1
|
Finck NS, Pacheco MCT, de Araújo MTM. Association of clinical indicators in TMJ, craniofacial, occlusal, and upper airway changes with symptoms of pediatric obstructive sleep apnea and mouth-breathing. Cranio 2024:1-7. [PMID: 38785125 DOI: 10.1080/08869634.2024.2356631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
OBJECTIVE To assess the association between self-reported symptoms of pediatric OSA and clinical signs in MB children. METHODS Seventy-three MB children aged 7-14 years answered an interview questionnaire on OSA symptoms in childhood, focusing on chewing, nasal, and sleep disturbances. MB children were checked for changes on the craniofacial, occlusion, TMJ, upper airway, and body posture by a multi-disciplinary team, consisting of medical residents, dental, and psychology postgraduate students. Multiple logistic regression analysis verified the association between clinical signs and self-reported symptoms. RESULTS Reported symptoms of chewing disturbance as TMD noise, muscle pain, and morning headache were significantly associated with the presence of lip incompetence and Class II malocclusion. Sleep disturbances as snoring, waking up at night, daytime sleepiness, and sleeping with the mouth open were significantly associated with the presence of hypertrophic tonsils and obstructive Mallampati score. CONCLUSION Symptoms of pediatric OSA were found in mouth-breathing children, which should be carefully investigated in order to prevent OSA in the future.
Collapse
|
2
|
Marincak Vrankova Z, Krivanek J, Danek Z, Zelinka J, Brysova A, Izakovicova Holla L, Hartsfield JK, Borilova Linhartova P. Candidate genes for obstructive sleep apnea in non-syndromic children with craniofacial dysmorphisms - a narrative review. Front Pediatr 2023; 11:1117493. [PMID: 37441579 PMCID: PMC10334820 DOI: 10.3389/fped.2023.1117493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 06/06/2023] [Indexed: 07/15/2023] Open
Abstract
Pediatric obstructive sleep apnea (POSA) is a complex disease with multifactorial etiopathogenesis. The presence of craniofacial dysmorphisms influencing the patency of the upper airway is considered a risk factor for POSA development. The craniofacial features associated with sleep-related breathing disorders (SRBD) - craniosynostosis, retrognathia and micrognathia, midface and maxillary hypoplasia - have high heritability and, in a less severe form, could be also found in non-syndromic children suffering from POSA. As genetic factors play a role in both POSA and craniofacial dysmorphisms, we hypothesize that some genes associated with specific craniofacial features that are involved in the development of the orofacial area may be also considered candidate genes for POSA. The genetic background of POSA in children is less explored than in adults; so far, only one genome-wide association study for POSA has been conducted; however, children with craniofacial disorders were excluded from that study. In this narrative review, we discuss syndromes that are commonly associated with severe craniofacial dysmorphisms and a high prevalence of sleep-related breathing disorders (SRBD), including POSA. We also summarized information about their genetic background and based on this, proposed 30 candidate genes for POSA affecting craniofacial development that may play a role in children with syndromes, and identified seven of these genes that were previously associated with craniofacial features risky for POSA development in non-syndromic children. The evidence-based approach supports the proposition that variants of these candidate genes could lead to POSA phenotype even in these children, and, thus, should be considered in future research in the general pediatric population.
Collapse
Affiliation(s)
- Zuzana Marincak Vrankova
- Clinic of Stomatology, Institution Shared with St. Anne's University Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Clinic of Maxillofacial Surgery, Institution Shared with the University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
| | - Jan Krivanek
- Department of Histology and Embryology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Zdenek Danek
- Clinic of Maxillofacial Surgery, Institution Shared with the University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
| | - Jiri Zelinka
- Clinic of Maxillofacial Surgery, Institution Shared with the University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Alena Brysova
- Clinic of Stomatology, Institution Shared with St. Anne's University Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Lydie Izakovicova Holla
- Clinic of Stomatology, Institution Shared with St. Anne's University Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - James K. Hartsfield
- E. Preston Hicks Professor of Orthodontics and Oral Health Research, University of Kentucky Center for the Biologic Basis of Oral/Systemic Diseases, Hereditary Genetics/Genomics Core, Lexington, KE, United States
| | - Petra Borilova Linhartova
- Clinic of Stomatology, Institution Shared with St. Anne's University Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Clinic of Maxillofacial Surgery, Institution Shared with the University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
| |
Collapse
|
3
|
Wijaya IC, Yohana W, Chemiawan E, Saptarini R, Irmaleni I, Nuraeni N, Soewondo W. Effects of Midface Hypoplasia and Facial Hypotonia at Rest and During Clenching on Drooling in Down syndrome Children. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND: Down syndrome is a chromosome 21 disorder and the most common cause of physical abnormalities including midface hypoplasia, facial hypotonia, and also drooling. Drooling is unintentional anterior salivary flow from the mouth. The objectives of the study is to determine and analyze the effects of midfacial hypoplasia and facial hypotonia on drooling in Down syndrome children. Subject and method:
METHODS: of the research is analytic correlational. Sample retrievement using purposive sampling technique and obtained 20 samples that fulfills the inclusive criterias, consisting of 13 boys and 7 girls with an age range of 6 to 16 years old.
