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两种口腔矫形器治疗儿童阻塞性睡眠呼吸暂停综合征后的肌功能反应

Myofunctional Responses in Obstructive Sleep Apnea Syndrome in Children Following the Use of Two Oral Orthopedic Devices.

作者信息

Bittencourt Ana Beatriz Bueno Carlini, Melo-Neto Clóvis Lamartine de Moraes, Dos Santos Gabriela Aparecida, da Silva Emily Vivianne Freitas, Muraoka Claúdia Sanae Akita Shimoide, Bertoz André Pinheiro de Magalhães, Dos Santos Daniela Micheline, Goiato Marcelo Coelho

机构信息

Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - São Paulo University, São Paulo, Brazil.

Department of Prosthodontics, Faculty of Dentistry - University of São Paulo (USP), São Paulo, Brazil.

出版信息

J Clin Exp Dent. 2025 Apr 1;17(4):e393-e398. doi: 10.4317/jced.62603. eCollection 2025 Apr.

Abstract

BACKGROUND

Rapid maxillary expansion (RME) is less invasive and an efficient method of treatment for obstructive sleep apnea syndrome (OSAS). Objective: To assess the therapeutic impact of oral orthopedic appliances in the treatment of obstructive sleep apnea syndrome with polysomnography (PSG), electromyography (EMG), bite force measurement (BFM), questionnaires, and cephalometric analysis.

MATERIAL AND METHODS

Eleven children (aged seven to eleven years) underwent three months of treatment with the Hyrax device, followed by the installation of the Balter´s Bionator appliance. Quality analysis, type III polysomnography (PSG), electromyography (EMG), and bite force measurement (BFM) were conducted. The analysis were performed through eleven months of treatment. The distributional normality were verified by the Kolmogorov-Smirnov, For these data, the Student test was performed. For data with non-normal distribution, the Wilcoxon test was performed. All analyzes were performed with a significance level of 5%.

RESULTS

Polysomnography data showed that severe scores became moderate or mild with the use of the devices. Electromyography, during rest periods, demonstrated that only the right temporal muscle exhibited increased electrical activity, while both muscles showed increased activity during dental clenching. There was an increase in the masseter and right temporalis during grape chewing. Bite Force Measurement (BFM) did not reveal any statistical difference before and after treatment. Questionnaire responses showed a statistically significant difference in the Sleep Disturbance Scale and OSA-18-PV.

CONCLUSIONS

It can be concluded that the use of the Balters Hyrax and Bionator devices in class II children and children with OSAS is a safe and effective treatment alternative. Sleep apnea obstructive, bite force, polysomnography, electromyography, oral health, children.

摘要

背景

快速上颌扩弓(RME)是一种侵入性较小且治疗阻塞性睡眠呼吸暂停综合征(OSAS)的有效方法。目的:通过多导睡眠图(PSG)、肌电图(EMG)、咬合力测量(BFM)、问卷调查和头影测量分析,评估口腔正畸矫治器对阻塞性睡眠呼吸暂停综合征的治疗效果。

材料与方法

11名7至11岁的儿童使用Hyrax矫治器进行了3个月的治疗,随后安装了Balter´s Bionator矫治器。进行了质量分析、III型多导睡眠图(PSG)、肌电图(EMG)和咬合力测量(BFM)。分析在11个月的治疗过程中进行。通过Kolmogorov-Smirnov检验验证分布正态性,对于这些数据,进行了Student检验。对于非正态分布的数据,进行了Wilcoxon检验。所有分析的显著性水平均为5%。

结果

多导睡眠图数据显示,使用这些矫治器后,严重评分变为中度或轻度。肌电图显示,在休息期间,只有右侧颞肌的电活动增加,而在紧咬牙时双侧肌肉的活动均增加。在咀嚼葡萄时,咬肌和右侧颞肌的活动增加。咬合力测量(BFM)在治疗前后未显示出任何统计学差异。问卷调查结果显示,在睡眠障碍量表和OSA-18-PV方面存在统计学显著差异。

结论

可以得出结论,对于II类错颌儿童和患有阻塞性睡眠呼吸暂停综合征的儿童,使用Balters Hyrax和Bionator矫治器是一种安全有效的治疗选择。阻塞性睡眠呼吸暂停、咬合力、多导睡眠图、肌电图、口腔健康、儿童。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0a6/12077835/d7b34f865537/jced-17-e393-g001.jpg

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