Missing teeth and pediatric obstructive sleep apnea

Guilleminault, Christian; Abad, Vivien C.; Chiu, Hsin–Hui; Peters, Brandon R.; Quo, Stacey

doi:10.1007/s11325-015-1238-3

Cited by 23 publications

(9 citation statements)

References 33 publications

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“…The proposed mechanism is a reduced arch depth in the sagittal plane resulting in decreased oral cavity volume and posterior displacement of the tongue and soft palate. The reduction in arch depth may be more significant in certain skeletal types, particularly Class II subtypes, and the decrease in airway space may lead to possible aggravation of snoring and OSA . Reopening of closed orthodontic extraction spaces was even recommended to resolve OSA .…”

Section: Introductionmentioning

confidence: 99%

Effects of bicuspid extractions and incisor retraction on upper airway of Asian adults and late adolescents: A systematic review

Song

Yap

2019

J of Oral Rehabilitation

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ObjectivesThis systematic review aimed to assess the effects of bicuspid extractions and incisor retraction on airway dimension, hyoid position and breathing of adults and late adolescents.MethodsThe review was conducted according to PRISMA guidelines. Eight databases including PubMed, EMBASE, Web of Science and Scopus were searched to August 2018. Minimum age of participants was 16 years. The intervention was dual‐arch bicuspid extractions with incisor retraction. Outcomes were airway dimension, hyoid position and breathing assessment.ResultsAll nine publications meeting inclusion criteria were from Asia. They were divided into three Asian subregions. All East Asian lateral cephalometric studies reported anteroposterior airway narrowing at the oropharynx and sometimes the hypopharynx. However, the narrowing was small, comparable to measurement errors, and highly variable. Two out of three East Asian computed tomography (CT) studies described reductions in airway dimensions. The single functional breathing study showed increased simulated flow resistance after incisor retraction in East Asians. South Asian studies had mixed findings, with some reporting significant airway narrowing. The single study from West Asia found no significant airway or hyoid changes.ConclusionsAirway response to bicuspid extractions and incisor retraction varied substantially when assessed with cephalometry. CT measurements present larger effect sizes and smaller variations, providing stronger evidence of airway narrowing. Orthodontic extractions for incisor retraction may be more frequently indicated in Asia, and East Asians seem particularly susceptible to airway narrowing and postero‐inferior hyoid movement with incisor retraction. Better designed CT studies are needed for confirmation due to small effect size and large variability.

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Section: Introductionmentioning

confidence: 99%

Effects of bicuspid extractions and incisor retraction on upper airway of Asian adults and late adolescents: A systematic review

Song

Yap

2019

J of Oral Rehabilitation

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“…En línea con lo anterior, se ha aconsejado evitar los tratamientos ortodóncicos con extracciones por el potencial riesgo a desarrollar SAOS. A su vez, se han asociado las agenesias y ausencia de piezas dentarias por otras causas con SAOS, aconsejando evitar exodoncias en tratamiento ortodóncicos (45) . Sin embargo, vale la pena destacar que dicha recomendación se realizó en base a un estudio observacional en pacientes evaluados en una clínica de sueño con diagnóstico de SAOS, sin grupo control, y sin considerar posibles variables de confusión importantes.…”

Section: Discussionunclassified

Apnea Obstructiva del Sueño y el Rol del Ortodoncista. Revisión bibliográfica.

Alvarado

Oyonarte

2021

Int. j interdiscip. dent.

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Introducción: La apnea obstructiva del sueño es un trastorno crónico, altamente prevalente, asociada a secuelas cardiovasculares y neurocognitivas, que afectan gravemente la calidad de vida de los individuos que la padecen. En aquel contexto, tanto el odontólogo general, como especialista, tienen un rol importante en el screening y potencial tratamiento interdisciplinario de esta patología. Revisión de la literatura actual: Se describen las causas y las secuelas asociadas a este trastorno, junto con los métodos de screening inicial que sirven para una derivación oportuna. Además, se plantean las alternativas de tratamiento y la evidencia actual disponible sobre sus efectos terapéuticos. Discusión y conclusión: Por ser la apnea obstructiva del sueño una patología compleja y de origen multifactorial, se aborda con un equipo interdisciplinario para determinar la mejor estrategia de tratamiento de acuerdo a las características de cada paciente, y entendiendo las repercusiones que cada terapia conlleva. En Ortodoncia, existen controversias respecto del efecto de los tratamientos con extracciones de premolares sobre las dimensiones de la vía aérea superior, donde es relevante analizar críticamente la evidencia científica disponible al respecto, y con ello, asegurar estrategias óptimas de tratamiento en la práctica clínica.

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“…This mouth breathing may be related to the fact that children who have been mouth breathers for a certain time due to obstruction of the nose and UA have a "disuse" of their nose when breathing, and removal of obstructive UA tissues does not mean a systematic return to normal nasal breathing during sleep [11] . This mouth breathing may also be related to the progressive occurrence of dysmorphism secondary to the presence of mouth breathing that impacts on maxillary and mandibular growth, as shown in the experiment preformed on Rhesus monkeys [14,15] , or to dysmorphism related to congenital dental agenesis [29,30] or other secondary dysfunctions (such as a short lingual frenulum or prematurity, etc. ).…”

Section: Negative Effect Of Not Addressing the Dysfunctionmentioning

confidence: 96%

Pediatric Obstructive Sleep Apnea: Where Do We Stand?

Huang

Guilleminault

2017

Advances in Oto-Rhino-Laryngology

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Pediatric obstructive sleep apnea (OSA) was initially described in 1976. In 1981, Dr. Guilleminault emphasized that pediatric OSA was different from the clinical presentation reported in adults. It was characterized by more disturbed nocturnal sleep than excessive daytime sleepiness, and presented more behavioral problems, particularly school problems, hyperactivity, nocturnal enuresis, sleep terrors, depression, insomnia, and psychiatric problems. The underlying causes of pediatric OSA are complex. Such factors as adenotonsillar hypertrophy, obesity, anatomical and neuromuscular factors, and hypotonic neuromuscular disease are also involved. Adenotonsillectomy (T&A) has been the recommended treatment for pediatric OSA, but in the recent past this practice has been placed very much in question. Therefore, we will discuss the mechanism of pediatric OSA and investigate obese and nonobese pediatric sleep-disordered breathing. Moreover, the important concept that dysfunction leads to the dysmorphism that impacts on the size of the Lin H-C (ed): Sleep-Related Breathing Disorders.

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Missing teeth and pediatric obstructive sleep apnea

Cited by 23 publications

References 33 publications

Effects of bicuspid extractions and incisor retraction on upper airway of Asian adults and late adolescents: A systematic review

Effects of bicuspid extractions and incisor retraction on upper airway of Asian adults and late adolescents: A systematic review

Apnea Obstructiva del Sueño y el Rol del Ortodoncista. Revisión bibliográfica.

Pediatric Obstructive Sleep Apnea: Where Do We Stand?

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