Document Type : Review article
Authors
1 Associate Professor, Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences,Tehran, Iran
2 Post-Graduate Student, Departments of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Background and Objective: The aim of this study is a systematic review on the long-term stability of growth modification treatment in children with obstructive sleep apnea (SA).
Methods: At first, all the papers (n=87) related to keywords (growth modification, headgear, functional therapy, herbst, twin block, forsus, AHI, orthodontics, sleep apnea, systematic review, meta-analysis) were searched for English databases; PubMed, Scopus, Embase, google scholar and Cochrane Database of Systematic Reviews covering the period from 2000 through 2021 was studied. As a result to inclusion and exclusion criteria, papers related to growth modification treatment in children with sleep apnea were found and analyzed (n=5). Predefined inclusion and exclusion criteria were: papers related to growth modification treatment for children with SA, Children 7 to 11 years old with SA grade 2 and above, follow-up 10 months to 11 years old, use of functional appliance and headgear, papers were English, papers were original and all the papers were free full text.
Results: Of the 87 studies on growth modification treatment and sleep apnea, only 5 studies clinically evaluated the long-term stability of growth modification treatment on airway dimensions. Growth modification treatments for sleep apnea are very important and can play very significant role in health improvement. So, paying more attention to benefits of orthodontics therapeutic tools in sleep apnea is necessary. On important points is the orthodontist’s active role play in screening the patients for this disease and advice oral appliance therapy, if needed.
Conclusion: The long-term stability of using orthodontic functional appliances in the treatment of sleep apnea in children demonstrated that the utilization of these tools can increase the width of airways in the oral cavity improving the respiratory condition in children eliminating problems associated with apnea.
Keywords
- National Center on Sleep Disorders Research. National Sleep Disorders Research Bethesda, MD: National Heart, Lung, and Blood Institute, National Institutes of Health. 2003; vii.
- Veasey SC, Rosen IM. Obstructive sleep apnea in adults. New England Journal of Medicine. 2019 Apr 11;380(15):1442-9.
- Burman D. Sleep Disorders: Sleep-Related Breathing Disorders. FP essentials. 2017 Sep;460:11.
- Young T, Palta M, Dempsey J, et al. The occurrence of sleepdisordered breathing among middle-aged adults. New Eng J Med. 1993;328(17):1230–1235.
- Young T, Evand L, Finn L, et al. Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep.1997; 20(9):705–706.
- Sutherland K, Keenan BT, Bittencourt L, Chen NH, Gislason T, Leinwand S, Magalang UJ, Maislin G, Mazzotti DR, McArdle N, Mindel J. A global comparison of anatomic risk factors and their relationship to obstructive sleep apnea severity in clinical samples. Journal of Clinical Sleep Medicine. 2019 Apr 15;15(4):629-39.
- Zinchuk AV, Gentry MJ, Concato J, Yaggi HK. Phenotypes in obstructive sleep apnea: a definition, examples and evolution of approaches. Sleep medicine reviews. 2017 Oct 1;35:113-23.
- Kara M, Erdogan H, Güçlü O, Sahin H, Dereköy FS. Evaluation of sleep quality in patients with nasal septal deviation via the Pittsburgh Sleep Quality Index. Journal of Craniofacial Surgery. 2016 Oct 1;27(7):1738-40.
- Hui JW, Ong J, Herdegen JJ, Kim H, Codispoti CD, Kalantari V, Tobin MC, Schleimer RP, Batra PS, LoSavio PS, Mahdavinia M. Risk of obstructive sleep apnea in African American patients with chronic rhinosinusitis. Annals of Allergy, Asthma & Immunology. 2017 Jun 1;118(6):685-8.
- Lai H, Huang W, Chen W, Wang D. Effectiveness of Continuous Positive Airway Pressure Versus Mandibular Advancement Device in Severe Obstructive Sleep Apnea Patients With Mandibular Retrognathia: A Prospective Clinical Trial. Ear, Nose & Throat Journal. 2020 Nov 4:0145561320969251.
- Asem A, Bhattacharya P, Ansar J, Agarwal DK, Bhandari R. Effects of functional therapy on hyoid bone, pharyngeal airway and tongue position in class II patients. Ind J Orthod Dentofacial Res. 2018 Jan;4(1):41-4.
