Korean J Orthod.  2012 Dec;42(6):318-328. 10.4041/kjod.2012.42.6.318.

Evaluation of hyoid bone movements in subjects with open bite: a study with real-time balanced turbo field echo cine-magnetic resonance imaging

• Karacay S
• Gokce S
• Yildirim E

• KMID: 1976684
• DOI: http://doi.org/10.4041/kjod.2012.42.6.318

Abstract

OBJECTIVE
To assess the position and movements of the hyoid bone during deglutition in patients with open bite.
METHODS
Thirty-six subjects were divided into 2 groups according to the presence of anterior open bite. The open bite group (OBG) and control group each comprised 18 patients with a mean overbite of -4.9 +/- 1.9 mm and 1.9 +/- 0.7 mm. The position of the hyoid bone during the 4 stages of deglutition was evaluated by measuring vertical and horizontal movement of the bone.
RESULTS
Interactions of group and stage showed no significant effect on the measurements (p > 0.05). However, when group and stage were evaluated individually, they showed significant effects on the measurements (p < 0.001). In OBG, the hyoid bone was more inferiorly and posteriorly positioned, and this position continued during the deglutition stages.
CONCLUSIONS
The hyoid bone reaches the maximum anterior position at the oral stage and maximum superior position at the pharyngeal stage during deglutition. Open bite does not change the displacement pattern of the bone during deglutition. The hyoid bone is positioned more inferiorly and posteriorly in patients with open bite because of released tension on the suprahyoid muscles.

Keyword

Magnectic resonance imaging; Dentofacial anomalies

MeSH Terms

Deglutition
Displacement (Psychology)
Humans
Hyoid Bone
Muscles
Open Bite
Oral Stage
Overbite

Figure

• 

  Figure 1 Anatomical structures visible on cine magnetic resonance imaging (a) nasal cavity, (b) nasopharynx, (c) tongue, (d) lips, (e) incisors, (f) floor of the mouth, (g) hyoid bone, (h) symphysis, (i) pharynx, (j) larynx, (k) spinal column, (l) spinal cord, (m) epiglottis, (n) cricoid cartilage and cricotracheal membrane, (o) trachea, and (p) upper portion of the esophagus.

• 

  Figure 2 Stages of deglutition. A, stage 1 (oral preparatory stage), the tongue tip contacts the maxillary incisors and/or the palatal mucosa; B, stage 2 (oral stage), the dorsum of the tongue loses contact with the soft palate; C, stage 3 (pharyngeal stage), the bolus crosses the posterior or inferior margin of the mandibular ramus; and D, stage 4 (esophageal stage), the bolus enters the esophageal opening.

• 

  Figure 3 Measurements used for evaluating hyoid bone movements. (1) H-S, distance between hyoidale (H, the most anterosuperior point of the hyoid bone) and point sella (S); (2) H-PP, perpendicular distance of hyoidale to the palatal plane (PP); (3) H-C3RGN, perpendicular distance of hyoidale to the line connecting the most anteroinferior point of the third cervical vertebra (C3) and retrognathion (RNG, the most prominent point of the posterior border of the symphysis); (4) H-C3, distance between hyoidale and the most anteroinferior point of the third cervical vertebra; and (5) H-RGN, distance between hyoidale and retrognathion.

• 

  Figure 4 Bland-Altman plots of the average differences in the measurements. A, H-S; B, H-C3RGN; C, H-PP; D, H-C3; and E, H-RGN. The overall bias of each measurement is shown, along with the 95% agreement interval. SD, Standard deviation. Refer to Figure 3 for measurements and abbreviations.

• 

  Figure 5 Plots of the mean A, H-S; B, H-C3RGN; C, H-PP; D, H-C3; and E, H-RGN values as a function of the stages of deglutition in the open bite group (group 1) and the control group (group 2). Refer to Figure 3 for measurements and abbreviations.

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