Polysomnographic Findings are Associated with Cephalometric Measurements in Mouth-Breathing Children

Polysomnographic Findings are Associated with Cephalometric Measurements in Mouth-Breathing Children

Author Juliano, Maria Ligia Autor UNIFESP Google Scholar
Machado, Marco Antonio Cardoso Autor UNIFESP Google Scholar
Carvalho, Luciane Bizari Coin de Autor UNIFESP Google Scholar
Zancanella, Edilson Autor UNIFESP Google Scholar
Santos, Gianni Mara Silva dos Autor UNIFESP Google Scholar
Prado, Lucila Bizari Fernandes do Autor UNIFESP Google Scholar
Prado, Gilmar Fernandes do Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Objectives: Children with adenotonsillar hypertrophy and those with an abnormal craniofacial morphology are predisposed to having sleep disordered breathing; many of these children are mouth breathers. The aim of this study was to determine whether an association exists between polysomnographic findings and cephalometric measures in mouth-breathing children.Methods: Twenty-seven children (15 mouth-breathing children and 12 nose-breathing children [control subjects]), aged 7 to 14 years, took part in the study. Polysomnographic variables included sleep efficiency, sleep latency, apnea-hypopnea index, oxygen saturation, arousal index, number of periodic limb movements in sleep, and snoring. Cephalometric measures included maxilla and mandible position, occlusal and mandibular plane inclination, incisor position, pharyngeal airway space width, and hyoid bone position.Results: As compared with nose-breathing children, mouth breathers were more likely to snore (p < 0.001) and to have an apnea-hypopnea index greater than 1 (p = 0.02). Mouth-breathing children were also more likely to have a retruded mandible, more inclined occlusal and mandibular planes, a smaller airway space, and a smaller superior pharyngeal airway space (p < 0.01). The apnea-hypopnea index increased as the posterior airway space decreased (p = 0.05).Conclusions: Our study showed an association between polysomnographic data and cephalometric measures in mouth-breathing children. Snoring was the most important variable associated with abnormal craniofacial morphology. Orthodontists should send any mouth-breathing child for an evaluation of sleep if they find that the child has a small superior pharyngeal airway space or an increased ANB (the relationship between the maxilla and mandible), NS.PIO (occlusal plane inclination in relationship to the skull base), or NS.GoGn (the mandibular plane inclination in relation to the skull base), indicating that the child has a steeper mandibular plane.
Keywords Sleep disordered breathing
polysomnography
lateral radiography
mouth-breathing children
Language English
Date 2009-12-15
Published in Journal Of Clinical Sleep Medicine. Westchester: Amer Acad Sleep Medicine, v. 5, n. 6, p. 554-561, 2009.
ISSN 1550-9389 (Sherpa/Romeo, impact factor)
Publisher Amer Acad Sleep Medicine
Extent 554-561
Origin http://jcsm.aasm.org/ViewAbstract.aspx?pid=27657
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000272780400011
URI http://repositorio.unifesp.br/11600/44335

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