Craniofacial structure and obstructive sleep apnea syndrome — a qualitative analysis and meta-analysis of the literature

Miles, Peter; Vig, Peter S.; Weyant, Robert J.; Forrest, Thomas D.; Rockette, Howard E.

doi:10.1016/s0889-5406(96)70177-4

Cited by 198 publications

(115 citation statements)

References 30 publications

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“…However, data in the literature are inconsistent, such that studies evaluating cephalometric anomalies in patients with OSAS have found no clearcut morphological characteristics. 25 In addition, a recent study showed that gender and racial variations are present in cephalometric parameters. 26 Because the structural relationship between the hard and soft tissues of the upper airway is confounded by obesity, which independently remains an important factor for increasing apneic activity, it is important to know which craniofacial parameters are risk factors for nonobese young adults.…”

Section: Discussionmentioning

confidence: 99%

Cephalometric Analysis of Nonobese Snorers Either with or Without Obstructive Sleep Apnea Syndrome

Tsai

Lee

et al. 2007

The Angle Orthodontist

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Objective: To determine if there is an indicator on the lateral cephalometric radiograph that can be used for the differential diagnosis of severe obstruct sleep apnea syndrome and simple snoring in nonobese young male adults. Materials and Methods: The subjects were Taiwanese male patients with a complaint of snoring and/or sleep apnea, whose body mass index was less than 25 kg/m 2 and who were younger than 40 years old. Forty-six patients with severe obstructive sleep apnea and 36 patients with simple snoring were selected and underwent lateral cephalometric radiography, from which 24 linear and 34 angular measurements were calculated. Differences between the two groups were studied, and a discriminatory analysis was performed. Results: Soft palate length, mandibular body length, tongue size, and distance from the hyoid bone to the mandibular plane were significantly larger in patients with severe obstructive sleep apnea syndrome. Of the original grouped cases, 76.5% were correctly classified using these five variables. The position of the hyoid bone in simple snorers was near the straight line from the third vertebra to the menton, whereas the position of the hyoid bone in severe obstruct sleep apnea syndrome patients was far below the line from the third vertebra to the menton. Conclusion:The position of the hyoid bone relative to the line from the third vertebra to the menton can be used as an indicator for a diagnosis of severe obstruct sleep apnea syndrome in nonobese young male Taiwanese adults.

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Section: Discussionmentioning

confidence: 99%

Cephalometric Analysis of Nonobese Snorers Either with or Without Obstructive Sleep Apnea Syndrome

Tsai

Lee

et al. 2007

The Angle Orthodontist

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“…Despite that observed alterations in craniofacial morphology are not uniform, a steeper mandibular plane angle, a shorter mandibular body length, and a low hyoid bone position were consistently reported by most investigations. 9 Gross changes in the hyoid bone position can be used to assess gross changes in the tongue position. 4 Kondo and Aoba 10 also stressed that lifting a low-postured tongue to improve airway patency was important for the treatment stability of a narrow maxillary arch.…”

Section: Introductionmentioning

confidence: 99%

“…9 Does this imply that a man with a short ramus length or smaller facial angle combined with an inferiorly positioned hyoid bone in his early 20s is predisposed to OSAHS in middle age? We consider it an interesting issue that deserves further investigation.…”

mentioning

confidence: 99%

Developmental Changes in Pharyngeal Airway Depth and Hyoid Bone Position from Childhood to Young Adulthood

Sheng

Lin

et al. 2009

The Angle Orthodontist

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Objective: (1) To test the hypothesis that there are no developmental changes in the pharyngeal airway depth and hyoid bone position from childhood to adulthood in normal Taiwanese persons, (2) to identify any sexual dimorphism, and (3) to find the predictive value of selective variables for the hyoid bone position. Materials and Methods: Lateral cephalometric radiographs of 239 normal Taiwanese (132 females and 107 males; aged 7-27 years) were separated into three stages according to dental age. Twenty-three linear and 20 angular measurements were made in all subjects. Sexual dimorphism was analyzed by Student's t-test. Analysis of variance was used to compare the three stages in both genders. A stepwise regression analysis was carried out to predict the hyoid bone position. The level of significance for all analyses was set at P Ͻ .05. Results:The pharyngeal airway depth increased from the mixed dentition stage to the permanent dentition stage in both genders. There was sexual dimorphism in the lower pharyngeal airway depth. The hyoid bone position showed an obvious difference in the permanent dentition stages between genders. The vertical position of the hyoid bone was associated with the mandibular morphology and position, but the relationship in males was reversed compared with that in females. Conclusions:The hypothesis was rejected. There are developmental changes in the pharyngeal airway depth and hyoid position from childhood to young adulthood. Sexual dimorphism appeared in the lower pharyngeal airway and the direction of change in the vertical position of the hyoid bone. (Angle Orthod. 2009;79:484-490.)

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“…Class III treatment [37,38] treatment of transverse problems [39][40][41][42] incisor intrusion [43] external apical root resorption [44] dental anomalies [45][46][47] frequency of occlusal problems [48] nickel hypersensitivity [49] orthodontics and temporomandibular disorders [50,51] obstructive sleep apnea [52,53] oral hygiene [54] dentition analysis [55,56] cephalometric analysis [57] and orthodontic education [58] …”

Section: Resultsmentioning

confidence: 99%

Meta-Analyses and Orthodontic Evidence-Based Clinical Practice in the 21st Century~!2009-09-21~!2009-10-05~!2010-07-16~!

Papadopoulos¹

2010

TODENTJ

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Abstract:Introduction: Aim of this systematic review was to assess the orthodontic related issues which currently provide the best evidence as documented by meta-analyses, by critically evaluating and discussing the methodology used in these studies. Material and Methods:Several electronic databases were searched and handsearching was also performed in order to identify the corresponding meta-analyses investigating orthodontic related subjects. In total, 197 studies were retrieved initially. After applying specific inclusion and exclusion criteria, 27 articles were identified as meta-analyses treating orthodontic-related subjects.Results: Many of these 27 papers presented sufficient quality and followed appropriate meta-analytic approaches to quantitatively synthesize data and presented adequately supported evidence. However, the methodology used in some of them presented weaknesses, limitations or deficiencies. Consequently, the topics in orthodontics which currently provide the best evidence, include some issues related to Class II or Class III treatment, treatment of transverse problems, external apical root resorption, dental anomalies, such as congenital missing teeth and tooth transposition, frequency of severe occlusal problems, nickel hypersensitivity, obstructive sleep apnea syndrome, and computer-assisted learning in orthodontic education. Conclusions:Only a few orthodontic related issues have been so far investigated by means of MAs. In addition, for some of these issues investigated in the corresponding MAs no definite conclusions could be drawn, due to significant methodological deficiencies of these studies. According to this investigation, it can be concluded that at the begin of the 21 st century there is evidence for only a few orthodontic related issues as documented by meta-analyses, and more well-conducted high quality research studies are needed to produce strong evidence in order to support evidence-based clinical practice in orthodontics.

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Craniofacial structure and obstructive sleep apnea syndrome — a qualitative analysis and meta-analysis of the literature

Cited by 198 publications

References 30 publications

Cephalometric Analysis of Nonobese Snorers Either with or Without Obstructive Sleep Apnea Syndrome

Cephalometric Analysis of Nonobese Snorers Either with or Without Obstructive Sleep Apnea Syndrome

Developmental Changes in Pharyngeal Airway Depth and Hyoid Bone Position from Childhood to Young Adulthood

Meta-Analyses and Orthodontic Evidence-Based Clinical Practice in the 21st Century~!2009-09-21~!2009-10-05~!2010-07-16~!

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