OSAS Severity and Occlusal Parameters: A Prospective Study among Adult Subjects with Comorbidities

Abstract

Introduction: OSAS is an emerging public health problem. Early diagnosis in adults with comorbidities is the gold standard to avoid complications caused by a late diagnosis. The aim of the study, part of the SLeeP@SA project, was to identify within a population with dysmetabolic comorbidities the association of occlusal clinical signs, defined by orthodontic parameters, and of the anthropometric phenotype, with the severity of OSAS. Materials and Methods: A dedicated questionnaire containing questions regarding the presence of deep bite, augmented overjet, partial edentulism, and bruxism was completed by clinic staff. OSAS was evaluated using an unattended home PSG device, which recorded the AHI value. BMI and neck circumference were also measured. The Kolmogorov-Smirnov test was performed to evaluate the association of the AHI with occlusal clinical signs. The significance was set at p ≤ 0.05. The association of AHI with BMI and neck circumference was evaluated with the Pearson correlation coefficient. Results: In total, 199 subjects were evaluated. No statistically significant association between occlusal parameters and AHI was found, while the AHI showed a positive correlation with BMI and neck circumference. The neck circumference seemed to be a better clinical predictor for OSAS severity than BMI, especially for females. Conclusions: These results highlight how the orthodontic clinical data alone are not sufficient to establish an association between occlusal anomalies and OSAS severity, but further investigation involving a specialist orthodontic diagnosis is necessary.

Friedman Tongue Position and the Anthropometric Parameters in Adult Patients with Obstructive Sleep Apnea: An Observational Study

“…Performing the same analysis with the neck circumference in place of the BMI resulted in an overall similar behavior (higher and stable correlation coefficients for classes from 2 to 4), with coefficients that were comparable or larger on average, especially for women, where it passed from 0.20 to 0.42. This was consistent with what was found in a previous study [ 22 ].…”

Look at the elephant! Commentary on ‘Prevalence of temporomandibular disorders in adult obstructive sleep apnoea patients: A cross‐sectional controlled study’

“…Oral appliances constitute a proven effective treatment in these cases. 2 Dentists and stomatologists have historically regarded malocclusion as a predisposing factor for TMDs. This traditional view has been recently criticised by Manfredini et al: in their 2017 systematic revision of the literature they show contrasting results, concluding that there is not enough strong evidence to support this theory.…”

“…A recent work by Luzzi et al ascertains a greater effect of the BMI over occlusal parameters on OSA severity. 2 Moreover, the control group consists of simple snorers, a benign condition that could be associated with a retruded bite even before a TMD has become evident. Both these aspects represent important confounders since in the study group OSA could have been caused or worsened by overweight or obesity and parapharyngeal fat, and not by a retrognathic bite, while the simple snorers in the control group could hide a considerable percentage of malocclusion traits.…”

“…Unfavourable dental and mandibular positions, especially the deep bite and mandibular retrusion, contribute to nocturnal airway collapse. Oral appliances constitute a proven effective treatment in these cases 2 …”

“…The Body Mass Index (BMI) of the study group is significantly higher than the BMI of the controls. A recent work by Luzzi et al ascertains a greater effect of the BMI over occlusal parameters on OSA severity 2 . Moreover, the control group consists of simple snorers, a benign condition that could be associated with a retruded bite even before a TMD has become evident.…”