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Maxillary morphology in obstructive sleep apnoea syndrome

Identifieur interne : 008955 ( Main/Exploration ); précédent : 008954; suivant : 008956

Maxillary morphology in obstructive sleep apnoea syndrome

Auteurs : Boon H. Seto [Australie] ; Helen Gotsopoulos ; Milton R. Sims [Australie] ; Peter A. Cistulli

Source :

RBID : ISTEX:3BEBC74538364261DD6FA361DDCD30BD4757BADF

Descripteurs français

English descriptors

Abstract

The aim of this case‐control study was to test the hypothesis that maxillary morphology differs between obstructive sleep apnoea (OSA) patients and non‐snoring, non‐apnoeic subjects. Forty randomly selected patients [36 M, 4 F; mean age 49 ± 2 (SEM) years] with varying degrees of OSA (mean Apnoea/Hypopnoea Index 32 ± 4/hour) were compared with 21 non‐snoring, non‐apnoeic control subjects (18 M, 3 F; mean age 40 ± 2 years). An intra‐oral assessment of the occlusion was carried out, particularly for the presence or absence of posterior transverse discrepancies. Maxillary dental arch width was assessed by standardized lateral inter‐tooth measurements (inter‐canine, inter‐premolar, and inter‐molar) from dental models. Palatal height and maxillary depth were also measured. The maxillary dental arch was described by a 4th order polynomial equation. The ratios of maxillary to mandibular width (max/mand) and maxillary to facial width (max/facial) were determined from standardized postero‐anterior cephalometric radiographs in a subgroup of patients (n = 29) and all controls. Twenty patients (50 per cent) had evidence of posterior transverse discrepancies compared with one control subject (5 per cent; P < 0.01). All patients had significantly reduced inter‐canine, inter‐premolar, and inter‐molar distances (P < 0.05). The maxillary depth was also shorter (P < 0.05), but palatal height was not different. The quadratic coefficient of the polynomial equation was greater in the patients than in the controls (P < 0.05), indicative of greater arch tapering. Patients had smaller maxillary to mandibular and maxillary to facial width ratios (P < 0.01). These results suggest that OSA patients have narrower, more tapered, and shorter maxillary arches than non‐snoring, non‐apnoeic controls. Further work is required to determine the relevance of these findings in the pathophysiology of OSA.

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DOI: 10.1093/ejo/23.6.703


Affiliations:


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Le document en format XML

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<term>American review</term>
<term>Angle orthodontist</term>
<term>Angular measurements</term>
<term>Antegonial protuberances</term>
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<term>Present study</term>
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<term>Schematic diagram</term>
<term>Screening questionnaire</term>
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<term>Significant difference</term>
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<term>Angular measurements</term>
<term>Antegonial protuberances</term>
<term>Anterior point</term>
<term>Apnea</term>
<term>Apnea syndrome</term>
<term>Apnoea</term>
<term>Apnoea severity</term>
<term>Arch dimensions</term>
<term>Arch form</term>
<term>Buccal cusp tips</term>
<term>Canine</term>
<term>Central incisors</term>
<term>Cephalograms</term>
<term>Cephalometric</term>
<term>Cephalometric analyses</term>
<term>Cephalometric analysis</term>
<term>Cephalometric measurements</term>
<term>Cephalometric radiographs</term>
<term>Cephalometric variables</term>
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<term>Constriction</term>
<term>Control group</term>
<term>Control groups</term>
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<term>Craniofacial abnormalities</term>
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<term>Palatal index</term>
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<term>Patient group</term>
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<term>Posterior point</term>
<term>Premolar</term>
<term>Present study</term>
<term>Profile gauge</term>
<term>Rapid maxillary expansion</term>
<term>Respiratory disease</term>
<term>Schematic diagram</term>
<term>Screening questionnaire</term>
<term>Second premolar</term>
<term>Second premolars</term>
<term>Significant correlations</term>
<term>Significant difference</term>
<term>Single investigator</term>
<term>Skeletal classification</term>
<term>Skeletal maxillary constriction</term>
<term>Skeletal morphology</term>
<term>Skeletal relationship</term>
<term>Soft palate</term>
<term>Standard deviation</term>
<term>Structural abnormalities</term>
<term>Superior point</term>
<term>Symphyseal outline</term>
<term>Syndrome</term>
<term>Thoracoabdominal wall movement</term>
<term>Tongue posture</term>
<term>Transverse discrepancies</term>
<term>Upper airway</term>
<term>Upper airway dimensions</term>
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<front>
<div type="abstract" xml:lang="en">The aim of this case‐control study was to test the hypothesis that maxillary morphology differs between obstructive sleep apnoea (OSA) patients and non‐snoring, non‐apnoeic subjects. Forty randomly selected patients [36 M, 4 F; mean age 49 ± 2 (SEM) years] with varying degrees of OSA (mean Apnoea/Hypopnoea Index 32 ± 4/hour) were compared with 21 non‐snoring, non‐apnoeic control subjects (18 M, 3 F; mean age 40 ± 2 years). An intra‐oral assessment of the occlusion was carried out, particularly for the presence or absence of posterior transverse discrepancies. Maxillary dental arch width was assessed by standardized lateral inter‐tooth measurements (inter‐canine, inter‐premolar, and inter‐molar) from dental models. Palatal height and maxillary depth were also measured. The maxillary dental arch was described by a 4th order polynomial equation. The ratios of maxillary to mandibular width (max/mand) and maxillary to facial width (max/facial) were determined from standardized postero‐anterior cephalometric radiographs in a subgroup of patients (n = 29) and all controls. Twenty patients (50 per cent) had evidence of posterior transverse discrepancies compared with one control subject (5 per cent; P < 0.01). All patients had significantly reduced inter‐canine, inter‐premolar, and inter‐molar distances (P < 0.05). The maxillary depth was also shorter (P < 0.05), but palatal height was not different. The quadratic coefficient of the polynomial equation was greater in the patients than in the controls (P < 0.05), indicative of greater arch tapering. Patients had smaller maxillary to mandibular and maxillary to facial width ratios (P < 0.01). These results suggest that OSA patients have narrower, more tapered, and shorter maxillary arches than non‐snoring, non‐apnoeic controls. Further work is required to determine the relevance of these findings in the pathophysiology of OSA.</div>
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