Cephalometric evaluation of pharyngeal obstructive factors in patients with sleep apneas syndrome.
ABSTRACT To determine accurately the morphological characteristics specific to patients with sleep apneas syndrome (SAS), a group of 43 adult males with SAS was compared in a cephalometric evaluation with a homologous control group. In SAS patients, the soft palate was elongated; the sagittal dimensions of upper face and anterior cranial base were reduced and correlated with reduced bony pharynx opening; and the increased lower face height was associated with a retruded position of the chin and tongue, thus contributing to lower pharynx crowding. With the four variables entering the discriminant function analysis, 93 percent of the whole population was correctly classified. If anatomical rehabilitation of the pharynx is to be envisaged, the leading factors to consider should be: soft palate length, maxillary position, chin and tongue position, in that order.
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ABSTRACT: Orthognathic surgery has been associated with airway narrowing and induction of sleep-related breathing disorders. Therefore, the pharyngeal airway dimensions of 32 orthognathic surgery cases were prospectively investigated, and the relationship between the surgery and sleep quality assessed. Digitized lateral cephalometric radiographs were used to compare oropharyngeal airway morphologies before and after surgery. Patients were assessed in two main surgical groups based on sagittal jaw relationship. A questionnaire was used to assess changes in daytime sleepiness. The mandibular surgery cases were also assessed by overnight domiciliary sleep monitoring. A significant decrease in the retrolingual airway dimension was found in all patients after mandibular setback surgery and a significant increase in this dimension after mandibular advancement. The questionnaire and sleep study revealed no significant changes in snoring incidence or apnoeic events after mandibular setback surgery. For the mandibular advancement group, a change in sleep quality was found, but only in cases with signs of a pre-existing sleep disorder.Journal of orthodontics 10/2000; 27(3):235-47. DOI:10.1179/ortho.27.3.235
Article: Sleep-disordered breathing.New England Journal of Medicine 12/1993; 329(19):1429; author reply 1429-30. · 54.42 Impact Factor
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ABSTRACT: The increased demand for orthodontic treatment in the developed countries has led to a recent proliferation of "motel courses" that are specifically designed for general practitioners. Most of the techniques presented are only those that have long been available for selection by discerning orthodontists. However, when they are applied exclusively and indiscriminately by inexperienced clinicians, this may result in either prolonged, unnecessary treatment or failure through instability. Therefore some of the claims that are made will be examined and discussed with a review of the literature.American Journal of Orthodontics and Dentofacial Orthopedics 08/1994; 106(1):96-105. DOI:10.1016/S0889-5406(94)70026-5 · 1.44 Impact Factor