeth, there was also a statistically significant difference with higher scores to the images with symmetrical nose in contrast with those with significant laterorhinia (mean difference = 1.03 cm). CONCLUSION: Teeth disharmonies had a more negative impact on the aesthetic perception of the face than did nose deviations, for both dentists and laypersons.

Reconsidering the role of nasolabial angle in premolar extraction decision-making: A case-series study.

OBJECTIVES: To evaluate the impact of changes in upper incisor inclination and position on the alteration of the nasolabial angle (NLA) in a series of cases involving the extraction of four first premolars. MATERIALS AND METHODS: The study included 41 patients who underwent orthodontic treatment with premolar extractions. The patients were divided into two groups based on their pretreatment NLA values: Group 1 (NLA ≤ 100°) and Group 2 (NLA > 100°). Measurements of NLA, U1.NA and U1-NA were obtained before and after treatment and U1-Ls pretreatment measure was registered. Statistical analyses were performed to compare the differences in NLA, U1.NA and U1-NA between the two groups and to evaluate the influence of these variables added to U1-Ls (T1) on NLA changes. RESULTS: The results showed that Group 1 exhibited significant changes in NLA, while Group 2 did not. However, both groups showed significant changes in U1.NA and U1-NA. In Group 1, 80% of the individuals presented an increase in NLA and 20% no changes. In Group 2, 10% presented a decrease, 57% no changes and 33% an increase in NLA values. Multiple linear regression analysis indicated that the group factor had a statistically significant influence on NLA variation. Additionally, in Group 2, a negative correlation was observed between changes in U1.NA and NLA. CONCLUSIONS: The findings suggest that individuals with higher pretreatment NLA values tend to maintain their NLA values even after the correction of upper incisor inclination.

Pain perception and expectation related to interradicular mini-implants insertion: a systematic review and meta-analysis.

OBJECTIVES: The aim of this systematic review was to compare the expectation and perception of pain reported by patients before and after the installation of interradicular mini-implants. MATERIALS AND METHODS: Electronic search was performed in six databases. Inclusion criteria were randomized controlled trials (RCTs) or non-randomized controlled clinical trials (nRCTs); studies using mini-implants in the interradicular region; assessment of pain intensity by visual analogue or numerical scale. The risk of bias assessment was based on the Rob 2 tool and Robins-I. RESULTS: A total of 1566 articles were retrieved, and 21 met the eligibility criteria. Six were classified as high risk, one as critical and the other one as uncertain, according to the Robins-I tool. In articles evaluated by the Rob2 tool, ten were classified as serious risk and three as moderate risk. A meta-analysis was also performed. Weighted means were calculated among the studies using the random-effects model and forest plots were generated. Heterogeneity was assessed through the Q test and I2 statistics. It was observed, with moderate evidence, that on a scale of 0 to 10, the pain expectation (effect size 4.75) is higher than that effectively pain generated by the procedure (effect size 1.94). CONCLUSION: Pain expectation was greater than that actually generated by the procedure, being almost non-existent 7 days postoperatively. CLINICAL RELEVANCE: This study may help the clinician to reassure the patient regarding the sensations that could be experienced during and after the installation.

Pharyngeal airway subdivisions in 3-dimensional analysis: Differences between anterior and posterior anatomic boundaries.

INTRODUCTION: This study aimed to evaluate if there were differences between anterior and posterior anatomic boundaries used for the 3-dimensional determination of pharyngeal airway. METHODS: The sample included 150 cone-beam computed tomography scans from healthy patients divided according to (1) age: 6-11, 12-16, and ≥16 years; (2) sex: female and male; (3) anteroposterior skeletal pattern: Class I, II, and III; (4) vertical pattern: brachyfacial, mesofacial, and dolichofacial; and (5) craniocervical inclination (CCI): natural head posture, head flexion, and head extension. Anatomic regions were created to determine the correspondences between structures anteriorly and posteriorly to the pharyngeal airway. RESULTS: The location of the epiglottis, vallecula, hyoid, C2, and C3 were statistically different according to the CCI, and the location of vallecula, C3, and C4 were different according to sex. However, no statistically significant differences were observed between the frequencies of anterior and posterior anatomic region locations among age and different anteroposterior and vertical skeletal patterns. Posterior landmarks tend to be located below the anterior ones; consequently, the anatomic subregion they define will also be located below. CONCLUSIONS: Anterior and posterior structures and vertical and anteroposterior skeletal patterns may determine upper airway limits regardless of age. However, the studies must be paired according to sex, and CCI must be standardized.