RESULTS AND DISCUSSION: The results were tested statistically by Kendall Coefficient of Concordance Test and Spearman Coefficient of Rank Correlation Test. The results showed that the effect of midfacial hypoplasia, facial hypotonia at rest, and during clenching on drooling is very significant (p-value 0.0002) with Kendall Coefficient of Concordance. Spearman Coefficient of Rank Correlation test results show correlation of midface hypoplasia on drooling is not significant (p-value 0,1265). Facial hypotonia at rest has a very significant correlation on drooling (p-value 0,0000) and during clenching also has a very significant correlation (p-value 0,0000).
CONCLUSION: Conclusion of the research is there are effects of midface hypoplasia, facial hypotonia at rest and facial hypotonia during clenching on drooling, also facial hypotonia at rest and facial hypotonia during clenching on drooling, but no effect of midface hypoplasia on drooling in Down syndrome children.
Collapse
|
4
|
Inada E, Saitoh I, Kaihara Y, Murakami D, Nogami Y, Kiyokawa Y, Tanaka R, Sakata K, Yamasaki Y. Factors related to mouth breathing syndrome in preschool children and the effects of incompetent lip seal: An exploratory study. Clin Exp Dent Res 2022; 8:1555-1560. [PMID: 36106473 PMCID: PMC9760156 DOI: 10.1002/cre2.661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 08/12/2022] [Accepted: 08/27/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES A set of orofacial signs and symptoms completely or partially present in individuals who replace the correct pattern of nasal breathing with an oral or mixed pattern is defined as mouth breathing syndrome (MBS). In a previous report, it was clarified that an incompetent lip seal (ILS) affected the occurrence of MBS among primary school children. However, the factors related to MBS and the effect of ILS in preschool children remain unclear. The purpose of this study was to clarify the factors relevant to MBS in preschool children and investigate the relationship of ILS to MBS. MATERIAL AND METHODS We surveyed 285 preschool children between 3 and 5 years of age. Their guardians completed the questionnaire, which consisted of 44 questions regarding the children's daily health conditions and lifestyle habits. To classify the closely related questions into their respective factors and to examine the strength of the correlation between the newly revealed factors, an exploratory factor analysis with promax rotation was performed. RESULTS The factor analysis identified nine items representing four factors. Factors 1-4 were defined as "diseases of the nose," "ILS," "problem with swallowing and chewing," and "eating and drinking habits," respectively. Factor 2 most strongly correlated with Factor 1, and both Factors showed a relatively strong correlation with Factor 3. CONCLUSIONS The initial stage of MBS may be present in preschool children. ILS and diseases of the nose can cause poor development of oral functions, such as breathing and eating.
Collapse
Affiliation(s)
- Emi Inada
- Department of Pediatric DentistryKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan
| | - Issei Saitoh
- Department of Pediatric DentistryAsahi University School of DentistryGifuJapan
| | | | - Daisuke Murakami
- Department of Pediatric DentistryKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan
| | - Yukiko Nogami
- Division of Pediatric Dentistry, Graduate School of Medical and Dental ScienceNiigata UniversityNiigataChuo‐kuJapan
| | - Yuki Kiyokawa
- Department of Pediatric DentistryAsahi University School of DentistryGifuJapan,Division of Pediatric Dentistry, Graduate School of Medical and Dental ScienceNiigata UniversityNiigataChuo‐kuJapan
| | - Reira Tanaka
- Department of Pediatric DentistryAsahi University School of DentistryGifuJapan
| | - Kensuke Sakata
- Department of Pediatric DentistryAsahi University School of DentistryGifuJapan
| | - Youichi Yamasaki
- Department of Pediatric DentistryKagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan
| |
Collapse
|
5
|
Burska Z, Burghard M, Brożek-Mądry E, Sierdziński J, Krzeski A. Oral cavity morphology among children at risk of sleep disordered breathing. Eur Arch Paediatr Dent 2022; 23:429-435. [PMID: 35366217 DOI: 10.1007/s40368-022-00701-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 03/02/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of this study was to evaluate oral cavity morphology in children at risk of sleep disordered breathing (SDB). METHODS The study included children 3-17 years of age. The risk of SDB was evaluated using the paediatric sleep questionnaire (PSQ); afterwards, children at risk of SDB were enrolled in the study group. A control group was randomly established from patients with negative PSQ results. The oral cavity morphology evaluation included assessment of the oropharynx using Mallampati classification (MC), palatine tonsil size using the Pirquet scale, occlusion and the presence of a high-arched palate and lingual frenulum. RESULTS A total of 131 children were evaluated, 65 in the study and 66 in the control group. The mean ages were 9.5 ± 3.0 and 9.4 ± 3.1 years, respectively. The presence of higher scores on the MC, higher scores in the Pirquet scale, a crossbite, a high-arched palate and a short frenulum were significantly more frequent in the study group than the control group. CONCLUSION The evaluation of oral morphology is an important part of paediatric examination. Enlarged palatine tonsils; higher scores on the MC; and the presence of a crossbite, short lingual frenulum and high-arched palate may suggest abnormal breathing during sleep in children.
