Maxillary morphology in obstructive sleep apnoea syndrome

Abstract

The aim of this case-control study was to test the hypothesis that maxillary morphology differs between obstructive sleep apnoea (OSA) patients and non-snoring, non-apnoeic subjects. Forty randomly selected patients [36 M, 4 F; mean age 49 +/- 2 (SEM) years] with varying degrees of OSA (mean Apnoea/Hypopnoea Index 32 +/- 4/hour) were compared with 21 non-snoring, non-apnoeic control subjects (18 M, 3 F; mean age 40 +/- 2 years). An intra-oral assessment of the occlusion was carried out, particularly for the presence or absence of posterior transverse discrepancies. Maxillary dental arch width was assessed by standardized lateral inter-tooth measurements (inter-canine, inter-premolar, and inter-molar) from dental models. Palatal height and maxillary depth were also measured. The maxillary dental arch was described by a 4th order polynomial equation. The ratios of maxillary to mandibular width (max/mand) and maxillary to facial width (max/facial) were determined from standardized postero-anterior cephalometric radiographs in a subgroup of patients (n = 29) and all controls. Twenty patients (50 per cent) had evidence of posterior transverse discrepancies compared with one control subject (5 per cent; P < 0.01). All patients had significantly reduced inter-canine, inter-premolar, and inter-molar distances (P < 0.05). The maxillary depth was also shorter (P < 0.05), but palatal height was not different. The quadratic coefficient of the polynomial equation was greater in the patients than in the controls (P < 0.05), indicative of greater arch tapering. Patients had smaller maxillary to mandibular and maxillary to facial width ratios (P < 0.01). These results suggest that OSA patients have narrower, more tapered, and shorter maxillary arches than non-snoring, non-apnoeic controls. Further work is required to determine the relevance of these findings in the pathophysiology of OSA.

Facial Profile Shape, Malocclusion and Palatal Morphology in Malay Obstructive Sleep Apnea Patients

“…27 Besides contributing to high nasal resistance, maxillary constriction can contribute to lateral narrowing of the upper oral cavity and a low tongue posture, which consequently narrow the retroglossal region. 28 This may provide a reasonable explanation for the narrowing of the posterior airway space seen in OSA patients.…”

“…We believe these differences may explain the presence of OSA in this group of patients but did not affect our observations in terms of any differences noted on clinical examination. 28 Fourth, the present study was based on single-night limited PSG, which may lead to underdiagnosis for some mild sleep apnea patients. Nevertheless, some studies failed to find differences in AHI between singleand two-night PSG in adults.…”

Effects of rapid maxillary expansion on nasal breathing and some naso-respiratory and breathing problems in growing children: A literature review

“…It has been well known in the light of the related literature that a high prevalence of maxillary constriction is typical for OSA patients [63]. RME may be a potential or contributory treatment alternative to currently used methods in mild-to-moderate OSA cases, where maxillary constriction is present.…”

Enlargement of the Pharynx Resulting From Surgically Assisted Rapid Maxillary Expansion

“…2 In addition, transverse maxillary deficiency has been indicated as a predisposing factor. [11][12][13][14][15][16] The anatomic proximity of the pharynx to the oral cavity suggests that any change in intraoral volume changes the oropharyngeal dimensions. Thus, imaging studies using computed tomography (CT) can properly assess the oral cavity and pharynx.…”