Influence of clinical and demographic factors on the oral health-related quality of life of patients with cleft lip and palate undergoing orthodontic treatment: a systematic review and meta-analysis.

OBJECTIVE: The purpose of this study was to evaluate the influence of orthodontic treatment on the oral health-related quality of life (OHRQoL) of patients with cleft lip and palate. SEARCH METHODS: Electronic searches were conducted in Pubmed, Scopus, Web of Science, Cochrane Library, VHL, and OpenGrey databases, completed in January 2021. SELECTION CRITERIA: Cross-sectional and longitudinal observational studies that presented an assessment of OHRQoL in cleft patients undergoing orthodontic treatment were included, according to PRISMA guidelines. Contacts via email were made with authors, to clarify inaccuracies or request additional data. DATA COLLECTION AND ANALYSIS: The entire process was accomplished by two authors, in case of disagreement, a third author mediated the discussion until there was a consensus. Risk assessment was performed by the Fowkes and Fulton qualifier, and the quality of evidence, assessed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool. A meta-analysis was performed considering the domains combined into three large groups (physical, psychological, and social). The questionnaires were standardized as to the scores and their direction. RESULTS: A total of 3822 studies were retrieved. After excluding duplicates, the titles and abstracts of the remaining articles were analysed. Twenty-eight articles were read in full; 13 met the eligibility criteria; 12 articles showed sufficient methodological quality and 7 were included in the quantitative assessment. The included studies were published between 2011 and 2019. The samples comprised 19 to 183 patients of both sexes. GRADE showed low evidence when compared to the control group, sexes, age, and types of cleft and very low evidence among longitudinal articles. CONCLUSIONS: The OHRQoL is lower in orthodontic patients with cleft than in those without. The OHRQoL of patients with cleft undergoing orthodontic treatment is not influenced by gender or age group, considering children and adolescents, but it is influenced by the type of cleft. The OHRQoL of patients with CLP does not undergo significant changes during orthodontic treatment. LIMITATIONS: The variety of instruments for measuring OHRQoL rendered meta-analysis difficult. REGISTRATION: PROSPERO database number CRD42017054764.

Evaluation of zirconia surface roughness after aluminum oxide airborne-particle abrasion and the erbium-YAG, neodymium-doped YAG, or CO2 lasers: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: Veneer chipping and crown decementation are the most frequent failures in restorations using zirconia as an infrastructure. Increasing the roughness of the zirconia surface has been suggested to address this problem. PURPOSE: The purpose of this systematic review and meta-analysis was to evaluate yttria-stabilized tetragonal zirconia polycrystal surface roughness, produced with aluminum oxide airborne-particle abrasion and the erbium yttrium aluminum garnet (YAG), neodymium-doped YAG, or CO2 lasers. MATERIAL AND METHODS: This study was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. The review identified relevant studies through December 2017 with no limit on the publication year in the search databases: Web of Science, Scopus, and MEDLINE via PubMed. The selected studies were submitted to a risk of bias assessment. The means and standard deviations of roughness were evaluated for the meta-analysis using Review Manager software. RESULTS: The 17 studies that met all inclusion criteria presented a medium risk of bias. All the treatment methods tested were able to create a roughness on the yttria-stabilized tetragonal zirconia polycrystal surface. The I2 test values presented a high heterogeneity among the studies. CONCLUSIONS: The presintered specimens submitted to airborne-particle abrasion had higher surface roughness compared with abrasion after the sintering process. Irradiation with the neodymium-doped YAG and CO2 lasers was destructive to the zirconia surfaces. The erbium laser used with lower energy intensity appears to be a promising method for surface treatment.