Collapse
Affiliation(s)
- Z Burska
- Department of Otorhinolaryngology, Medical University of Warsaw, Stępińska 19/25, 00-739, Warsaw, Poland
| | - M Burghard
- Medical Center in Ostrołęka, Ostroleka, Poland
| | - E Brożek-Mądry
- Department of Otorhinolaryngology, Medical University of Warsaw, Stępińska 19/25, 00-739, Warsaw, Poland.
| | - J Sierdziński
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Warsaw, Poland
| | - A Krzeski
- Department of Otorhinolaryngology, Medical University of Warsaw, Stępińska 19/25, 00-739, Warsaw, Poland
| |
Collapse
|
6
|
Arnett GW, Trevisiol L, Grendene E, McLaughlin RP, D'Agostino A. Combined orthodontic and surgical open bite correction. Angle Orthod 2022; 92:161-172. [PMID: 34986216 PMCID: PMC8887413 DOI: 10.2319/101921-779.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/01/2021] [Indexed: 11/14/2023] Open
Abstract
OBJECTIVES To examine the stability of combined surgical and orthodontic bite correction with emphasis on open-bite closure. All study patients were treated with strict and consistent orthodontic and surgical protocols. MATERIALS AND METHODS Study inclusion required all patients to have anterior open bites, maxillary accentuated curve of Spee, 36-month minimum follow-up, and no temporomandibular joint pathology. Thirty patients met the inclusion/exclusion criteria. Importantly, segmental upper arch orthodontic preparation (performed by EG) was used. Surgery consisted of a multisegment Le Fort I (MSLFI) combined with a bilateral sagittal osteotomies (BSSO). Surgery was performed (by ADA and LT) at the Department of Dentistry and Maxillofacial Surgery of the University of Verona, Italy. RESULTS The long-term open bite and overjet relapse were not statistically significant. The mean transverse relapse of the upper and lower molars was statistically significant. Of great importance, the upper and lower arch widths narrowed together, maintaining intercuspation of the posterior dentition which prevented anterior open bites from developing. CONCLUSIONS This study revealed stability of three-dimensional occlusal correction including anterior open bite. Stable open bite closure was achieved by using rigid protocols for orthodontic preparation, surgical techniques, surgical follow-up, and orthodontic finishing.
Collapse
|
7
|
Zhao Z, Zheng L, Huang X, Li C, Liu J, Hu Y. Effects of mouth breathing on facial skeletal development in children: a systematic review and meta-analysis. BMC Oral Health 2021; 21:108. [PMID: 33691678 PMCID: PMC7944632 DOI: 10.1186/s12903-021-01458-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 02/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mouth breathing is closely related to the facial skeletal development and malocclusion. The purpose of this systematic review and meta-analysis was to assess the effect of mouth breathing on facial skeletal development and malocclusion in children. METHODS An electronic search in PubMed, the Cochrane Library, Medline, Web of Science, EMBASE and Sigle through February 23rd, 2020, was conducted. Inclusion criteria were children under 18 years of age with maxillofacial deformities due to mouth breathing. The risk of bias in nonrandomized studies of interventions (ROBINS-I) tool for controlled clinical trials. The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used for the quality assessment. The included indicators were SNA, SNB, ANB, SN-OP, SN-PP, PP-MP, SNGoGn, MP-H, 1-NA, 1. NA, 1. NB, 1-NB, Overjet, Overbite, SPAS, PAS, and C3-H. Data concerning the mean difference in mesial molar movement and extent of canine retraction were extracted for statistical analysis. The mean differences and 95% confidence intervals were analyzed for continuous data. Review Manager 5.3, was used to synthesize various parameters associated with the impact of mouth breathing on facial skeletal development and malocclusion. RESULTS Following full-text evaluations for eligibility, 10 studies were included in the final quantitative synthesis. In Sagittal direction, SNA (MD: - 1.63, P < 0.0001), SNB (MD: - 1.96, P < 0.0001) in mouth-breathing children was lower than that in nasal-breathing children. ANB (MD: 0.90, P < 0.0001), 1. NA (MD: 1.96, P = 0.009), 1-NA (MD: 0.66, P = 0.004), and 1-NB (MD: 1.03, P < 0.0001) showed higher values in children with mouth breathing. In vertical direction, SN-PP (MD: 0.68, P = 0.0050), SN-OP (MD: 3.05, P < 0.0001), PP-MP (MD: 4.92, P < 0.0001) and SNGoGn (MD: 4.10, P < 0.0001) were higher in mouth-breathing individuals. In airway, SPAS (MD: - 3.48, P = 0.0009), PAS (MD: - 2.11, P < 0.0001), and C3-H (MD: - 1.34, P < 0.0001) were lower in mouth breathing group. CONCLUSIONS The results showed that the mandible and maxilla rotated backward and downward, and the occlusal plane was steep. In addition, mouth breathing presented a tendency of labial inclination of the upper anterior teeth. Airway stenosis was common in mouth-breathing children. Trial registration crd-register@york.ac.uk, registration number CRD42019129198.
