The Journal
nasopharyngeal Review of Literature
depth are significantly larger in subjects with
normal occlusion than in those with Class II
14
malocclusion. According to Sorensen et al
airway adequacy was related to the size and
position of the mandible rather than maxillary
variables. The debate in orthodontics concerning the role
of respiration in the etiology of malocclusion
and facial deformity dates back over 100 years.
Current trends in clinical practice are focused
on attempting to modify growth in an endeavor
to prevent the development of orthodontic
problem or at least to minimize the effect of
environmental factors that may alter growth
unfavourably. A logical extension of this interest
in early treatment and growth modification is the
revival of the controversy over the role of
respiration. Many current concepts are based
on the subjective impressions and anecdotal
reports that form the bulk of clinical literature on
this subject. A surprisingly large number of
clinicians now recommend surgical intervention
or other forms of non orthodontic treatment
directed at "improving" nasal airway function. It
is appropriate to examine the validity of these
ideas and attempt to distinguish between fact
and opinion. An evaluation of previous research
and some work currently in progress should
provide the clinician with the necessary data to
form his own opinion on the main aspects of the
controversy.
A study by Marcos Freitas and Janson in 2006
was done in Brazilian population to compare the
upper and lower pharyngeal airways in Class I
and Class II malocclusions and different growth
patterns with the mean age group of 11.64 years
and concluded that malocclusion does not
influence the lower pharyngeal airway width6.
Another study in 2007 by Kirjavamen was done
to evaluate the effects of cervical headgear
treatment to Class II division I malocclusion on
the upper airway structures in children and
concluded that headgear treatment is
associated with increase in the retropalatal
airway space.
So an attempt has been made to correlate the
upper and lower pharyngeal airway in adult
Indian population and also to evaluate the
sexual dimorphism in soft tissue pharyngeal
airway structures.
Thus, it might be considered to be useful that
the assessment of the pharyngeal structures be
included with the orthodontic diagnosis and
treatment planning, as the functional,
positional, and structural assessments of the
dentofacial pattern are carried out. Associations
of the pharyngeal airway sizes and the different
types of malocclusions and growth patterns can
then be easily identified and determined 10 .
36
The current version of this old debate is
reaching new heights of absurdity and
vehemence between protagonists of
diametrically opposed views. Because much of
the argument is conducted at various
intellectual levels, ranging from polemics to
scientific discourse, it is inevitable that
confusion reigns. It is hardly just to blame the
practicing clinician for not knowing whom to
believe. The extensive literature in this subject
provides a choice of papers from which one
may judiciously select an impressive array of
references to support any prejudice or point of
view. It becomes necessary, therefore, to
establish any ground rules for a fair evaluation
of what is known, what we need to know and
what conclusions are appropriate to date.
Ultimately, this process translates into how
Vol. 14 No. 2
May-August 2018