The Role of Malocclusion in Non-obese Patients with Obstructive Sleep Apnea Syndrome
Open accessAbstract
OBJECTIVE: The maxillofacial characteristics of patients with obstructive sleep apnea syndrome (OSAS) have previously been analyzed using standard cephalometric analysis. Malocclusion influences the occurrence of sleep apnea, but the pathology of malocclusion in OSAS has not yet been fully investigated. Therefore, we investigated malocclusion in patients with OSAS using cephalometric and dental analysis. METHODS: Cephalometric and dental analyses were performed to evaluate malocclusion in 97 male patients with OSAS (49.7+/-11.7 years). The number of apnea and hypopnea episodes per hour (apnea-hypopnea index: AHI) was determined by standard polysomnography. RESULTS: The overall prevalence of severe overjet (the horizontal distance between the upper and lower incisors of >or=6 mm) was 43.3%. AHI was significantly correlated with body mass index (BMI) in obese OSAS patients (r=0.385, p=0.010), whereas it was significantly correlated with overjet in non-obese OSAS patients (BMI<25 kg/m2) (r=0.313, p=0.022). Multiple regression analysis revealed that BMI was the significant factor contributing to increased AHI in all patients, and overjet was in non-obese OSAS patients. There were no significant differences between non-obese and obese OSAS patients in the angle of protrusion of the superior alveolar base (SNA) or in the angle of protrusion between the superior and inferior alveolar bases (ANB). The angle of protrusion of the inferior alveolar base (SNB) was significantly smaller in non-obese than in obese OSAS patients. CONCLUSION: We have shown that overjet was associated with the severity of OSAS in non-obese patients. Our findings suggest that malocclusion may play an important role in the development of sleep apnea/hypopnea.
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Open bite, overbite, overjet, and proclination of the mandibular incisors are dental findings that may suggest underlying craniofacial deficiency in OSA.
“Dental findings may also be suggestive of underlying craniofacial deficiency and include: open bite, overbite, overjet, and proclination of the mandibular incisors.219,234,237”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [237]
The Discussion (page unavailable) reports that deep overbite and severe overjet were more prevalent in patients with OSAS than in the general Japanese population, and suggests a role for abnormal craniofacial anatomy. It does not identify open bite or proclination of the mandibular incisors as findings; its mention of protruding teeth concerns the maxillary anterior teeth. (LLM, conf=0.88)
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Cited by
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International Consensus Statement on Obstructive Sleep Apnea
Chang, J. L., Goldberg, A. N., Alt, J. A., Mohammed, A., Ashbrook, L., Auckley, D., Ayappa, I., Bakhtiar, H., Barrera, J. E., Bartley, B. L., et al. (2023) · International Forum of Allergy & Rhinology · doi:10.1002/alr.23079 · Cited by 350 · see citing works
- Authors
- Miyao, E., Noda, A., Miyao, M., Yasuma, F., & Inafuku, S.
- Affiliations
- Ars Orthodontics Clinic
- Nagoya University (JP)
- National Hospital Organization Suzuka National Hospital (JP)
- Aichi Medical University (JP)
- Venue
- Internal Medicine
- Published
- 2008
- Volume
- 47
- Issue
- 18
- Pages
- 1573-1578
- ISSN
- 0918-2918 (ISSN-L)
- 1349-7235
- OpenAlex
- W2168265368
- Semantic Scholar
- e269b86ebf9b53d2339616a55ffd43e9686045c1
- Cited by
- 39
- References
- 25
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 3 · 2023: 2 · 2022: 3 · 2021: 1 · 2020: 1 · 2019: 3 · 2018: 2 · 2017: 1 · 2016: 1 · 2015: 1 · 2014: 2 · 2013: 3 · 2012: 2
- FWCI
- 1.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Dentistry › Orthodontics › Orthodontics and Dentofacial Orthopedics
- Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
- Keywords
- obstructive sleep apnea, malocclusion, overjet, non-obese patients, body mass index, apnea-hypopnea index, cephalometric analysis, dental analysis, maxillofacial morphology, SNA angle, SNB angle, ANB angle, sleep apnea severity
- MeSH terms
- Adult, Humans, Male, Malocclusion, Angle Class II, Middle Aged, Cohort Studies, Polysomnography, Sleep Apnea, Obstructive
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