Scientific Article
ABSTRACT
Obstructive sleep apnea syndrome (OSAS) has been a subject of increasing interest
from the orthodontic point of view, but less attention has been paid to the
possible influence of orthodontic treatment on its occurrence. The aim here was
to study possible associations between the use of cervical headgear and
nocturnal cessations of airflow and the severity of the latter.
The subjects
were 30 children (12 boys, 18 girls, mean age 8.2, sd 1.61 years), divided into
three groups: a group of 10 children undergoing headgear therapy, selected for
this examination because of symptoms of OSAS while using headgear, an
age-matched control group of 10 healthy children and a group of 10 with OSAS.
Standard cephalograms of the headgear group prior to the orthodontic therapy
and the corresponding cephalograms of healthy controls were analysed. A
polygraphic (PG) sleep evaluation was used to assess the tendency for OSAS.
Apnea and hypopnea periods were summated as apnea index (AI) and number of
desaturations as desaturation index (ODI). All the subjects spent one night
sleeping under laboratory conditions, those with orthodontic treatment spending
the first half of the night with the headgear and the latter half without.
The position
of the mandible was found to be slightly more posterior in the headgear group
than in the control group. The children in the headgear group were found to
have significantly more apnea/hypopnea periods during the hours when the
appliance was used, and the ODI-index showed increased values in this group.
We suggest
that headgear therapy may contribute to the occurrence of sleep apnea, when a
strong predisposition, such as mandibular retrognathia to the development of
upper airway occlusion already exists.
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