Background/objectives/aims: Controversy exists regarding maxillary bone changes in nongrowing adults. However, previous studies have relied on two-dimensional (2D) cephalo metric analyses, which may be unable to capture three-dimen sional (3D) pheno mena. In this study, we investigated 2D and 3D parameters to test the null hypothesis that maxillary bone volume cannot be changed in nongrowing adults that had been diagnosed with mid facial underdevelopment.Methods: After obtaining informed consent, we undertook 3D cone beam computed tomography scans of 11 consecutive, adult patients prior to and after biomimetic, oral appliance therapy. The mean treatment time was 18.4 months ± 2.5 using the DNA appliance ® system. The intramolar width and 3D volume of the midface was calculated prior to and after the mid facial redevelopment protocol. The findings were subjected to statistical analysis.
Results:The mean intramolar increased from 33.5 mm ± 3.4 prior to treatment to 35.8 mm ± 2.9 after appliance therapy (p = 0.0003). Similarly, the mean midfacial bone volume was 17.4 cm 3 ± 3.9 prior to treatment and increased to 19.1 cm 3 ± 2.6 after appliance therapy (p = 0.0091).
Conclusion:These data support the notion that maxillary bone width and volume can be changed in nongrowing adults. Furthermore, midfacial redevelopment may provide a potentially-use ful method of managing adults diagnosed with obstructive sleep apnea, using biomimetic, oral appliances.
Obstructive sleep apnea (OSA) is a clinical disorder within the spectrum of sleep-related breathing disorders (SRDB) which is used to describe abnormal breathing during sleep resulting in gas exchange abnormalities and/or sleep disruption. OSA is a highly prevalent disorder with associated sequelae across multiple physical domains, overlapping with other chronic diseases, affecting development in children as well as increased health care utilization. More precise and personalized approaches are required to treat the complex constellation of symptoms with its associated comorbidities since not all children are cured by surgery (removal of the adenoids and tonsils). Given that dentists manage the teeth throughout the lifespan and have an important understanding of the anatomy and physiology involved with the airway from a dental perspective, it seems reasonable that better understanding and management from their field will give the opportunity to provide better integrated and optimized outcomes for children affected by OSA. With the emergence of therapies such as mandibular advancement devices and maxillary expansion, etc., dentists can be involved in providing care for OSA along with sleep medicine doctors. Furthermore, the evolving role of myofunctional therapy may also be indicated as adjunctive therapy in the management of children with OSA. The objective of this article is to discuss the important role of dentists and the collaborative approach between dentists, allied dental professionals such as myofunctional therapists, and sleep medicine specialists for identifying and managing children with OSA. Prevention and anticipatory guidance will also be addressed.
The physiologic rest position of the mandible might have an effect on balance by showing a trend (demonstrating a tendency) in enhancing cerebral blood flow as measured by transcranial Doppler. Further studies are needed to confirm this study's finding.
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