Cozza Paola, Polimeni Antonella, Ballanti Fabiana
Department of Orthodontics, University of Rome 'Tor Vergata', Italy.
Eur J Orthod. 2004 Oct;26(5):523-30. doi: 10.1093/ejo/26.5.523.
The aims of this study were to determine the differences in craniofacial morphology between children with obstructive sleep apnoea (OSA) and control subjects, and to investigate the effects of modified monobloc (MM) appliance treatment in OSA children. The treatment group consisted of 20 OSA Caucasian subjects (10 boys and 10 girls) with ages ranging from 4 to 8 years (mean 5.91 years). The control group comprised 20 healthy Caucasian subjects without OSA (10 boys and 10 girls) with ages ranging from 5 to 7 years (mean 6 years). Polysomnography was used to establish the diagnosis of OSA and to evaluate the effects of MM treatment in the test group. Cephalometric radiographs and study models were obtained for all subjects. A number of statistically significant differences were detected in craniofacial morphology between the treatment group and controls. The treatment group demonstrated a skeletal Class II pattern (P= 0.04), with a reduced mandibular length (P= 0.03) and a corresponding increase in overbite. The hyoid bone was located superiorly in the OSA group (P = 0.04). Analysis of the dental arches demonstrated a significantly smaller distance between the first and second inter-molar primary mandibular regions (P = 0.03 and P = 0.04, respectively) in OSA patients. Repeat polysomnography, with the MM in situ, after 6 months of wear, revealed a significant reduction in the apnoea-hypopnoea index in children with OSA (P= 0.0003). The MM was found to reduce daytime sleepiness and to subjectively improve assessed sleep quality. The patients and their parents reported good compliance with MM treatment.
本研究的目的是确定阻塞性睡眠呼吸暂停（OSA）儿童与对照组儿童在颅面形态上的差异，并研究改良单块矫治器（MM）治疗对OSA儿童的影响。治疗组由20名OSA白种人受试者组成（10名男孩和10名女孩），年龄在4至8岁之间（平均5.91岁）。对照组由20名无OSA的健康白种人受试者组成（10名男孩和10名女孩），年龄在5至7岁之间（平均6岁）。采用多导睡眠图来确诊OSA并评估MM治疗在试验组中的效果。为所有受试者拍摄了头颅侧位片并制取了研究模型。在治疗组和对照组之间检测到颅面形态存在一些具有统计学意义的差异。治疗组表现出骨骼II类错（P = 0.04），下颌长度缩短（P = 0.03），覆盖相应增加。OSA组的舌骨位置较高（P = 0.04）。对牙弓的分析表明，OSA患者第一和第二乳磨牙间下颌区域之间的距离明显更小（分别为P = 0.03和P = 0.04）。佩戴MM 6个月后，在MM就位的情况下重复进行多导睡眠图检查，结果显示OSA儿童的呼吸暂停低通气指数显著降低（P = 0.0003）。发现MM可减轻白天嗜睡并主观上改善评估的睡眠质量。患者及其父母报告对MM治疗的依从性良好。
