Objective: To test the null hypothesis that there is no difference in facial profile shape, malocclusion class, or palatal morphology in Malay adults with and without obstructive sleep apnea (OSA). Materials and Methods: Subjects were 120 adult Malays aged 18 to 65 years (mean Ϯ standard deviation [SD], 33.2 Ϯ 13.31) divided into two groups of 60. Both groups underwent clinical examination and limited channel polysomnography (PSG). The mean OSA and control values were subjected to t-test and the chi square test. Results: Physical examination showed that 61.7% of the OSA patients were obese, and 41.7% of those obese patients had severe OSA. The mean body mass index (BMI) was significantly greater for the OSA group (33.2 kg/m 2 Ϯ 6.5) than for the control group (22.7 kg/m 2 Ϯ 3.5; P Ͻ .001). The mean neck size and systolic blood pressure were greater for the OSA group (43.6 cm Ϯ 6.02; 129.1 mm Hg Ϯ 17.55) than for the control group (35.6 cm Ϯ 3.52; 114.1 mm Hg Ϯ 13.67; P Ͻ .001). Clinical examination showed that the most frequent findings among OSA groups when compared with the control group were convex profiles (71.7%), Class II malocclusion (51.7%), and V palatal shape (53.3%), respectively; the chi square test revealed a significant difference in terms of facial profile and malocclusion class (P Ͻ .05), but no significant difference in palatal shape was found. Conclusion:The null hypothesis is rejected. A convex facial profile and Class II malocclusion were significantly more common in the OSA group. The V palatal shape was a frequent finding in the OSA group. (Angle Orthod. 2010;80:37-42.)

Craniofacial obesity in the bucco-submandibular regions is associated with OSA and may provide valuable screening information for the identification of patients with undiagnosed OSA.

Obstructive sleep apnea is an exciting area for orthodontists to be involved. The level of awareness of sleep apnea and related health issues is growing rapidly. The demand of integrating sleep into the orthodontic practice shortly will be driven by the need of the societies as some of our patients will be shortly coming into our offices aware of sleep apnea. However, with our busy clinical orthodontic practice, the need of condense short review become more demanding. Therefore, this review will try to summarize the clinical and orthodontic observation in the diagnoses of adult obstructive sleep apnea with clinical application in orthodontic practice.

Students’ reasons for choosing dentistry as a profession have not been well documented, especially in the developing countries. Therefore, the aim of this study was to determine the reasons why undergraduate Yemeni dental students who attended the University of Science and Technology (UST) chose dentistry as a career. A total of 300 out of 500 responses were recorded for this study, a response rate of 60 percent. An anonymous questionnaire was administered to dental students at UST, and a chi‐square test was used for statistical analysis of the data. The results showed that students chose dentistry as a career for the following reasons: economic (easy to find jobs, 44.7 percent); vocational (I like to treat people to improve their health, 39.0 percent); personal (my family dentist's encouragement, 37.3 percent); and professional (I can work in many fields, 33.0 percent). When group and item scores were compared between genders, statistically significant differences were only found for vocational reasons (p<0.05). In conclusion, the reasons Yemeni dental students chose dentistry as a profession were primarily economic, then vocational. However, vocational reasons were found to be the significant factors for choosing dentistry as a career by both genders in this group of UST Yemeni dental students.

Aims:The objectives of this study were to assess perceptions of the Saudi dental students of the problem-based learning (PBL) curriculum and to compare their perceptions among different sex and academic years.Subjects and Methods:Data was collected through a questionnaire-based survey at Qassim College of dentistry. The questionnaire consisted of 19 questions regarding the perception of PBL curriculum and was distributed to 240 students. The chi-square test was used for statistical analysis of the data.Results:Out of the 240 students recruited for this study, 146 returned a complete questionnaire (the response rate was 60.8%). The majority of the students perceived that PBL enhances the ability to speak in front of people (91.1%); improved the ability to find the information using the internet/library (81.5%); enhances the problem-solving skills (71.3%); increases the practice of cooperative and collaborative learning (69.2%); improves the decision-making skills (66.4%). Sixty-five percent (n = 96) noted that some students dominate whereas others are passive during PBL discussion session. Statistically, significant differences were found in the following variables according to the academic year students assuming before responsibility for their own learning (P < 0.037) and the role of facilitator in the process (P < 0.034). Moreover, according to gender; there were statistically significant differences in the following variables, assuming responsibility for own learning (P < 0.003); activating prior knowledge and learning to elaborate and organize their knowledge (P < 0.009); enhancing the ability to find the information using the Internet/library (P < 0.014); PBL is effective without having lecture of the same topic (P < 0.025); helping in identifying the areas of weakness for improvement (P < 0.031); student understanding the objectives of the PBL session better than the conventional way (P < 0.040); and enhancing the ability to speak in front of people (P < 0.040).Conclusions:Perceptions of Saudi dental students regarding their education environments at Qassim College of dentistry using PBL hybrid curriculum were more positive than negative. However, improvements are still required to provide students with stimulating favorable learning environment and to take the students recommendations into consideration.

