Facial Profile Shape, Malocclusion and Palatal Morphology in Malay Obstructive Sleep Apnea Patients

Abstract

Objective: To test the null hypothesis that there is no difference in facial profile shape, malocclusion class, or palatal morphology in Malay adults with and without obstructive sleep apnea (OSA). Materials and Methods: Subjects were 120 adult Malays aged 18 to 65 years (mean Ϯ standard deviation [SD], 33.2 Ϯ 13.31) divided into two groups of 60. Both groups underwent clinical examination and limited channel polysomnography (PSG). The mean OSA and control values were subjected to t-test and the chi square test. Results: Physical examination showed that 61.7% of the OSA patients were obese, and 41.7% of those obese patients had severe OSA. The mean body mass index (BMI) was significantly greater for the OSA group (33.2 kg/m 2 Ϯ 6.5) than for the control group (22.7 kg/m 2 Ϯ 3.5; P Ͻ .001). The mean neck size and systolic blood pressure were greater for the OSA group (43.6 cm Ϯ 6.02; 129.1 mm Hg Ϯ 17.55) than for the control group (35.6 cm Ϯ 3.52; 114.1 mm Hg Ϯ 13.67; P Ͻ .001). Clinical examination showed that the most frequent findings among OSA groups when compared with the control group were convex profiles (71.7%), Class II malocclusion (51.7%), and V palatal shape (53.3%), respectively; the chi square test revealed a significant difference in terms of facial profile and malocclusion class (P Ͻ .05), but no significant difference in palatal shape was found. Conclusion:The null hypothesis is rejected. A convex facial profile and Class II malocclusion were significantly more common in the OSA group. The V palatal shape was a frequent finding in the OSA group. (Angle Orthod. 2010;80:37-42.)

Orthodontic view in the diagnoses of obstructive sleep apnea

“…[22] From the orthodontic point of view, reduced overbite, narrower upper, and shorter lower dental arch; crowding in the mandibular arch; Class II malocclusion were reported as dental features that were associated with OSA patients. [2324] Specifically, lateral crossbite and increased overjet were seen more frequently in OSA patients. Lateral crossbite due to maxillary skeletal constriction were found to be approximately 30–50% in OSA patients[2526] compared to 10 per cent which was found in the general population.…”

“…[30] In addition, Class II malocclusion was found to be the most frequent findings among OSA Malay patients when compared with the control group. [23] This lead to an interesting question, is a patient with Class II malocclusion at a higher risk of having a higher apnea-hypopnea index than a patient with Class I occlusion? The Regression analysis supported yes answer for this question as an increased in overjet was found to be a significant factor contributing to increased AHI in OSA patients.…”

“…[23] A statistically significant difference was found in palatal heights between OSA and control patients at the level of the first premolar, second premolar, and molar. [26] Other dental features which were reported frequently in OSA patients is a palatal morphology.…”

“…[35] In addition, we previously found that those patients with OSA had significantly narrower maxillary and mandibular arch widths with an increase in maxillary and mandibular arch length when compared with controls. [23] In view of the fact that the roof of the mouth is also the floor of the nose, a narrow arch can infringe on the nasal cavity space. Therefore, maxillary dimensions.…”

Oral Health Status of Children With High Risk of Sleep-Disordered Breathing

“…9 Because failure to recognize oral health complications in children with SDB can increase the personal and economic burden for affected individuals, their caregivers, and community, further investigations of oral health issues are warranted in this pediatric population Children with SDB have oral manifestations such as tonsillar hypertrophy, narrow dental arches, macroglossia, malocclusion, and mouth breathing. 10,11 In spite of the extensive description of these manifestations as key findings for SDB diagnosis, there is little understanding of their consequences on the oral health of the affected population. Snoring and OSA accompanied by unhealthy open mouth breathing are known to cause dry mouth, which if untreated can have detrimental effects on oral health.…”