Department of Dental Public Health and Professional Practice, School of Dentistry, West Virginia University, Morgantown, West Virginia, USA.
Department of Restorative Dentistry, School of Dentistry, 1073 Health Sciences Center North, West Virginia University, Morgantown, West Virginia, USA.
Community Dent Oral Epidemiol. 2024 Dec;52(6):809-816. doi: 10.1111/cdoe.12983. Epub 2024 Jun 2.
Orthodontic treatment often involves four first premolar extractions. There is concern that the retraction of the anterior teeth due to extraction of first premolars may constrict tongue space and will reduce oral cavity and oropharynx space. Constricted airways are often associated with sleep disordered breathing (SDB) and sleep disruption. The aim of this study was to determine if there is an association of SDB factors with the absence of first premolars.
A cross-sectional study was conducted using National Health and Nutrition Examination Survey (NHANES) 2017-March 2020 data on participants, aged 18-65 years (n = 4742). Variables of interest included self-reports of SDB (symptoms of disrupted sleep such as snoring, snorting, daytime sleepiness, and inappropriate number of hours of sleep). Data for the presence/absence of first premolars were gathered from the oral examination section of NHANES. An assumption was made that absence of four first premolars in dentate participants indicated extractions for orthodontic treatment. Data analyses were conducted with Rao Scott chi squared test.
There were no significant associations of SDB and symptoms of disrupted sleep associated with the absence of four first premolars in dentate participants.
Concerns of the impact of first premolar extractions on SDB were not supported with this study.
正畸治疗常涉及拔除四颗第一前磨牙。人们担心，由于拔除第一前磨牙导致的前牙后移可能会限制舌空间，并减少口腔和口咽空间。狭窄的气道通常与睡眠呼吸障碍（SDB）和睡眠中断有关。本研究旨在确定 SDB 因素与缺失第一前磨牙之间是否存在关联。
使用 2017 年 3 月至 2020 年期间全国健康和营养调查（NHANES）的数据进行横断面研究，研究对象为 18-65 岁的参与者（n=4742）。感兴趣的变量包括 SDB 的自我报告（如打鼾、鼻息、白天嗜睡和睡眠时间不合适等睡眠中断症状）。NHANES 的口腔检查部分收集了第一前磨牙缺失/存在的数据。假设在有牙参与者中，缺失四颗第一前磨牙表示为正畸治疗而拔牙。采用 Rao-Scott 卡方检验进行数据分析。
在有牙参与者中，缺失四颗第一前磨牙与 SDB 或与睡眠中断相关的症状之间无显著关联。
本研究未支持第一前磨牙拔除对 SDB 影响的担忧。