Influence of canine vertical position on smile esthetic perceptions by orthodontists and laypersons.

INTRODUCTION: Our objectives were to verify the impact of alterations in the vertical position of the maxillary canines in smile esthetic perceptions and to determine whether exposure of the gingival margins directly affects laypersons' and orthodontists' perceptions. METHODS: A smile photograph of a male subject showing gingival zeniths was selected, and the canine vertical positions were symmetrically modified in increments of 0.5 mm, creating 4 new images varying from 1.0 mm of intrusion to 1.0 mm of extrusion, with and without gingival exposure. The total of 10 images were evaluated by 60 orthodontists and 60 laypersons, who determined the level of attractiveness of each smile on a visual analog scale. RESULTS: For both orthodontists and laypersons, the canine vertical position modifications had a statistically significant influence (P <0.0001), and the gingival exposure had no significant influence on the smile esthetic evaluations. CONCLUSIONS: For both groups of evaluators, the most attractive smiles were the standard smile and the smiles with 0.5 mm of intrusion. The less attractive smiles were those with 1.0 mm of extrusion and 1.0 mm of intrusion. Orthodontists were more critical in their assessments. There were no differences in the esthetic evaluations of smiles with and without gingival margin exposure for both groups of evaluators.

Clinical recognition of mouth breathers by orthodontists: A preliminary study.

INTRODUCTION: A routine diagnosis of a patient's breathing status performed by an orthodontist normally includes visual assessment, medical history, clinical examination of habitual lip posture, size and shape of the nostrils, reflex control of the alar muscle and respiratory tests, and the dental mirror test. The objective of this study was to test the recognition of mouth breathers in young persons by an orthodontist and agreement with an otolaryngologist's reference diagnosis when routine assessments were carried out. METHODS: Three independent and blind evaluations were conducted on the same day by 2 orthodontists independently (anamnesis and breathing tests, respectively) and an otolaryngologist (rhinoscopy, nasal endoscopy, and visual assessment). The weighted kappa coefficient was used to test intraexaminer and interexaminer agreement. The frequencies of answers and findings were reported for each breathing status. RESULTS: Fifty-five volunteers composed the sample of this study; 20 participants were nasal breathers, and 35 participants were classified as mouth breathers (and subdivided into mouth breathers with airway obstruction and mouth breathers by habit) by the otolaryngologist. The weighted kappa coefficient showed poor interrater agreement for most comparisons. CONCLUSIONS: Recognition of mouth breathing in young persons by orthodontists is poor.

Genetic polymorphisms underlying the skeletal Class III phenotype.

INTRODUCTION: Our goal was to verify the association between candidate polymorphisms and skeletal Class III malocclusion in a well-characterized homogeneous sample set. METHODS: Thirty-five single-nucleotide polymorphisms were studied from 10 candidate loci in 54 Class III subjects and 120 controls. Skeletal Class III characteristics included ANB angle less than 0°, SNB angle greater than 83° (mandibular prognathism), SNA angle less than 79° (maxillary deficiency), Class III molar relationship, and negative overjet. Inclusion criteria for the controls were ANB angle between 0° and 4°, Class I molar relationship, and normal overjet. Chi-square and Fisher exact tests and principal component (PC) analysis were used to determine overrepresentation of marker alleles with alpha of 0.05. Odds ratios and 95% confidence intervals were calculated. RESULTS: MYO1H (rs10850110 AG) (P = 0.001) with PC2 and between FGF10 (rs593307 A

Prosthetic replacement vs space closure for maxillary lateral incisor agenesis: A systematic review.

