Analogue simulation of pharyngeal airflow response to Twin Block treatment in growing patients with Class II1 and mandibular retrognathia

The flow dynamics of respiratory airflow is the basic factor that influences the ventilation function of the upper airway. This research aimed to investigate the pharyngeal flow field characteristics after Twin Block (TB) treatment in growing patients with Class II(1) and mandibular retrognathia by computation fluid dynamics (CFD) simulation. Cone beam computed tomography (CBCT) scans of patients who have completed TB treatment (n = 30) and about to accept TB treatment (n = 30) were reconstructed. After CFD simulation, correlations between the pharyngeal pressure drop and morphological parameters were further analyzed. During inspiration, we found that the pressure minimum occurred in the hypopharynx, while the maximum pressure drop and velocity was located in the oropharynx. After TB treatment, the oropharynx and hypopharynx showed significant differences in airflow features, and the most obvious change was observed in the oropharynx. A significant correlation was discovered between the change amount of oropharyngeal pressure drop and volume (r = 0.694, p = 0.001), mean cross-sectional area (r = 0.859, p = 0.000), and ratio of the minimum and mean cross-sectional area (r = 0.898, p = 0.000) of the oropharynx. Our research suggested that the pharyngeal airflow characteristics response positively to mandibular advancement with the enlargement in volume, cross-sectional area and more uniform oropharyngeal area distribution.