Collapse
Affiliation(s)
- Ziyi Zhao
- The Affiliated Stomatology Hospital of Chongqing Medical University, No.426 Songshi North Road, Yubei district, Chongqing, 401147, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 401147, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 401147, China
| | - Leilei Zheng
- The Affiliated Stomatology Hospital of Chongqing Medical University, No.426 Songshi North Road, Yubei district, Chongqing, 401147, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 401147, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 401147, China
| | - Xiaoya Huang
- The Affiliated Stomatology Hospital of Chongqing Medical University, No.426 Songshi North Road, Yubei district, Chongqing, 401147, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 401147, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 401147, China
| | - Caiyu Li
- The Affiliated Stomatology Hospital of Chongqing Medical University, No.426 Songshi North Road, Yubei district, Chongqing, 401147, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 401147, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 401147, China
| | - Jing Liu
- The Affiliated Stomatology Hospital of Chongqing Medical University, No.426 Songshi North Road, Yubei district, Chongqing, 401147, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 401147, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 401147, China
| | - Yun Hu
- The Affiliated Stomatology Hospital of Chongqing Medical University, No.426 Songshi North Road, Yubei district, Chongqing, 401147, China.
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 401147, China.
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 401147, China.
| |
Collapse
|
8
|
Do breastfed children have a lower chance of developing mouth breathing? A systematic review and meta-analysis. Clin Oral Investig 2021; 25:1641-1654. [PMID: 33506425 DOI: 10.1007/s00784-021-03791-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 01/08/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Determine the association between breastfeeding and the development of mouth breathing in children. MATERIALS AND METHODS Seven databases were searched for studies investigating the association between the type of feeding and the development of the breathing pattern in children. Descriptive analysis and meta-analysis were performed, with the calculation of the prevalence and likelihood (odds ratios (95% CI)) of mouth breathing according to the duration of breastfeeding. RESULTS The overall prevalence of mouth breathing was 44% (95% CI: 38-49) (N total = 1182). Breastfeeding was a protection factor against the development of mouth breathing (OR = 0.62; 95% CI: 0.41-0.93). The likelihood of developing mouth breathing was 41% and 34% lower among children that were breastfed for more than 12 and more than 24 months, respectively. No association was found between exclusive breastfeeding for up to 6 months and the occurrence of mouth breathing (OR = 0.60; 95% CI: 0.31-1.18). CONCLUSIONS Due to the scarcity of cohort studies that met the inclusion criteria and the low certainty of the evidence, no strong evidence-based conclusion can be drawn. However, breastfeeding should be encouraged due to its possible protective effect, evidenced by the substantial reduction in the prevalence of mouth breathing pattern when performed for up to 2 years. Exclusive breastfeeding was not associated with the development of the breathing pattern. CLINICAL RELEVANCE The results reveal that breastfeeding can protect children from the development of mouth breathing. Thus, healthcare providers should offer support so that mothers feel prepared and encouraged to perform breastfeeding. TRIAL REGISTRATION PROSPERO registry: CRD42017062172.
