Cited by 284Obstructive Sleep Apnea ResearchOrthodontics and Dentofacial OrthopedicsTemporomandibular Joint Disorders

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Obstructive sleep apnea and orthodontics: An American Association of Orthodontists White Paper

Behrents, Rolf G., Shelgikar, Anita Valanju, Conley, R. Scott, Flores-Mir, Carlos, Hans, Mark, Levine, Mitchell, McNamara, James A., Palomo, Juan Martin, Pliska, Benjamin, Stockstill, John W., Wise, John, Murphy, Sean, Nagel, Norman J., Hittner, Jackie·2019·American Journal of Orthodontics and Dentofacial Orthopedics

DOI 10.1016/j.ajodo.2019.04.009

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Abstract

The Board of Trustees of the American Association of Orthodontists asked a panel of medical and dental experts in sleep medicine and dental sleep medicine to create a document designed to offer guidance to practicing orthodontists on the suggested role of the specialty of orthodontics in the management of obstructive sleep apnea. This White Paper presents a summary of the Task Force's findings and recommendations.

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“Consequently, the AUC of 0.93 (95% CI: 0.88–0.97; p < 0.001) demonstrates efficient validity of the SRBD scale for screening PSDB for use in clinical settings and aligns with international recommendations [ 1 , 8, 9].”
Influential
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“Research has found associations between upper airway calibre and craniofacial and overall development in the growing child [3–6].”
Influential
Az achondroplasia a fogszabályozás szemszögéből
Gurdán, Z., Szalma, J., & Benedek, P. E. (2021) · Orvosi Hetilap · doi:10.1556/650.2021.32074 · Cited by 1
Orthodontic Interceptive Treatment on Obstructive Sleep Apnea Cases
Narmada, I. B., Winoto, E. R., & Hakim, A. M. (2022) · Indonesian Journal of Dental Medicine · doi:10.20473/ijdm.v5i1.2022.12-17 · Cited by 1
Airway dimensions and mandibular position in adults with different growth patterns: a cone-beam computed tomography study
Paul, P., Thakur, A., Mathur, A., & Chitra, P. (2022) · Journal of Stomatology · doi:10.5114/jos.2022.117340 · Cited by 1
Orthodontic management of bilateral ectopic and transposed canines using mini-implant assisted rapid palatal expander and an implant-borne distalizer
Al-Gazzawi, A. M. Q., Venugopal, A., Al-Murtadha, R. H., Adel, S. M., & Vaid, N. R. (2022) · AJO-DO Clinical Companion · doi:10.1016/j.xaor.2022.07.005 · Cited by 1
Airway morphology and its influence on OSA severity and surgical intervention: a retrospective study
Petrykowski, F., Lam, R., Lewis, R., Islam, S. M. S., & Goonewardene, M. S. (2022) · Australasian Orthodontic Journal · doi:10.2478/aoj-2022-031 · Cited by 1
Pediatric Obstructive Sleep Apnea: An Interdisciplinary Approach to Treatment
Stark, T. R., O’Connor, P. D., & Fischer, T. (2020) · Journal of the California Dental Association · doi:10.1080/19424396.2020.12222573 · Cited by 1
Cirurgia ortognática dos maxilares em caso grave de apneia obstrutiva do sono: um relato de caso
Marques, M. V. C., Freitas, T. S. D., Macedo, L. M., Barbosa, L. N. D. S., & Mascarenhas, M. L. (2023) · Brazilian Journal of Health Review · doi:10.34119/bjhrv6n3-258 · Cited by 1
[Technical standards for the diagnosis and treatment of pediatric total facial management in Shenzhen].
Zhang, Q., Dai, J., & Li, L. (2023) · PubMed Central · doi:10.13201/j.issn.2096-7993.2023.08.002 · Cited by 1
Cephalometrics in Obstructive Sleep Apnea Patients with Mixed Dentition
Manrikyan, G., Khachatryan, S. G., Markaryan, M. M., Ter-Poghosyan, H., Hakobyan, A., Manrikyan, M., & Vardanyan, I. (2024) · Applied Sciences · doi:10.3390/app14020688 · Cited by 1
Interprofessional collaboration in Paediatric Obstructive Sleep Apnoea (POSA) treatment: Assessment of professional orientation levels amongst otolaryngologists in South India
Avinash, B., Bharathi, M. B., Channanayak, C., Prabhakar, R. V., Lim, Y. R. A., & Nayak, P. P. (2024) · Journal of Oral Biology and Craniofacial Research · doi:10.1016/j.jobcr.2024.02.003 · Cited by 1
Disclosure orthodontic and TMD – new study
Lockerman, L. Z. (2024) · Evidence-Based Dentistry · doi:10.1038/s41432-024-00991-y · Cited by 1
“Their recommendation for orthodontists is that “ Individual orthodontists may elect to participate in the treatment and monitoring of OSA patients ” 10 .”
Functional therapy and adenotonsillectomy clinical trial for class II malocclusion (FACT-II): protocol for a randomised controlled trial
Guo, F., Lv, C., Tang, B., Lin, L., Zhang, C., Zheng, J., Zhao, T., & He, H. (2024) · BMJ Open · doi:10.1136/bmjopen-2023-079571 · Cited by 1
Undergraduate dental sleep medicine teaching at German university dental schools - a questionnaire-based survey
Sambale, J., Jablonski‐Momeni, A., & Korbmacher-Steiner, H. M. (2024) · BMC Medical Education · doi:10.1186/s12909-024-06042-5 · Cited by 1
“Behrents et al. [5] presented a White Paper from the American Association of Orthodontics (AAO) that emphasizes the necessity of integrating sleep medicine, particularly the subject of OSA, into the dental curriculum.”
Background
It may be worth considering restraint before the genie leaves the bottle
