Combined Orthodontic and Surgical Treatment in a 8-Years-Old Patient Affected By Severe Obstructive Sleep Apnea: A Case-Report

Gracco, Antonio; Bruno, Giovanni; Stefani, Alberto De; Marchese‐Ragona, Rosario; Mazzoleni, Sergio; Stellini, Edoardo

doi:10.17796/1053-4628-42.1.14

Cited by 9 publications

(33 citation statements)

References 3 publications

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“…The included studies were categorized into one randomized controlled trial (RCT) [ 27 ], two non-randomized controlled trials (NRCTs) [ 22 , 26 ], two observational case–control studies [ 24 , 25 ] and five case reports [ 18 , 19 , 20 , 21 , 23 ]. The sample sizes ranged from one to 80 subjects.…”

Section: Resultsmentioning

confidence: 99%

“…The mean BMI varied between 15.75 and 22.4, however, only five studies reported the BMI [ 19 , 22 , 23 , 25 , 26 ]. To diagnose and evaluate the severity of OSA, eight studies [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 27 ] employed PSG and two [ 18 , 26 ] used home sleep studies (HSTs). All study participants received surgery and orthodontic treatment.…”

Section: Resultsmentioning

confidence: 99%

“…All study participants received surgery and orthodontic treatment. Among the surgical treatments, AT was the most commonly used, but there was also one case report [ 21 ] which performed other types of surgery: epiglottoplasty and a reduction of the tongue base. Two types of orthodontic treatment were carried out: RME or MA.…”

Section: Resultsmentioning

confidence: 99%

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Combined Surgical and Orthodontic Treatments in Children with OSA: A Systematic Review

Templier

Rossi

Miguez

et al. 2020

JCM

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Obstructive sleep apnea (OSA) is a sleeping breathing disorder. In children, adenotonsillar hypertrophy remains the main anatomical risk factor of OSA. The aim of this study was to assess the current scientific data and to systematically summarize the evidence for the efficiency of adenotonsillectomy (AT) and orthodontic treatment (i.e., rapid maxillary expansion (RME) and mandibular advancement (MA)) in the treatment of pediatric OSA. A literature search was conducted in several databases, including PubMed, Embase, Medline, Cochrane and LILACS up to 5th April 2020. The initial search yielded 509 articles, with 10 articles being identified as eligible after screening. AT and orthodontic treatment were more effective together than separately to cure OSA in pediatric patients. There was a greater decrease in apnea hypoapnea index (AHI) and respiratory disturbance index (RDI), and a major increase in the lowest oxygen saturation and the oxygen desaturation index (ODI) after undergoing both treatments. Nevertheless, the reappearance of OSA could occur several years after reporting adequate treatment. In order to avoid recurrence, myofunctional therapy (MT) could be recommended as a follow-up. However, further studies with good clinical evidence are required to confirm this finding.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Combined Surgical and Orthodontic Treatments in Children with OSA: A Systematic Review

Templier

Rossi

Miguez

et al. 2020

JCM

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“…Given the growing recognition of orofacial characteristics as important developmental factors of sleep disorders, as well as their therapeutic implications in some disorders (such as OSAS, snoring and bruxism), dentists are nowadays more conscious of sleep disorders, with a potential role in the diagnostic and therapeutic process [ 22 , 23 , 24 , 25 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

Validity of the STOP-Bang Questionnaire in Identifying OSA in a Dental Patient Cohort

et al. 2020

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Background and objectives: Obstructive Sleep Apnea represents a widespread problem in the population, but it is often not diagnosed and not considered a true pathology. Different diagnostic tools are available for the diagnosis of sleep apnea. This study aims to demonstrate the ability of the STOP-Bang (Snoring, Tiredness, Observed apnea, high blood Pressure, Body mass index, Age, Neck circumference, and Gender) questionnaire in identifying subjects with Obstructive Sleep Apnea (OSA) Syndrome, highlighting the role of dentists as epidemiological sentinels. Materials and methods: the STOP-Bang questionnaire was administered to a cohort of 1000 patients, assessing three private dental clinics in Italy. Excessive daytime sleepiness was measured using Epworth Sleepiness Scale (ESS) and defined as ≥ 10. Subjects were considered at risk of OSA if they had three or more positive items at STOP-Bang and were invited to undergo further examination with a type 3 polygraph. Presence of OSA was measured with the apnea-hypopnea index (AHI) and defined as AHI ≥ 5. Results: 482/1000 subjects (48.2%) had three or more positive items in the STOP-Bang questionnaire and were considered at risk for Obstructive Sleep Apnea Syndrome (OSAS). Excessive daytime sleepiness (EDS ≥ 10) was more frequent among subjects at risk for OSAS (73/482, 15.1%) vs. those not at risk for OSAS (30/518, 5.8%) (p < 0.0001). Moreover, 153/482 subjects at risk for OSAS (31.7%) accepted further examination with a type 3 polygraph. Presence of OSAS (AHI ≥ 5) was suggested in 121/153 subjects (79.1%, 95% CI 71.6% to 85.1%), with 76/121 subjects (62.8%) needing treatment (AHI ≥ 15). Conclusion: the high prevalence of OSAS highlights the role of dentists as “epidemiological sentinels”. The STOP-Bang questionnaire is a simple and efficacious instrument for screening sleep apnea patients.

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“…In childhood an obstructive AHI ≤ 1 episodes/hr is considered to be normal, 1 < AHI ≤ 5 to be mild OSA, 5 < AHI ≤ 10 to be moderate OSA, and an AHI > 10 episodes/hr as severe OSA [7].…”

Section: Introductionmentioning

confidence: 99%

Multidisciplinary Approach in a 12-Year-Old Patient Affected by Severe Obstructive Sleep Apnea: a Case-Report

et al. 2019

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A 12-year-old boy shows a restless sleep and snoring episodes declaring himself tired during the day and the school lessons. On clinical examination the patient presents a second-class profile, a retrusive jaw with a small chin and an open nasolabial angle. From the intraoral examination a tonsillar hypertrophy is denoted. The patient is sent by the ear, nose, and throat specialist (ENT) and subsequently subjected to a polysomnography (PSG). The ENT decides to subject him to a tonsillectomy and the subsequent PSG shows an improvement in the obstructive sleep apnea syndrome (OSAS) pathology with an apnea-hypopnea index (AHI) improved from 25.5 episodes/hr to 3.4 episodes/hr. Subsequently a orthodontic treatment with twin-block was start to further reduce the apnea episodes. The last PSG highlights the success of the treatment further lowering the AHI to 0.7 episodes/hr. This case report shows how a multidisciplinary approach to OSAS is fundamental also in the young patient and that the orthodontist carried out in this area a fundamental task both in diagnosis and treatment.

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Combined Orthodontic and Surgical Treatment in a 8-Years-Old Patient Affected By Severe Obstructive Sleep Apnea: A Case-Report

Cited by 9 publications

References 3 publications

Combined Surgical and Orthodontic Treatments in Children with OSA: A Systematic Review

Combined Surgical and Orthodontic Treatments in Children with OSA: A Systematic Review

Validity of the STOP-Bang Questionnaire in Identifying OSA in a Dental Patient Cohort

Multidisciplinary Approach in a 12-Year-Old Patient Affected by Severe Obstructive Sleep Apnea: a Case-Report

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