Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China.
Faculty of Dental Medicine, Université de Montréal, Montreal, Canada.
J Dent Res. 2023 Mar;102(3):263-269. doi: 10.1177/00220345221133278. Epub 2022 Nov 4.
The objective of this study was to examine to what extent the anatomic characteristics of the upper airway can influence the effect of nocturnal wearing of dentures on the sleep of edentulous elders with untreated sleep apnea. This study used the data from a randomized crossover clinical trial and an exploratory approach to address its objectives. Cone beam computed tomography scans of 65 edentulous individuals (female, = 37; male, = 28; mean ± SD age, 74.54 ± 6.42 y) with untreated obstructive sleep apnea (OSA) were used to identify anatomic variables. Polysomnography data were collected by means of one portable overnight recording. The respiratory variable values, including apnea-hypopnea index (AHI), with and without denture worn during sleep were used to calculate the change. Statistical analyses included multiple linear regressions, cluster analysis, and binary logistic regressions. A receiver operator characteristic curve was used to illustrate the accuracy of the statistical model. The regression model explained 15.8% () of AHI change. An increase in the lateral dimension of the minimum cross-sectional area was associated with a decrease in AHI, oxygen desaturation index, and respiratory arousal index changes ( ≤ 0.041). Furthermore, an increase in the length of the hypopharynx was associated with an increase in AHI and oxygen desaturation index changes ( ≤ 0.027). An increase in the lateral dimension of the minimum cross-sectional area of the upper airway was associated with a decreased likelihood of being in the group having a worsened AHI (odds ratio = 0.85; 95% CI, 0.76 to 0.95; = 0.006). An increase in the length of the oropharynx was associated with an increased likelihood of having increased AHI (odds ratio = 1.10; 95% CI, 1.01 to 1.20; = 0.026). The nocturnal aggravation of respiratory variables in edentulous individuals with OSA who wear dentures at night can be linked to certain anatomic characteristics of the upper airway. Replication of these findings may open novel avenues for personalized advice regarding nocturnal wearing of dentures in edentulous individuals with OSA (ClinicalTrials.gov: NCT01868295).
本研究旨在探讨上气道解剖特征在多大程度上影响未经治疗的阻塞性睡眠呼吸暂停(OSA)的无牙老年人夜间戴义齿对睡眠的影响。本研究使用了一项随机交叉临床试验的数据和探索性方法来解决其目标。对 65 名患有未经治疗的阻塞性睡眠呼吸暂停(OSA)的无牙个体(女性 37 名;男性 28 名;平均年龄 ± 标准差,74.54 ± 6.42 岁)进行了锥形束计算机断层扫描(CBCT)扫描,以确定解剖学变量。通过一次便携式夜间记录收集多导睡眠图数据。使用呼吸变量值(包括睡眠时有无义齿佩戴的呼吸暂停低通气指数(AHI))来计算变化。统计分析包括多元线性回归、聚类分析和二元逻辑回归。接收者操作特征曲线用于说明统计模型的准确性。回归模型解释了 15.8%()的 AHI 变化。最小横截面积的侧向尺寸增加与 AHI、氧减饱和度指数和呼吸唤醒指数变化的减少相关(≤0.041)。此外,咽下部长度的增加与 AHI 和氧减饱和度指数变化的增加相关(≤0.027)。上气道最小横截面积的侧向尺寸增加与 AHI 恶化的可能性降低相关(比值比=0.85;95%可信区间,0.76 至 0.95;=0.006)。口咽长度的增加与 AHI 增加的可能性增加相关(比值比=1.10;95%可信区间,1.01 至 1.20;=0.026)。患有 OSA 的无牙个体夜间佩戴义齿会导致夜间呼吸变量恶化,这可能与上气道的某些解剖特征有关。复制这些发现可能会为患有 OSA 的无牙个体夜间佩戴义齿提供个性化建议开辟新途径(ClinicalTrials.gov:NCT01868295)。