Khalil, A. S., & Zaher, A. R. (2025) · APOS Trends in Orthodontics · doi:10.25259/apos_102_2025 · Cited by 1
Consideration of Maxillary Skeletal Expansion (MSE) and Mandibular Symphyseal Distraction Osteogenesis (MSDO) for the Treatment of Sleep Apnea and Snoring
Chamberland, S. (2020) · Journal of Dental Sleep Medicine · doi:10.15331/jdsm.7124 · Cited by 1
“Estimates of the prevalence of OSA in adults is reportedly 14% in men and 5% in women, and 1% to 6% of children.(1,2) Risk factors commonly associated with OSA include obesity, menopause, male gender, and advancing age.”
Background
Cone Beam Computerized Tomography Imaging for Orthodontic Diagnosis
Boucher, N. S., Mupparapu, M., & Matsumoto, K. (2021) · Springer eBooks · doi:10.1007/978-3-030-57223-5_4 · Cited by 1
Rapid maxillary expansion in children, an update
., A. (2022) · International Journal of Applied Dental Sciences · doi:10.22271/oral.2022.v8.i2a.1486 · Cited by 1
índrome da apneia obstrutiva do sono e sua relação com a odontologia: Revisão de Literatura
Oliveira, G. C. M., Ferrari, M. V., & Tognetti, V. M. (2022) · Pubsaúde · doi:10.31533/pubsaude10.a301 · Cited by 1
The Role of Orthodontic Treatment in the Management of Sleep Apnea and Other Sleep-Related Breathing Disorders
Najjar, H. E., Alsaykhan, K., Alzahrani, A., Ahmed, A., Aladwan, W., Alharbi, F., Bahws, A., Alshahran, N., Alsalman, R., Alharb, N., et al. (2023) · Journal of Healthcare Sciences · doi:10.52533/johs.2023.30906 · Cited by 1
Evaluación del tratamiento de ortodoncia y de cirugía en el síndrome de apnea obstructiva del sueño infantil
Templier, L. (2021) · Gredos (University of Salamanca) · doi:10.14201/gredos.150722 · Cited by 1
The effect of rapid maxillary expansion on children with obstructive sleep apnea: a systematic review and meta-analysis
Yu, K., Li, Y., Ngan, P., Li, L., Huang, J., Hua, F., Zhao, T., & He, H. (2026) · Sleep And Breathing · doi:10.1007/s11325-026-03606-1 · Cited by 3
Prediction of Aerodynamic Characteristics in Upper Airways with Lateral CephalogramsPreprint
Feng, X., Chen, Y.-C., Cai, W., Lie, S. A., Hellén‐Halme, K., & Shi, X. (2021) · Research Square · doi:10.21203/rs.3.rs-494769/v1
Obstructive Sleep Apnea Treated with Maxillomandibular Advancement Surgery by Computer-Assisted Simulation
Yang, B.-L., Chen, Y., Chou, S., & Tseng, Y. (2021) · Chǐʼèjiǎozhèng xuéhuì zázhì/Journal of Taiwan Association of Orthodontists · doi:10.38209/2708-2636.1087
“There are many different treatment options in treating OSA, including CPAP, weight loss, positional therapy, oral appliances, maxillary expansion, tongue suspension, UPPP, nasal surgery and MMA [4].”
Background
Interdisciplinary Approach of Pediatric Obstructive Sleep Apnea with Congenitally Missing Second Premolars
Lin, S.-H., Chen, Y., & Tseng, Y. (2021) · Chǐʼèjiǎozhèng xuéhuì zázhì/Journal of Taiwan Association of Orthodontists · doi:10.38209/2708-2636.1088
Dental considerations in obstructive sleep apnea – Retrieving current status
Sarita, S., Nandan, R. K., Gajavalli, M., & George, S. (2021) · The Saint s International Dental Journal · doi:10.4103/sidj.sidj_53_20
Prevention of Obstructive Sleep Apnea by Functional Genioplasty Clinical Research
Neani, H., Oualalou, Y., Bahoum, A., Satté, A., & Zaoui, F. (2021) · International Journal of Medical Science and Health Research · doi:10.51505/ijmshr.2021.5301
The risk for paediatric obstructive sleep apnoea in rural Queensland
Fischer, M. A., Karadeniz, E. İ., Flores‐Mir, C., Lindsay, D., & Karadeniz, C. (2021) · Australasian Orthodontic Journal · doi:10.21307/aoj-2021.025
Self-citation
Obstructive Sleep Apnea – Do Orthodontist Have A Role?
Johns, G. (2021) · International Journal of Dental and Medical Specialty · doi:10.30954/ijdms.1.2021.3
Comparison of miniscrew-anchored maxillary protraction protocols: a randomized clinical trial
Miranda, F. (2020) · doi:10.11606/t.25.2020.tde-22102021-122004
Orthodontic Management of Adult Sleep Apnea: Clinical Case Reports
Ousehal, L., Sahim, S., Bouzid, H., Aghoutan, H., Mabrak, A. E., Mahtar, M., & Hassani, M. E. F. K. (2021) · Dentistry · doi:10.5772/intechopen.101193
Diagnosis and treatment of obstructive sleep apnea
Salamah, F. S. B., Alfayez, H. M. A., & Melibary, R. T. (2022) · International Journal of Community Medicine and Public Health · doi:10.18203/2394-6040.ijcmph20220016
“The clinical feature often has a history of chocking, snoring, and apnea during sleep; the consequences of untreated OSA are wideranging and postulated to result from frequent nocturnal awakenings, fatigue, headaches, insomnia, and excessive daytime sleepiness.(8,16) Witnessed apnea consider as an excellent diagnostic…”
BackgroundInfluential
Evaluating the Reliability of CBCT Airway Measurement: A Pilot StudyPreprint
Jorgensen, B. L., Park, J. H., & Bay, R. C. (2020) · doi:10.21203/rs.3.rs-35711/v1
Sleep-Disordered Breathing – A Dental Perspective
Rao, D., Avinash, B., Raghunath, N., Kudagi, V., Kumar, S. S., & Oommen, K. E. (2022) · Journal of Pharmacy And Bioallied Sciences · doi:10.4103/jpbs.jpbs_564_21
“[7] According to the International Classification of Sleep Disorders, OSA can be diagnosed by either of two sets of criteria.”

