Hubei-MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
Eur J Orthod. 2023 May 31;45(3):346-355. doi: 10.1093/ejo/cjac074.
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.
The aim of this systematic review was to summarize evidence regarding the association between paediatric OSA and children's dental and craniofacial characteristics.
PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched from inception to 1 June 2022.
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.
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.
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.
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.
PROSPERO (CRD42020162274).
小儿阻塞性睡眠呼吸暂停（OSA）是一种睡眠呼吸障碍，可能对儿童的行为、神经发育、代谢和整体健康产生巨大影响。错颌畸形和颅面形态可能与小儿 OSA 有关，因此为临床医生提供了识别、评估和治疗这种睡眠障碍患者的信息。
本系统综述的目的是总结小儿 OSA 与儿童牙齿和颅面特征之间关联的证据。
从建库至 2022 年 6 月 1 日，检索 PubMed、Embase 和 Cochrane 对照试验中心注册库。
纳入比较 OSA 儿童（年龄小于 18 岁，经夜间多导睡眠图诊断）和健康儿童的牙齿或颅面特征的横断面研究，使用临床牙科检查或放射学发现进行比较。
使用 Joanna Briggs 研究所分析性横断面研究的批判性评价清单评估纳入研究的质量。使用 RevMan 软件进行 Meta 分析。
纳入了 16 项研究。Meta 分析显示，OSA 儿童的上切牙覆盖（MD = 0.86，95%CI：0.20 至 1.51；P = 0.01）、矢状骨颌差异（ANB；MD = 1.78，95%CI：1.04 至 2.52；P < 0.00001）和下颌平面角（FH-MP；MD = 3.65，95%CI：2.45 至 4.85；P < 0.00001）更大。相比之下，OSA 组的上颌第一乳磨牙宽度（MD = -1.86，95%CI：-3.52 至 -0.20；P = 0.03）、上颌第二乳磨牙宽度（MD = -1.06，95%CI：-1.88 至 -0.24；P = 0.01）、SNB（MD = -2.10，95%CI：-3.11 至 -1.09；P < 0.0001）和上颌长度（ANS-PNS；MD = -1.62，95%CI：-2.66 至 -0.58；P = 0.002）更小。
本综述表明，OSA 儿童往往表现为下颌后缩或下颌后缩、下颌平面角增大和前牙覆盖过大。然而，由于相应的差异在临床上可能并不显著，因此需要谨慎看待这些发现。
PROSPERO（CRD42020162274）。