INTRODUCTION: Defining the best treatment for maxillary lateral incisor agenesis is a challenge. Our aim in this study was to determine, with the evidence available in the literature, the best treatment for maxillary lateral incisor agenesis in the permanent dentition, evaluating the esthetic, occlusal (functional), and periodontal results between prosthetic replacement and orthodontic space closure. METHODS: Electronic databases (CENTRAL, PubMed, Web of Science, Scopus, and LILACS) were searched in September 2014 and updated in January 2015, with no restriction on language or initial date. A manual search of the reference lists of the potential studies was performed. Risk of bias was assessed by the Newcastle Ottawa Scale. RESULTS: The search identified 2174 articles, of which 1196 were excluded because they were duplicates. Titles and abstracts of 978 articles were accessed, and 957 were excluded. In total, 21 articles were read in full, and 9 case-control studies were included after applying the inclusion and exclusion criteria. Data were extracted from the articles selected, and a table was compiled for comparison and analysis of the results. There were no randomization and blinding, and the risk of bias evaluation found gaps in compatibility and outcome domains in almost all selected studies. CONCLUSIONS: Tooth-supported dental prostheses of maxillary lateral incisor agenesis had worse scores in the periodontal indexes than did orthodontic space closure. Space closure is evaluated better esthetically than prosthetic replacements, and the presence or absence of a Class I relationship of the canines showed no relationship with occlusal function or with signs and symptoms of temporomandibular disorders.

Reliability of upper airway linear, area, and volumetric measurements in cone-beam computed tomography.

INTRODUCTION: Our objective was to assess the intraexaminer and interexaminer reliabilities of upper airway linear, area, and volumetric measurements in cone-beam computed tomography. METHODS: Cone-beam computed tomography scans of 12 subjects were randomly selected from a pool of 132 orthodontic patients. An undergraduate student, an orthodontist, and a dental radiologist independently made linear, area, and volumetric measurements. Linear anteroposterior and transversal measurements, cross-sectional area, sagittal area, minimum axial area, and volume measurements were made. The intraclass correlation coefficient (ICC) was used to assess intraexaminer and interexaminer reliabilities, and measurement errors were assessed. Agreement was further assessed with the Bland-Altman method and 95% limits of agreement. RESULTS: Overall, the ICC values indicated good reliability for the measurements assessed. The ICC values were greater than 0.9 (excellent) for 93% of intraexaminer and 73% of interexaminer assessments. Transversal width measurements and cross-sectional area at the level of the vallecula, however, had only moderate reliability (minimum ICC, 0.63), large 95% limits of agreement, and the greatest mean measurement errors (as high as 16% and 13% of the mean measurements, respectively). Linear anteroposterior measurements; cross-sectional areas at the levels of the palatal plane, soft palate, and tongue; and sagittal area and volume were reliable measurements, with a minimum ICC of 0.93 and more restricted limits of agreement. CONCLUSIONS: Based on these results, airway assessments by examiners with different backgrounds might have reliable anteroposterior linear measurements; cross-sectional areas at the levels of the palatal plane, soft palate, and tongue; and sagittal area and volume. The unreliable measurements were linear width, cross-sectional area at the level of the vallecula, and minimum axial area.

Redirection of palatally ectopic maxillary canines: Case report and proposition of an interceptive sequential guideline.

The eruptive deviation of the permanent maxillary canine must be identified early, at the beginning of the second transitional period of the mixed dentition. Acting at this moment is fundamental for its spontaneous redirection and eruption. The aim of the paper is to present a case where the extraction of the deciduous canines was the choice for redirecting the maxillary permanent canines with eruptive palatal deviation, as well as to suggest a sequence of procedures for diagnosis and choice of treatment. The success of deciduous canine extraction in redirecting the ectopic permanent canines is discussed in this case, as well as aspects that might lead to failure. Still, it highlights the importance of computed tomography for choosing conservative treatment or traction, including it in the sequential guideline for acting in these cases.

Successful treatment of dumping syndrome with diazoxide in an infant with hypoplastic left heart syndrome.