- Xiang M, Hu B, Liu Y, Sun J, Song J. Changes in airway dimensions following functional appliances in growing patients with skeletal class II malocclusion: a systematic review and meta-analysis. Int J Pediatr Otorhinolaryngol. 2017;97:170–80.
- Kirjavainen M, Kirjavainen T. Upper airway dimensions in Class II malocclusion: effects of headgear treatment. Angle Orthod. 2007;77(6):1046–53.
- Talvitie T, Helminen M, Karsila S, Varho R, Signorelli L, Peltomäki T. Adherence to instructions and fluctuation of force magnitude in cervical headgear therapy. The Angle Orthodontist. 2019 Mar;89(2):268-74.
- Godt A, Koos B, Hagen H, Göz G. Changes in upper airway width associated with Class II treatments (headgear vs activator) and different growth patterns. The Angle Orthodontist. 2011;81(3):440-6.
- Iwasaki T, Sato H, Suga H, Minami A, Yamamoto Y, Takemoto Y, et al. Herbst appliance effects on pharyngeal airway ventilation evaluated using computational fluid dynamics. The Angle Orthodontist. 2017;87(3):397-403.
- Zhang C, He H, Ngan P. Effects of twin block appliance on obstructive sleep apnea in children: a preliminary study. Sleep and Breathing. 2013;17(4):1309-14.
- Julku J, Pirilä-Parkkinen K, Pirttiniemi P. Airway and hard tissue dimensions in children treated with early and later timed cervical headgear—a randomized controlled trial. European journal of orthodontics. 2017;40(3):285-95.
- Hänggi MP, Teuscher UM, Roos M, Peltomäki TA. Long-term changes in pharyngeal airway dimensions following activator-headgear and fixed appliance treatment. The European Journal of Orthodontics. 2008;30(6):598-605.
- Rezaeitalab F, Moharrai F, Tavakkoli M. Case presentation: Sleep Apnea Syndrome in an adolescent with psychiatric presentation. medical journal of mashhad university of medical sciences. 2015;57(9):1016-9.
- Azagra-Calero E, Espinar-Escalona E, Barrera-Mora JM, Llamas-Carreras JM, Solano-Reina E. Obstructive sleep apnea syndrome (OSAS). Review of the literature. Medicina oral, patologia oral y cirugia bucal. 2012;17(6):e925.
- Ali N, Pitson D, Stradling J. Snoring, sleep disturbance, and behaviour in 4-5 year olds. Archives of disease in childhood. 1993;68(3):360-6.
- Brunetti L, Rana S, Lospalluti ML, Pietrafesa A, Francavilla R, Fanelli M, et al. Prevalence of obstructive sleep apnea syndrome in a cohort of 1,207 children of southern Italy. Chest. 2001;120(6):1930-5.
- Marcus CL. Sleep-disordered breathing in children. American journal of respiratory and critical care medicine. 2001;164(1):16-30.
- Chervin RD, Weatherly RA, Ruzicka DL, Burns JW, Giordani BJ, Dillon JE, et al. Subjective sleepiness and polysomnographic correlates in children scheduled for adenotonsillectomy vs. other surgical care. Sleep. 2006;29(4):495.
- Brouillette RT, Fernbach SK, Hunt CE. Obstructive sleep apnea in infants and children. The Journal of pediatrics. 1982;100(1):31-40.
- Hoban TF. Polysomnography should be required both before and after adenotonsillectomy for childhood sleep disordered breathing. Journal of Clinical Sleep Medicine. 2007;3(7):675-7.
- Schmidt-Nowara W, Lowe A, Wiegand L, Cartwright R, Perez-Guerra F, Menn S. Oral appliances for the treatment of snoring and obstructive sleep apnea: a review. Sleep. 1995;18(6):501-10.
- Rapoport DM. Treatment of sleep apnea syndromes. The Mount Sinai Journal of Medicine, New York. 1994;61(2):123-30.
- Battagel J, L'estrange P. The cephalometric morphology of patients with obstructive sleep apnea (OSA). European journal of orthodontics. 1996;18(6):557-69.
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