Habitual snoring, OSA and craniofacial modification. Orthodontic clinical and diagnostic aspects in a case control study.
BACKGROUND
This research aims to analized the clinical and diagnostic aspects of OSA in the orthodontic research field.


METHODS
Through a case control study, the presence of early craniofacial modifications in a study group constituted of 13 children with long history of habitual snoring and obstructive sleep apnea syndrome (mean age 54 months, range 36-103) and in a control group constituted of 13 children with no history of snoring (mean age 60 months, range 55-67), is analyzed. Clinical neurological and orthodontic examination, cefalometrics analysis and MESAM 4 has been performed to each single child.


RESULTS
Neurological clinical examination and diurnal polysomnography or nocturnal ambulatory monitoring of snoring (MESAM 4) showed that this pathology started very early in the childhood: snoring onset was 22.7 months, the apnea onset was 34.7 months. Moreover 23% of the children showed a failure to thrive. The cephalometric results revealed that OSA children showed different cranio-facial features: a maxillo-mandibular micrognathia and or retrognathia, an increment of divergency associated with an increase in the vertical development of the face and a reduced perviety of the upper airway space caused by a mechanical obstruction due to enlarged adenoids. The orthodontic clinical examination revealed that OSA patients showed posterior cross-bite, anterior open-bite and lip-incompetence.


CONCLUSIONS
These results suggest that oral breathing, that is present in sleep apnea patients, is responsible of different cranio-facial anomalies. For this reason these features must be recognized, as soon as possible, in order to start an early treatment of this pathology.
Caprioglio
A
A
School of Specialization in Orthognathodontics, Faculty of Medicine and Surgery, University of Insubria, Varese. capri@telnetwork.it
Zucconi
M
M
Calori
G
G
Troiani
V
V
D000367:Age Factors; D016022:Case-Control Studies; D002508:Cephalometry; D002675:Child, Preschool; D019465:Craniofacial Abnormalities / Q000150:complications; D006801:Humans; D009460:Neurologic Examination; D017286:Polysomnography; D012886:Skull / Q000254:growth & development; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000628:therapy; D012913:Snoring / Q000209:etiology* / Q000517:prevention & control