Summary: Dumping syndrome is a rare but potentially serious condition that causes inappropriate postprandial hyperinsulinemia leading to hypoglycemia in children following gastrointestinal surgeries. While dietary modifications are often the first line of treatment, severe cases may require pharmacological intervention to prevent severe hypoglycemia. We present a case of successful treatment of dumping syndrome with diazoxide. A 2-month-old infant with left hypoplastic heart syndrome who underwent single ventricle palliation pathway and developed feeding intolerance that required Nissen fundoplication. Postprandial hypoglycemia was detected following the procedure, with glucose level down to 12 mg/dL, and the diagnosis of dumping syndrome was established. The patient was successfully managed with diazoxide, which effectively resolved postprandial hypoglycemia without any major adverse events. The patient was eventfully weaned off the medication at the age of 5 months. This case highlights the potential role of diazoxide in the management of pediatric patients with postprandial hyperinsulinemic hypoglycemia secondary to dumping syndrome. Learning points: Dumping syndrome is a possible complication of gastrointestinal surgeries and should be suspected in children with abnormal glucose levels. Postprandial hyperglycemia should be monitored closely for significant subsequent hypoglycemia. Diazoxide might be considered as part of the treatment plan for dumping syndrome.

Class II subdivision treatment and stability with asymmetric Herbst appliance: A case report.

Non-surgical treatment of Class II subdivision may involve complex mechanics or asymmetric tooth extraction in its resolution. This report demonstrates the result and the short-term stability of Class II subdivision treated with asymmetrically installed Herbst appliance followed by conventional fixed orthodontic appliance. The approach allowed the correction of the unilateral Class II molar relationship and increased overjet, as well as the deviation of dental midlines, with improvement in lip posture and facial profile. The results remained stable two years after treatment, confirming the treatment success.

Tooth movement toward alveolar bone grafting with rhBMP-2 in a child with unilateral cleft lip and palate: Case report with long-term follow-up.

The secondary alveolar bone grafting procedure is typically recommended during the late mixed dentition phase, prior to the eruption of the permanent canine, in patients with cleft lip and palate. The anatomical and functional adaptations observed in the grafted area allow spontaneous migration and eruption of the adjacent maxillary canine. An alveolar bone graft can be performed using autogenous bone or recombinant human bone morphogenetic protein-2 (rhBMP-2). Employing rhBMP-2 in a collagen membrane eliminates the need for a donor site, thus reducing surgical morbidity. This paper aims to present a case involving complete orthodontic rehabilitation with a three-year follow-up of a male patient with a unilateral complete cleft lip and palate, posterior and anterior crossbite, where grafting was performed with rhBMP-2 at a single centre. Orthodontic intervention began at 8 years of age with rapid maxillary expansion, followed by facemask therapy. The alveolar bone grafting procedure was performed using rhBMP-2 in a collagen membrane, according to the surgical protocol developed by the Oslo team. Comprehensive orthodontic treatment started 15 months post bone grafting, during which the maxillary permanent lateral incisor distal to the alveolar cleft was successfully moved mesially into the grafted region. This intervention resulted in adequate occlusal and periodontal outcomes. The alveolar graft with rhBMP-2 produced adequate and stable alveolar bone formation, facilitating tooth eruption, orthodontic movement, and stability at the cleft site.

Descriptive analysis of the cases published in the Align® Global Gallery.

INTRODUCTION: Social media enhanced access to information, making it easier to share dental treatments. OBJECTIVE: This study aimed to conduct a descriptive analysis of the clinical cases published on the Align® Global Gallery platform. MATERIAL AND METHODS: A retrospective cross-sectional study of 1,582 cases was conducted, data extracted referred to the following basic information: case number; patient's age; reported gender; Invisalign® package modality; treatment time; aligner exchange protocol; total number of aligners per arch; type of retainers, and inclusion of initial and final panoramic and cephalometric radiographs. RESULTS: The majority were young (mean age 24.6 years, SD = 11.6), female patients (69.1%) with Class I malocclusion (39.4%) and crowding (77.9%). Comprehensive treatment was common (66.5%), with an average treatment time of 18 months (SD = 8.56; 95% CI = 17.6-18.5), with the most frequently reported aligner exchange protocol being 7 days (49.5%), with an average of 50.6 aligners in the upper arch (SD = 26.9; 95% CI = 49.2-51.9), and 48.7 in the lower arch (SD = 26.1; 95% CI = 47.4-50.0). Arch expansion (66.9%) and interproximal reduction (59.7%) were common approaches, while extractions were rare (4.3%). In most cases, initial lateral cephalometric (80.4%) and panoramic (93.3%) radiographs were presented. However, the final radiograph count dropped, with lateral cephalometric at 69.2%, and panoramic at 82.2% of cases. CONCLUSION: Cases in the Align®Global Gallery mostly feature Class I patients with crowded teeth, treated with expansion and interproximal reduction. The absence of standardized information and post-treatment data restricts the applicability of these findings to broader Invisalign® treatment trends.