Collapse
|
9
|
Baddam P, Biancardi V, Roth DM, Eaton F, Thereza-Bussolaro C, Mandal R, Wishart DS, Barr A, MacLean J, Flores-Mir C, Pagliardini S, Graf D. Neural crest-specific deletion of Bmp7 leads to midfacial hypoplasia, nasal airway obstruction, and disordered breathing modelling Obstructive Sleep Apnea. Dis Model Mech 2021; 14:dmm.047738. [PMID: 33431521 PMCID: PMC7888714 DOI: 10.1242/dmm.047738] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/22/2020] [Indexed: 12/14/2022] Open
Abstract
Pediatric obstructive sleep apnea (OSA), a relatively common sleep-related breathing disorder (SRBD) affecting approximately 1-5% of children, is often caused by anatomical obstruction and/or collapse of the nasal and/or pharyngeal airways. The resulting sleep disruption and intermittent hypoxia lead to various systemic morbidities. Predicting the development of OSA from craniofacial features alone is currently not possible and a controversy remains if upper airway obstruction facilitates reduced midfacial growth or vice-versa. Currently, there is no rodent model that recapitulates both the development of craniofacial abnormalities and upper airway obstruction to address these questions. Here, we describe that mice with a neural crest-specific deletion of Bmp7 (Bmp7ncko) present with shorter, more acute angled cranial base, midfacial hypoplasia, nasal septum deviation, turbinate swelling and branching defects, and nasal airway obstruction. Interestingly, several of these craniofacial features develop after birth during periods of rapid midfacial growth and precede the development of an upper airway obstruction. We identified that in this rodent model, no single feature appeared to predict upper airway obstruction, but the sum of those features resulted in a reduced breathing frequency, apneas and overall reduced oxygen consumption. Metabolomics analysis of serum from peripheral blood identified increased levels of hydroxyproline, a metabolite upregulated under hypoxic conditions. As this model recapitulates many features observed in OSA, it offers unique opportunities for studying how upper airway obstruction affects breathing physiology and leads to systemic morbidities.
Collapse
Affiliation(s)
- Pranidhi Baddam
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Vivian Biancardi
- Department of Physiology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Equal contributions
| | - Daniela M Roth
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Equal contributions
| | - Farah Eaton
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Claudine Thereza-Bussolaro
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Department of Dentistry, Hospital dos Pinheiros, UNIFASIPE, Sinop, Mato Grosso, Brazil
| | - Rupasri Mandal
- The Metabolomics Innovation Centre, Department of Biological Sciences, Faculty of Science, University of Alberta, Edmonton, AB, Canada
| | - David S Wishart
- The Metabolomics Innovation Centre, Department of Biological Sciences, Faculty of Science, University of Alberta, Edmonton, AB, Canada
| | - Amy Barr
- Department of Pharmacology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Joanna MacLean
- Department of Pediatrics and the Women & Children's Health Research Institute, Faculty of Medicine and Dentistry, University of Alberta
- Stollery Children's Hospital; Edmonton, AB, Canada
| | - Carlos Flores-Mir
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Silvia Pagliardini
- Department of Physiology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Daniel Graf
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Department of Medical Genetics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
10
|
Havakeshian G, Koretsi V, Eliades T, Papageorgiou SN. Effect of Orthopedic Treatment for Class III Malocclusion on Upper Airways: A Systematic Review and Meta-Analysis. J Clin Med 2020; 9:jcm9093015. [PMID: 32962101 PMCID: PMC7563370 DOI: 10.3390/jcm9093015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/08/2020] [Accepted: 09/14/2020] [Indexed: 12/26/2022] Open
Abstract
The aim of this systematic review is to compare the effect on the upper airways of orthopedic treatment for skeletal Class III malocclusion with untreated controls. Nine databases were searched up to August 2020 for randomized or nonrandomized clinical trials comparing orthopedic Class III treatment (facemask or chin-cup) to untreated Class III patients. After duplicate study selection, data extraction, and risk of bias assessment (Risk Of Bias In Non-randomized Studies - of Interventions [ROBINS-I]), random-effects meta-analyses of Mean Differences (MDs)/Standardized Mean Differences (SMD) and 95% Confidence Intervals (CIs) were performed, followed by the Grading of Recommendations Assessment, Development and Evaluation assessment evidence-quality. A total of 10 papers (9 unique nonrandomized studies) with 466 patients (42.7% male; average age 9.1 years) were finally included. Limited evidence indicated that compared to normal growth, maxillary protraction with facemask was associated with increases in total airway area (n = 1; MD = 222.9 mm2; 95% CI = 14.0-431.7 mm2), total nasopharyngeal area (n = 4; SMD = 1.6; 95% CI = 1.2-2.0), and individual airway dimensions (upper-airway MD = 2.5 mm; lower-airway MD = 2.1 mm; upper-pharynx MD = 1.6 mm; lower-pharynx MD = 1.0 mm; all n = 6). Subgroup/meta-regression analyses did not find any significant effect-modifiers, while the results were retained 2-5 years postretention. Our confidence in these estimates was, however, very low, due to the inclusion of nonrandomized studies with methodological issues. Limited data from 2 chin-cup studies indicated smaller benefits on airway dimensions. Existing evidence from controlled clinical studies on humans indicates that maxillary protraction for skeletal Class III treatment might be associated with increased airway dimensions, which are, however, mostly minor in magnitude.