Authors: Behrents, R. G., Shelgikar, A. V., Conley, R. S., Flores-Mir, C., Hans, M., Levine, M., McNamara, J. A., Palomo, J. M., Pliska, B., Stockstill, J. W., Wise, J., Murphy, S., Nagel, N. J., & Hittner, J.
Affiliations: Saint Louis University (US)
University of Michigan (US)
University at Buffalo, State University of New York (US)
Case Western Reserve University (US)
University of Tennessee Health Science Center (US)
University of British Columbia (CA)
Fresno City College (US)
American Association of Orthodontists (US)
Corresponding author: Behrents, Rolf G.
ORCID: Shelgikar, Anita Valanju
Conley, R. Scott
Hans, Mark
McNamara, James A.
Pliska, Benjamin
Nagel, Norman J.
Venue: American Journal of Orthodontics and Dentofacial Orthopedics
Publisher: Elsevier BV
Published: 2019-07
Volume: 156
Issue: 1
Pages: 13-28.e1
ISSN: 0889-5406 (ISSN-L)
DOI: 10.1016/j.ajodo.2019.04.009
OpenAlex: W2954751744
Cited by: 284
References: 54
Citations by year: 2026: 39 · 2025: 37 · 2024: 50 · 2023: 44 · 2022: 51 · 2021: 45 · 2020: 15 · 2019: 3
FWCI: 19.55
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: American Journal of Orthodontics and Dentofacial Orthopedics (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
Health Sciences › Dentistry › Orthodontics › Orthodontics and Dentofacial Orthopedics
Health Sciences › Dentistry › Oral Surgery › Temporomandibular Joint Disorders
Keywords: obstructive sleep apnea, orthodontics, dental sleep medicine, sleep medicine, clinical guidelines
MeSH terms: Academies and Institutes, Orthodontists, Humans, Orthodontic Appliances, Orthodontics, Physicians, Radiography, Dental, Risk Factors, Severity of Illness Index, United States, Prevalence, Treatment Outcome, Polysomnography, Sleep Apnea, Obstructive, Surgeons

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Obstructive sleep apnea and orthodontics: An American Association of Orthodontists White Paper

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