Does mandibular advancement ortho-surgical procedure cause condyle changes? A case-series analysis.

INTRODUCTION: Mandibular advancement surgery corrects bone bases while establishing patients' functional and aesthetic rehabilitation. However, little is known about the results of this procedure in the structures that make up the stomatognathic system, as the condyles. OBJECTIVE: This study aimed to evaluate the structural and positional changes of mandibular condyles in ortho-surgical patients who underwent mandibular advancement surgery. MATERIAL AND METHODS: A prospective investigation was conducted with cone-beam computed tomography images. Using Dolphin Imaging® software, seven ortho-surgical patients with Angle Class II malocclusion and mandibular deficiency were evaluated. The images assessed were obtained at pre-surgical phase and after, at least, 1 year of the procedure. To study the structural and positional changes of condyles, linear and angular measurements were obtained, and the right and left sides of patients were compared. Descriptive statistical analysis was performed and, in order to verify possible significant differences, normality tests (Kolmogorov-Smirnov) were applied, followed by a paired t-test to define significance. RESULTS: For all measures evaluated in this study, no statistically significant differences were found. CONCLUSION: The ortho-surgical procedure performed did not change the structure and position of the condyles of patients who underwent surgical mandibular advancement. Right and left mandibular condyles behaved similarly, suggesting stability and condylar adaptation after surgery.

Pharyngeal airway characterization in adolescents related to facial skeletal pattern: a preliminary study.

INTRODUCTION: The objective of this study was to characterize the volume and the morphology of the pharyngeal airway in adolescent subjects, relating them to their facial skeletal pattern. METHODS: Fifty-four subjects who had cone-beam computed tomography were divided into 3 groups-skeletal Class I, Class II, and Class III-according to their ANB angles. The volumes of the upper pharyngeal portion and nasopharynx, and the volume and morphology of the lower pharyngeal portion and its subdivisions (velopharynx, oropharynx, and hypopharynx) were assessed with software (version 11.5; Dolphin Imaging & Management Solutions, Chatsworth, Calif). The results were compared with the Kruskal-Wallis and the Dunn multiple comparison tests to identify intergroup differences. Correlations between variables assessed were tested by the Spearman correlation coefficient. Correlations between the logarithms of airway volumes and the ANB angle values were tested as continuous variables with linear regression, considering the sexes as subgroups. RESULTS: The minimum areas in the Class II group (112.9 ± 42.9, 126.9 ± 45.9, and 142.1 ± 83.5 mm(2)) were significantly smaller than in Class III group (186.62 ± 83.2, 234.5 ± 104.9, and 231.1 ± 111.4 mm(2)) for the lower pharyngeal portion, the velopharynx, and the oropharynx, respectively, and significantly smaller than the Class I group for the velopharynx (201.8 ± 94.7 mm(2)). The Class II group had a statistically significant different morphology than did the Class I and Class III groups in the velopharynx. There was a tendency to decreased airway volume with increased ANB angle in the lower pharyngeal portion, velopharynx, and oropharynx. In the upper pharyngeal portion, nasopharynx, and hypopharynx, there seemed to be no association between the airway volume and the skeletal pattern. CONCLUSIONS: The Class II subjects had smaller minimum and mean areas (lower pharyngeal portion, velopharynx, and oropharynx) than did the Class III group and significantly less uniform velopharynx morphology than did the Class I and Class III groups. A negative correlation was observed between the ANB value and airway volume in the lower pharyngeal portion and the velopharynx (both sexes) and in the oropharynx (just in male subjects).