Association among craniofacial morphology, ethnicity, and risk of pediatric sleep-related breathing disorders: A multicenter study

INTRODUCTION

Craniofacial morphology and ethnicity may be risk factors for sleep-related breathing disorder (SRBD) in children but have not yet been assessed in an international multicenter study. The objectives of this study were to assess the association among craniofacial features, self-reported ethnicity, and risk of SRBD in children undergoing orthodontic treatment.

METHODS

Children aged 5-18 years who presented for orthodontic evaluation were enrolled in the United States, South Africa, South Korea, Saudi Arabia, and Japan. The risk of SRBD was defined as answering ≥0.33 positive responses to the Pediatric Sleep Questionnaire. Craniofacial features included measurements in sagittal and vertical dimensions to evaluate the cranial base, maxillomandibular and dental relationships, and nasopharyngeal airway dimensions. Logistic regression was performed to assess the association among craniofacial features, ethnicity, age, body mass index, and risk of SRBD.

RESULTS

Data were obtained from 602 patients from 5 sites. A total of 76 patients (12.6%) had a risk of SRBD. The mean age was 12.5 years. Male gender (odds ratio [OR], 1.9; 95% confidence interval [CI], 1.0-3.4; P = 0.041), Middle Eastern ethnicity (OR, 10.2; 95% CI, 4.1-25.4; P = 0.001), body mass index (OR, 1.1; 95% CI, 1.04-1.10; P = 0.001), gonial angle (OR, 0.91; 95% CI, 0.85-0.98; P = 0.011), and inferiorly positioned hyoid (OR, 1.1; 95% CI, 1.0-1.2; P = 0.002) were significantly associated with the risk of SRBD.

CONCLUSIONS

In an ambidirectional cohort study across 5 sites, male gender, Middle Eastern ethnicity, body mass index, gonial angle, and inferiorly positioned hyoid were associated with the risk of SRBD in children undergoing orthodontic treatment.

Assessment of dental, skeletal, and soft tissue changes following mandibular advancement with Invisalign in skeletal Class II

Objective

This study evaluated the dentoskeletal and soft tissue changes for Class II malocclusion patients treated with Invisalign clear aligners with mandibular wings (IAMW).

Methods

This retrospective study included 50 skeletal Class II patients treated with Invisalign clear aligner with mandibular wings. Records of 20 subjects were collected from the AAOF Legacy Collection (The Case Western Bolton Brush Growth Study) and were used as a control. The dental, skeletal, and facial soft tissue changes were assessed by digitizing and analyzing lateral cephalograms using Dolphin Imaging software (version 11.95 Premium; Dolphin Imaging & Management Solutions, Chatsworth, Calif). Paired t-tests and independent t-tests were used to assess the changes before and after and to compare between the IAMW and control groups.

Results

The different measurements of the maxilla have shown that IAMW effect on the maxilla included minimal, non-significant retraction compared to the control group. The SNB and mandibular base position increased by 1.17° (±2.63) and 3.79 (±8.13), respectively. The mandible advanced significantly in the treatment group compared to the control group. Dentally, the lower incisors tipped slightly buccally, but the change was not significant (p > 0.05). The facial convexity angle decreased by 1.16° (±4.36).

Conclusion

Invisalign clear aligner with mandibular advancer wings was able to correct the Class II malocclusion. This correction was mainly skeletal with some dental changes. This device can be used to address the growth modification problem in Class II malocclusion at the same time as addressing the other occlusal problems.

Perception and Attitude of Dental Students and Interns Regarding the Diagnosis and Management of Oral Mucosal Lesions and Salivary Glands Hypofunction

Background:

The perception and attitude of dental students/graduates regarding diagnosing/managing oral medicine cases are scarcely investigated.

Objective:

The aim of this investigation was to evaluate the level of confidence in diagnosing/managing cases of oral mucosal lesions and salivary glands hypofunction.

Methods:

A 29-items questionnaire descriptive survey was distributed among dental interns and sixth-year students in the city of Jeddah during March-April of 2020.

Results:

A total of 136 (81 interns and 55 sixth-year students) completed the questionnaire, of which 69.9% were from a government school, and 30.1% were from private schools. For oral mucosal lesions [i.e., aphthous/herpes simplex virus ulceration], the majority of government and private schools’ participants reported being confident in their ability to diagnose (88.4% and 87.8%, respectively) and provide treatment (63.2% and 56.1%, respectively). For oral candidiasis, the majority were confident in their ability to diagnose (government: 95.8%; private: 59.1%) and treat (government: 77.9%; private: 65.9%). The confidence in diagnosing lesions suspicious for dysplasia/premalignancy was high in 77.9% of government and 80.5% of private schools. Similar reporting was found regarding salivary hypofunctions (government: 93.7%; private: 90.2%). For the likeness to refer, the majority of participants were likely to refer to oral medicine, as the 1st choice, followed by oral surgery.

Conclusion:

Dental interns/sixth-year students seemed to have high levels of confidence in diagnosing/managing oral mucosal lesions and salivary hypofunctions. However, the partial participation and the subjectivity of reporting may have hindered capturing the full/precise picture.