title: Cephalometric evaluation of tongue position and airway remodelling in children treated with swallowing occlusal contact intercept appliance (S.O.C.I.A.).
abstract: BACKGROUND
  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.
  
  
  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.
authors.affiliation: Department of Clinical and Experimental Medicine, School of Dentistry, University of Foggia, via Rovelli 48, Foggia 71100, Italy. Electronic address: drdomenicociavarella2@yahoo.it.
authors.forename: Domenico
authors.initials: D
authors.lastname: Ciavarella
authors.affiliation: Department of Clinical and Experimental Medicine, School of Dentistry, University of Foggia, via Rovelli 48, Foggia 71100, Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Lo Russo
authors.affiliation: Department of Clinical and Experimental Medicine, School of Dentistry, University of Foggia, via Rovelli 48, Foggia 71100, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Mastrovincenzo
authors.affiliation: Department of Clinical and Experimental Medicine, School of Dentistry, University of Foggia, via Rovelli 48, Foggia 71100, Italy.
authors.forename: Saverio
authors.initials: S
authors.lastname: Padalino
authors.affiliation: Department of Clinical and Experimental Medicine, School of Dentistry, University of Foggia, via Rovelli 48, Foggia 71100, Italy.
authors.forename: Graziano
authors.initials: G
authors.lastname: Montaruli
authors.affiliation: Department of Clinical and Experimental Medicine, School of Dentistry, University of Foggia, via Rovelli 48, Foggia 71100, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Giannatempo
authors.affiliation: Department of Clinical and Experimental Medicine, School of Dentistry, University of Foggia, via Rovelli 48, Foggia 71100, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Cassano
authors.affiliation: Department of Clinical and Experimental Medicine, School of Dentistry, University of Foggia, via Rovelli 48, Foggia 71100, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Laino
authors.affiliation: Department of Clinical and Experimental Medicine, School of Dentistry, University of Foggia, via Rovelli 48, Foggia 71100, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Lo Muzio
mesh_terms: D056151:Airway Remodeling; D002508:Cephalometry; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008312:Malocclusion, Angle Class II / Q000628:therapy; D009968:Orthodontic Appliances, Removable; D063173:Retrognathia / Q000628:therapy; D012189:Retrospective Studies; D013284:Stomatognathic System / Q000033:anatomy & histology
keywords: Cephalometric evaluation; Functional appliance; Open bite; Upper airway obstruction; Upper airway space