PURPOSE: To correlate instrumental polysomnographic variables in children with Sleep Disordered Breathing (SDB) and their clinical craniofacial reports to make an orthodontic diagnosis avoiding conventional radiographic exposures.
METHODS: We studied, from Jan 2000 to July 2005, 197 pediatric patients with SDB, 116 M and 81 F, mean age 4.11±2.09 (range 0-12), stratified into 3 categories: A: 0-2 yrs 16%; B: 3-5 yrs 68%; C:>6 yrs 16%. All patients had one-night cardio-respiratory monitoring and specific orthodontic clinical evaluation by Pediatric and Orthodontics Clinic, University of Insubria, Varese, Italy.
RESULTS: Main polysomnographic results (mean): ODI (Oxygen Desaturation Index): 10.6; min SaO2 %: 79.4; mean SaO2 %: 96.4; Hand-scored snoring %: 46.0; Heart Rate Variation Index (HRVI) phase/h: 17.8; HRVI %: 40.0; Mean Heart Rate: 90.2.5 groups have been identified: Primary Snoring 19%, Obstructive Sleep Apnea Syndrome: mild 38%, moderate25% and severe18%.Main clinical orthodontic evaluation: Face: 11% low angle, 73% normal angle, 16% high angle; Lip competence: 75% lip competent, 25% lip incompetent; Deglutition: 72% correct, 28% incorrect; Mid Line: 80%correct, 20% incorrect; Crossbite: 75% absent, 25% present; Overjet: 10% reduced, 61% normal, 29% increased; Overbite: 18% reduced, 64% normal, 18% increased.
CONCLUSION: We haven’t found a significant correlation (linear regression) between polysomnographic and orthodontic clinical parameters; orthodontic aspects can be associated to SDB only through a teleradiographic exam. On the other hand, we have found a high incidence of craniofacial anomalies in the children studied with SDB. A score was computed by using the three most important parameters for both their sensitivity and accuracy in the children clinical examination: crossbite, overjet and overbite; if at least one of them turns out to be pathologic from a clinical point of view, we have 61,42% of probability to find out a SDB patient.
CLINICAL IMPLICATIONS: Once SDB children have been tested with the pathologic polysomnography, we strongly recommend an orthodontic evaluation.
DISCLOSURE: Luana Nosetti, No Financial Disclosure Information; No Product/Research Disclosure Information