Collapse
|
11
|
Restrepo C, Botero P, Valderrama D, Jimenez K, Manrique R. Brain Cortex Activity in Children With Anterior Open Bite: A Pilot Study. Front Hum Neurosci 2020; 14:220. [PMID: 32714165 PMCID: PMC7340172 DOI: 10.3389/fnhum.2020.00220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/15/2020] [Indexed: 01/04/2023] Open
Abstract
Anterior open bite (AOB) is related to functional alterations of the stomatognathic system. There are no studies concerning brain activation of the cortex comparing children with and without AOB during rest and activities such as deglutition and phonation. The aim of this study was to determine the activity of the brain cortex of children with AOB at rest and during phonation and deglutition and to evaluate the association of intelligence quotient (IQ), attention (Test of Variables of Attention, known as TOVA), beats per minute (BPM), and oxygen saturation measurement (SpO2) with brain activity in subjects with AOB. Fourteen children (seven with AOB and seven without AOB) with mixed dentition, aged 10–13 years, underwent an IQ test, TOVA, SpO2, and quantitative electroencephalography (QEEG). Electrodes were set in the scalp, according to the 10–20 protocol. Data were analyzed using statistical tests to assess comparisons between children with and without AOB. The results showed that IQ, TOVA, SpO2, or BPM did not show any statistically significant differences between the groups, except for the response time (contained in TOVA) (p = 0.03). Significant differences were found for the brain activity during rest (Condition 1) of the tongue, between children with and without AOB (p < 0.05 for alpha/theta and alpha peaks), whereas there were no differences during function (Condition 2). The findings of this investigation provide insights about the cortex activity of the brain while the tongue is in the resting position in children with AOB. This may imply an altered activity of the brain cortex, which should be considered when diagnosing and treating AOB. Other diagnostic techniques derived from investigations based on neuroscience could develop new diagnostic and therapeutic techniques to give better solutions to children with malocclusions. Treatments should be focused not only on the teeth but also on the brain cortex.
Collapse
Affiliation(s)
| | - Paola Botero
- GIOM Group, Universidad Cooperativa de Colombia, Envigado, Colombia
| | | | - Kelly Jimenez
- CES-LPH Research Group, Universidad CES, Medellín, Colombia
| | - Rubén Manrique
- CES-LPH Research Group, Universidad CES, Medellín, Colombia
| |
Collapse
|
12
|
Aroucha Lyra MC, Aguiar D, Paiva M, Arnaud M, Filho AA, Rosenblatt A, Thérèse Innes NP, Heimer MV. Prevalence of sleep-disordered breathing and associations with malocclusion in children. J Clin Sleep Med 2020; 16:1007-1012. [PMID: 32052740 PMCID: PMC7954063 DOI: 10.5664/jcsm.8370] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 02/03/2020] [Accepted: 02/03/2020] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES This study aimed to determine the prevalence of sleep-disordered breathing (SDB) and its association with malocclusion among children in Recife, Brazil. METHODS This study included 390 children aged 7 to 8 years. The data comprised the measurement of body mass, orthodontic examination, and parental information required by the Sleep Disturbance Scale for Children. The statistics tools used were Pearson's chi-square test and the Lemeshow test. RESULTS Positively screened for SDB was found in 33.3% of the children, and the association with overjet was P = .007 (odds ratio [OR], 95%, confidence interval [CI]: 1.93). The association with anterior open bite was P = .008 (OR, 95% CI: 2.03), and the association with posterior crossbite was P = .001 (OR, 95% CI: 2.89). This report was unable to indicate an association between body mass index and SDB. The multivariate logistic regression model revealed that the anterior open bite (P = .002; OR, 95% CI: 2.34) and posterior crossbite (P = .014; OR, 95% CI: 2.79) had an association with positively screened for SDB. CONCLUSIONS The results of this study indicated that the prevalence of SDB was high and highly associated with malocclusion. Since posterior crossbite and anterior open bite were associated with positively screened for SDB, early diagnosis and intervention may prevent and minimize adverse effects of SDB on individuals lives.
