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Published on: December 6, 2016
The dental and craniofacial characteristics among children with obstructive sleep apnoea: a systematic review and
Yanxiaoxue Liu1,2,3, Tingting Zhao1,2, Peter Ngan4
1Hubei-MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
Insights
Paediatric obstructive sleep apnoea (OSA) is linked to distinct craniofacial and dental characteristics in children. These findings suggest potential diagnostic indicators for this common childhood sleep disorder.
Area of Science:
- Pediatric Sleep Medicine
- Orthodontics
- Craniofacial Biology
Background:
- Paediatric obstructive sleep apnoea (OSA) significantly impacts children's behavior, neurodevelopment, and overall health.
- Malocclusion and craniofacial morphology are potentially associated with paediatric OSA, aiding in early identification and treatment.
Approach:
- A systematic review and meta-analysis summarized evidence on the association between paediatric OSA and dental/craniofacial characteristics.
- Searched PubMed, Embase, and Cochrane Central Register of Controlled Trials up to June 2022.
- Included 16 cross-sectional studies comparing OSA-diagnosed children with healthy controls.
Key Points:
- Children with OSA exhibited greater overjet, sagittal skeletal jaw discrepancy (ANB), and mandibular plane angle (FH-MP).
- Conversely, OSA-affected children showed smaller upper molar arch width, SNB, and maxillary length (ANS-PNS).
- Meta-analyses revealed statistically significant differences in these craniofacial metrics.
Conclusions:
- Children with OSA tend to present with mandibular retroposition, increased mandibular plane angle, and excess anterior overjet.
- These craniofacial and dental characteristics may serve as indicators for OSA in children.
- Clinical significance of these findings requires cautious interpretation due to potential variability.
Background:
Paediatric obstructive sleep apnoea (OSA) is a sleep breathing disorder which may have dramatic effects on childhood behaviour, neurodevelopment, metabolism, and overall health in children. Malocclusion and craniofacial morphology may be related to paediatric OSA, and therefore provide information for clinicians to recognize, evaluate and treat patients with this sleeping disorder.
Objective:
The aim of this systematic review was to summarize evidence regarding the association between paediatric OSA and children's dental and craniofacial characteristics.
Search Methods:
PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched from inception to 1 June 2022.
Selection Criteria:
Cross-sectional studies, comparing dental or craniofacial characteristics using clinical dental examinations or radiographic findings between OSA children (less than 18 year, diagnosed with overnight polysomnography) and healthy children, were included.
Data Collection And Analysis:
The Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies was used to assess the quality of included studies. RevMan software was used for performing the Meta-analyses.
Results:
Sixteen studies were included. Meta-analyses showed that the overjet (MD = 0.86, 95% CI: 0.20 to 1.51; P = 0.01), the saggital skeletal jaw discrepancy (ANB; MD = 1.78, 95% CI: 1.04 to 2.52; P < 0.00001) and mandibular plane angle (FH-MP; MD = 3.65, 95% CI: 2.45 to 4.85; P < 0.00001) were greater in OSA-affected children. In contrast, the upper molar arch width (upper first deciduous molar width; MD = -1.86, 95% CI: -3.52 to -0.20; P = 0.03), (Upper second deciduous molar width; MD = -1.06, 95% CI: -1.88 to -0.24; P = 0.01), SNB (MD = -2.10, 95% CI: -3.11 to -1.09; P < 0.0001), and maxillary length (ANS-PNS; MD = -1.62, 95% CI: -2.66 to -0.58; P = 0.002) were smaller in the OSA group.
Conclusions:
This review shows that OSA-affected children tend to present with mandibular retroposition or retrognathia, increased mandibular plane angle and excess anterior overjet. However, these findings need to be viewed with caution as the corresponding differences may not be significant clinically.
Registration:
PROSPERO (CRD42020162274).
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