Intra- and interobserver agreement in the diagnosis of malocclusion in sleep-disordered breathing

Abstract

Sleep-disordered breathing (SDB) is often related to malocclusion, and dentists should be able to recognize occlusal changes that may be associated with the development, onset, or persistence of SDB. Although clinical examination is routinely used by specialists in orthodontics and functional jaw orthopedics, differences in diagnosis are very common. Method : Two observers, both dentists specializing in functional jaw orthopedics, examined 56 children aged 7 to 9 years. Intra- and interobserver agreement in identification of functional orthopedic and orthodontic conditions were assessed. Results : Intraobserver agreement was strong for all variables. Interobserver agreement was also strong, except for the variable overbite, which showed good agreement. Conclusion : Diagnostic criteria provide an opportunity for dentists to recognize dental malocclusions that may be associated with sleep-disordered breathing.

Photobiomodulation therapy on the palliative care of temporomandibular disorder and orofacial/cervical skull pain: study protocol for a randomized controlled clinical trial

“…Calibration will consist of reading the RDC/TMD manual together [19, 20], discussion of possible doubts, and application of the instrument to one patient, performed by each researcher (FRC and RQB). After checking the results and discussion, should there be any disagreement about the results the researchers will reapply the RDC/TMD form in another participant and, if any discordant points still remain, the form will be applied to other patients for the purpose of calculating the intra- and interobserver Kappa index of agreement [21].…”

“…The evaluation of occlusion is divided into sagittal analysis, vertical analysis, and transverse analysis [21, 22]. All definitions of the types of occlusions evaluated and how the analysis was divided have been described in a previous study [21]. The researcher (FRC or RQB) will assess the participant’s occlusion before the first clinical appointment.…”

A singular oral appliance to treat obstructive sleep apnea in CPAP non-adherent patients

“…The philosophy of the NOR 15,16 and gnathological school 13,14 advocate that the CP is the best reference plane for the occlusal rehabilitation because it promotes functional stability during stomatognathic functions. The DIORS ® design respects the same principles, in search for a better OAT adherence, with stability and neuromuscular balance, providing a good prognosis and successful treatment outcomes.…”

“…13,14 The OP can show differences in the orthogonal planes (sagittal, coronal and transversal), such as a unilateral masticatory function, generating skeletal asymmetries between the reference points of the orthogonal planes. Therefore, in the concepts of Neuro-Occlusal Rehabilitation (NOR), 15 the main reference for a diagnosis is clinical examination of OP associated with CP to decide which treatment 16 would bring neuromuscular balance and functional stability. Such diagnosis main tool is Gnathostatic Model (GM), observing the sagittal, coronal and transversal plane, to verify whether or not there is a CP and OP 15 parallelism (Fig 2).…”

Sleep‐disordered breathing and malocclusion in children and adolescents—a systematic review

“…51 Regarding malocclusion traits in the sagittal dimension, all studies used Angle's classification to assess the sagittal dimension of dental occlusion. [50][51][52][53] Three studies determined the occlusion according to Björk et al, 50,52,53,56 and one study referred to Moyers et al 51,57,58 None of the studies found associations between SDB symptoms and molar relationship regarding neutral, distal, or mesial molar occlusion. [50][51][52][53] Of the two studies that included horizontal maxillary overjet, only one found an association between horizontal maxillary overjet and SDB symptoms.…”