Collapse
Affiliation(s)
- Maria Carlla Aroucha Lyra
- Department of Pediatric Dentistry, School of Dentistry, University of Pernambuco, Recife, Pernambuco, Brazil
| | - Débora Aguiar
- Department of Pediatric Dentistry, School of Dentistry, University of Pernambuco, Recife, Pernambuco, Brazil
| | - Mabel Paiva
- Department of Pediatric Dentistry, School of Dentistry, University of Pernambuco, Recife, Pernambuco, Brazil
| | - Manuela Arnaud
- Department of Pediatric Dentistry, School of Dentistry, University of Pernambuco, Recife, Pernambuco, Brazil
| | - Arnoldo Alencar Filho
- Department of Odontology, School of Dentistry, Uninassau, Recife, Pernambuco, Brazil
| | - Aronita Rosenblatt
- Department of Pediatric Dentistry, School of Dentistry, University of Pernambuco, Recife, Pernambuco, Brazil
| | | | - Mônica Vilela Heimer
- Department of Pediatric Dentistry, School of Dentistry, University of Pernambuco, Recife, Pernambuco, Brazil
| |
Collapse
|
13
|
Vázquez-Casas I, Sans-Capdevila O, Moncunill-Mira J, Rivera-Baró A. Prevalence of sleep-related breathing disorders in children with malocclusion. J Clin Exp Dent 2020; 12:e555-e560. [PMID: 32665814 PMCID: PMC7335603 DOI: 10.4317/jced.56855] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 02/24/2020] [Indexed: 11/05/2022] Open
Abstract
Background The paediatric population has a high incidence of sleep-related breathing disorders (SRBD). A notable risk factor is the presence of craniofacial abnormalities. The objective of the study was therefore to survey the prevalence of SRBD in patients presenting for interceptive treatment. Material and Methods Prospective study with a sample of 249 healthy patients. The "Paediatric Sleep Questionnaire" and "Sleep Disturbance Scale for Children" were completed by the children's parents and the results were evaluated. All patients had their medical records reviewed and underwent orthodontic diagnosis by oral examination, as well as dental cast and cephalometric analysis. Finally, we compared the results of the pre- and post-treatment questionnaires of 50 patients in the sample. Results Based on the results of the questionnaires, 22.8% of the study sample had SRBD. No statistically significant correlation was found between SRBD and the anthropometric characteristics and occlusal variables assessed. According to the cast analysis, patients with SRBD had a smaller maxillary width (p<0.003), and according to the cephalometric study, less overbite (p<0.003). Furthermore, the prevalence of SRBD was higher among patients with a history of adenotonsillectomy (p<0.02). Comparison of the results of pre- and post-treatment questionnaires revealed significant differences after orthodontic treatment (p<0.0005). Conclusions It is necessary to identify the presence of SRBD in orthodontic patients given its high prevalence. Patients with SRBD have a smaller maxillary width and less overbite. Key words:Sleep-related breathing disorders, paediatric sleep questionnaire, cephalometry.
Collapse
Affiliation(s)
- Ivette Vázquez-Casas
- Graduate in dentistry from University of Barcelona, Master of Ortodoncia y malformaciones dentofaciales from Sant Joan de Déu /University of Barcelona
| | - Oscar Sans-Capdevila
- Medical director of AdSalutem Institute. Coordinator of Sleep disorders unit from Sant Joan de Déu Hospital
| | - Jordi Moncunill-Mira
- Adjunct in Department of Odontopediatria and Orthodontics from Sant Joan de Déu Hospital. Hospital Dentistry, Clinical Orthodontics & Periodontal Medicine Research Group. Institut de Recerca Sant Joan de Déu (IRSJ), Fundació Sant Joan de Déu (FSJ)
| | - Alejandro Rivera-Baró
- Director in Department of Odontopediatria and Orthodontics from Sant Joan de Déu Hospital. Hospital Dentistry, Clinical Orthodontics & Periodontal Medicine Research Group. Institut de Recerca Sant Joan de Déu (IRSJ), Fundació Sant Joan de Déu (FSJ)
| |
Collapse
|
14
|
Tamasas B, Nelson T, Chen M. Oral Health and Oral Health-Related Quality of Life in Children With Obstructive Sleep Apnea. J Clin Sleep Med 2019; 15:445-452. [PMID: 30853038 PMCID: PMC6411169 DOI: 10.5664/jcsm.7672] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 10/21/2018] [Accepted: 11/12/2018] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES This aim of this study was to evaluate oral health and oral health-related quality of life (OHRQoL) in children with obstructive sleep apnea (OSA). METHODS This cross-sectional study involved 31 children who had baseline polysomnography studies and in whom a diagnosis of OSA was made by a sleep physician. They were evaluated against 36 control patients who, based on parent responses to the Pediatric Sleep Questionnaire, were at very low risk for having sleep problems. The mean age of the cohort was 12.3 ± 2.7 years. The oral health status was examined clinically and recorded using caries and periodontal indices. OHRQoL was measured using the Child Oral Health Impact Profile (COHIP) questionnaires. RESULTS Children with OSA had significantly worsened oral health compared to control patients as evidenced by more caries (15.2 and 3.2, respectively; P < .001) and more periodontitis. Periodontitis severity was measured by the presence of bleeding on probing, (87% versus 30%, P < .001) and higher number of sites with abnormally deep periodontal probing depths (2.7 versus 0.3, P < .001). The COHIP scores were significantly higher among children with OSA compared to control patients, (29.7 versus 11.8, P < .001) consistent with poorer OHRQoL. CONCLUSIONS This study suggests that in children OSA may have a significant association with poorer oral health when compared to control patients without sleep problems, and that their oral health status may have a negative effect on their quality of life. Increased awareness regarding the oral health effects of sleep-disordered breathing in the medical and dental community is needed.
