Location of the narrowest area of the pharynx regarding body mass index and obstructive sleep apnoea severity

BACKGROUND

Among authors studying morphological determinants of the obstructive sleep apnoea (OSA) controversies exist on the location of the narrowest area within the pharynx, critical for development of obstruction. Those disagreements primarily revolve around differences between obese and nonobese OSA patients. Determination whether the location and size of the narrowest area within the pharynx differentiates the obese and nonobese OSA patients.

MATERIALS AND METHODS

A population of 55 subjects was investigated after being diagnosed with OSA in the Polysomnography Laboratory of the Department and Clinic of Otolaryngology in the Medical University of Warsaw, Poland. Additionally a head computed tomography (CT) was performed in all the subjects. The CT images were used to do several crucial measurements which described the geometry of the facial skeleton as well as soft tissues of the head. The obtained results were correlated with apnoea-hypopnoea index (AHI) and body mass index (BMI) values. The data were statistically analysed.

RESULTS

The distance between the hard palate and posterior pharyngeal wall parallel to the horizontal plane as well as the shortest distance between the soft palate and posterior pharyngeal wall significantly differentiated patients in the subgroups by AHI but not by BMI.

CONCLUSIONS

Pharyngeal obstruction at the level of the hard and soft palate differentiates patients with severe OSA from patients with mild and moderate OSA regardless of BMI.

Clinical use of allogeneic bone granulates to reconstruct maxillary and mandibular alveolar processes

INTRODUCTION

Lack of adequate mass of a patient's own bone is still a clinical problem in dental implantology; it precludes dental embedment. Surgical widening of an atrophied alveolar process with the use of an allogeneic bone granulate to fill the bone defect constitutes a first-line method to prepare for implant-prosthetic treatment. Transplantation of allogeneic material allows reconstruction of optimal height, thickness, and width of the alveolar process facilitating a procedure with a good long-term outcome. The study assessed outcomes following augmentation of atrophied alveolar processes before intraosseous implantation.

MATERIALS AND METHODS

Filling bone defects in the maxilla and mandible as an introductory measure for implant-prosthetic treatment was performed in 59 patients (24 females and 35 males of age range 22-65 years). Bone granulate was used for maxillary sinus floor elevation (n=29), augmentation of the postextraction alveoli (n=12), and filling of defects in the outer table of the compact bone formed following inflammatory conditions (n=18). The bone grafts were covered with plasma-rich fibrin (PRF) obtained from the patient's blood to accelerate the formation of synostoses and prevent epithelial penetration between the patients' own bone and the bone graft.

RESULTS

In all of the patients normal union was observed, as confirmed by radiological images as well as intraprocedural assessment. Sufficient height and width as well as thickness of the alveolar process was obtained, which allowed embedment.

CONCLUSIONS

Allogeneic bone granulate constitutes a good material to reconstruct maxillary and mandibular alveolar processes in out-patient care.