Snoring is considered as the most common clinical symptom of obstructive sleep apnea-hypopnea syndrome. However, many snoring studies were done in western population, and data from around Asia is scarce. Therefore, the purposes of this study were to determine the prevalence of snoring among Malaysian children from hospital-based medical clinic population setting and to compare the craniofacial features of children with and without snoring using cephalometric analysis. A cross-sectional study among children aged 7-15 years were carried out in Hospital Kuala Terengganu. Sleep behavior questionnaire (Berlin questionnaire) was given to 500 children. The respondents were divided into snoring and non-snoring groups. Thirty children from each group were randomly selected to undergo a cephalometric X-ray. For each lateral cephalometric radiograph, 17 parameters consisting bony, soft tissue, and angular measurements were recorded using computer software VixWin2000. Independent t test was used to analyze the data. The results indicated that the whole questionnaire respondents were 317 (46 snoring and 271 non-snoring), hence, the prevalence of snoring in our survey population was 14.51%. The cephalometric X-ray showed that the snoring children manifested a significant different craniofacial features, such as narrow airway at the level of the soft palate and oropharynx (p < 0.05), more inferiorly positioned hyoid bone (p < 0.05), longer vertical airway length from posterior nasal spine to the base of epiglottis (p < 0.05), more protruding maxilla, and anterior-posterior discrepancy of maxilla and mandible (p < 0.05). In conclusion, our snorer children exhibit significant craniofacial differences compared to non-snorer groups.

The association between dental arch morphology and the aetiology of obstructive sleep apnoea (OSA) is not clear. To compare dental arch morphology in 108 Asian adults with and without ''OSA, overnight'' hospital polysomnography was performed, and sleep reports were obtained for all subjects. Standardized digital photographs were also taken of the subjects' upper and lower study models. Using 25 homologous landmarks, mean OSA and control dental arch configurations were computed, and subjected to finite-element morphometry (FEM), t-tests and principal components analysis (PCA). Mean upper and lower OSA dental arch morphologies were statistically different from respective Control upper and lower arch morphologies (P < 0.05). FEM of the upper arch indicated that the mean OSA configuration was 7-11% narrower in the transverse plane in the incisor and canine regions when compared with the control configuration, and inter-landmark analysis (ILA) confirmed this finding. FEM for the lower arch indicated that the mean OSA configuration was 10-11% narrower in the antero-posterior plane in the pre-molar and molar regions, and confirmed by ILA. Using PCA, significant differences were also found between the two groups in the lower arch using the first two eigenvalues, which accounted for 90% of the total shape change (P < 0.001). Supporting their role as aetiological factors, size and shape differences in dental arch morphology are found in patients with OSA.

The aim of the present study is to investigate nasal airway morphology in Asian adults with and without obstructive sleep apnea (OSA) using acoustic rhinometry (AR), principal components analysis (PCA), and 3-D finite-element analysis (FEA). One hundred eight adult Malays aged 18-65 years (mean ± SD, 33.2 ± 13.31) underwent clinical examination and limited channel polysomnography, providing 54 patients with OSA and 54 non-OSA controls. The mean minimal cross section area 1 (MCA1) and the mean minimal cross sectional area 2 (MCA2) were obtained from AR for all subjects and subjected to t tests. The OSA and control nasal airways were reconstructed in 3-D and subjected to PCA and FEA. The mean MCA1 and MCA2 using AR were found to be significantly smaller in the OSA group than in the control group (p < 0.001). Comparing the 3-D OSA and control nasal airways using PCA, the first two eigenvalues accounted for 94% of the total shape change, and statistical differences were found (p < 0.05). Similarly, comparing the nasal airways using FEA, the 3-D mean OSA nasal airway was significantly narrower in the OSA group compared to the control group. Specifically, decreases in size of approx. 10-22% were found in the nasal valve/head of inferior turbinate area. In conclusion, differences in nasal airway morphology are present when comparing patients with OSA to controls. These differences need to be recognized as they can improve our understanding of the etiological basis of obstructive sleep apnea and facilitate its subsequent management.