Collapse
Affiliation(s)
- Basma Tamasas
- Department of Oral Health Sciences, University of Washington, Seattle, Washington
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Travis Nelson
- Department of Pediatric Dentistry, School of Dentistry, University of Washington, Seattle, Washington
| | - Maida Chen
- Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine, Seattle, Washington
- Pediatric Sleep Disorders Center, Seattle Children's Hospital, Seattle, Washington
| |
Collapse
|
15
|
Paulino CEB, Laureano Filho JR, Menezes LFFD, Rocha Neto AMD, Studart-Pereira LM. Pressure and resistance of the lips in subjects with and without occlusal change. REVISTA CEFAC 2019. [DOI: 10.1590/1982-0216/20192139118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to evaluate the resistance and pressure of the lips in Class I, II and III Angle’s malocclusion subjects, in comparison to reference values and relate them with gender and age. Methods: a quantitative, descriptive and cross-sectional study. Participants included 40 subjects, 20 women and 20 men, average age 26.3 years, separated by occlusal classification. The volunteers answered on the self-reported performance of the stomatognathic functions and were submitted to the evaluation of the mobility and posture of the lips. Pressure and resistance were measured with the Iowa Oral Performance Instrument (IOPI) and the results compared to the reference values described in the instrument´s manual. The data were analyzed descriptively and, for inferential analysis, Pearson's Chi-Square test was used. The significance level was considered 5%. Results: a decrease in pressure and resistance values wasobserved in all patients, including Angle’s class I group. There was an inverse relationship between the age of the subjects and the values of pressure of lips with statistical significance (p = 0.02). In general, women had lower pressure values than men. Conclusion: all study subjects had lower pressure of the lips than the reference values described in the literature.
Collapse
|
16
|
Milanesi JDM, Berwig LC, Marquezan M, Schuch LH, Moraes ABD, Silva AMTD, Corrêa ECR. Variables associated with mouth breathing diagnosis in children based on a multidisciplinary assessment. Codas 2018; 30:e20170071. [DOI: 10.1590/2317-1782/20182017071] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 07/31/2017] [Indexed: 12/14/2022] Open
Abstract
ABSTRACT Purpose : This study was conducted to identify variables associated with mouth breathing diagnosis in children, based on multidisciplinary domains. Methods 119 children, six to 12 years old, underwent anamnesis, speech therapy (orofacial structures and stomatognathic functions), otorhinolaryngologic (OTRL) with clinical and endoscopic examinations, dental (occlusion) and physiotherapy (body posture and nasal patency) assessments. Nasal patency was evaluated using Peak Nasal Inspiratory Flow (PNIF) and the Nasal Obstruction Symptom Evaluation (NOSE) scale. A multiple logistic regression was performed considering breathing mode as the dependent variable and the co-variables from each multidisciplinary assessment as associated variables. Results Association with MB diagnosis was found in each professional domain with: nasal obstruction report (Odds ratio - OR=5.55), time of pacifier use (OR=1.25), convex facial type (OR=3.78), obtuse nasal angle (OR=4.30), half-open or open lip posture (OR=4.13), tongue position on the mouth floor (OR=5.88), reduced hard palate width (OR=2.99), unexpected contraction during mastication (OR=2.97), obstructive pharyngeal tonsils (OR=8.37), Angle Class II malocclusion (OR=10.85) and regular gingival maintenance (OR=2.89). Conclusion We concluded that a multidisciplinary diagnosis is important, given that each evaluation domain, including OTRL, dental and speech therapy, presented variables associated with MB diagnosis. Body posture and nasal patency variables were not associated with MB.
Collapse
|
17
|
Zaimoğlu E, Hoxha S, Özdiler O, Özbek M, Memikoğlu UT. Reported prevalence of habitual pediatric snoring and the level of parental awareness. Sleep Biol Rhythms 2016. [DOI: 10.1007/s41105-016-0082-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|