Faculty of Dental Medicine, Université de Montréal, Montreal, Que., Canada; Centre de recherche, CHU Ste-Justine, Montreal, Que., Canada.
Centre de recherche, CHU Ste-Justine, Montreal, Que., Canada.
Sleep Med Rev. 2016 Feb;25:84-94. doi: 10.1016/j.smrv.2015.02.002. Epub 2015 Feb 17.
A small maxilla and/or mandible may predispose children to sleep-disordered breathing, which is a continuum of severity from snoring to obstructive sleep apnea. Preliminary studies have suggested that orthodontic treatments, such as orthopedic mandibular advancement or rapid maxillary expansion, may be effective treatments. The aim is to investigate the efficacy of orthopedic mandibular advancement and/or rapid maxillary expansion in the treatment of pediatric obstructive sleep apnea. Pubmed, Medline, Embase, and Internet were searched for eligible studies published until April 2014. Articles with adequate data were selected for the meta-analysis; other articles were reported in the qualitative assessment. Data extraction was conducted by two independent authors. A total of 58 studies were identified. Only eight studies were included in the review; of these, six were included in the meta-analysis. The research yielded only a small number of studies. Consequently, any conclusions from the pooled diagnostic parameters and their interpretation should be treated carefully. Although the included studies were limited, these orthodontic treatments may be effective in managing pediatric snoring and obstructive sleep apnea. Other related health outcomes, such as neurocognitive and cardiovascular functions have not yet been systematically addressed. More studies are needed with larger sample size, specific inclusion and exclusion criteria and standardized data reporting to help establish guidelines for the orthodontic treatment of pediatric obstructive sleep apnea.
上颌骨和/或下颌骨较小可能使儿童易患睡眠呼吸障碍，这是一种从打鼾到阻塞性睡眠呼吸暂停的严重程度连续谱。初步研究表明，正畸治疗，如矫形下颌前伸或上颌快速扩展，可能是有效的治疗方法。目的是探讨矫形下颌前伸和/或上颌快速扩展治疗小儿阻塞性睡眠呼吸暂停的疗效。检索了 Pubmed、Medline、Embase 和互联网上截至 2014 年 4 月发表的合格研究。选择有足够数据的文章进行荟萃分析；其他文章在定性评估中报告。由两名独立作者进行数据提取。共确定了 58 项研究。只有 8 项研究被纳入综述；其中 6 项研究被纳入荟萃分析。研究结果只包括少数研究。因此，对汇总诊断参数及其解释的任何结论都应谨慎对待。尽管纳入的研究数量有限，但这些正畸治疗可能对治疗小儿打鼾和阻塞性睡眠呼吸暂停有效。其他相关健康结果，如神经认知和心血管功能，尚未得到系统解决。需要更多具有更大样本量、具体纳入和排除标准以及标准化数据报告的研究，以帮助制定小儿阻塞性睡眠呼吸暂停的正畸治疗指南。
