Pediatric Obstructive Sleep Apnea: The Role of Orthodontic
Management - Review Article
Supakit Peanchitlertkajorn DDS, MSD¹, Rasintra Jaroenying MD², Premthip Chalidapongse DDS, MSc, PhD³,
Boworn Klongnoi DDS, MD, PhD⁴, Supatchai Boonpratham DDS, PhD¹
Affiliation :
¹ Department of Orthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand ² Division of Pediatric Pulmonary and Critical Care, Department of Pediatrics, Phramongkutklao Hospital, Bangkok, Thailand ³ Department of Stomatology, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla, Thailand ⁴ Department of Oral Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
Pediatric obstructive sleep apnea (OSA) is a common breathing-related sleep disorder affecting 1% to 5% of children. It often presents with less
recognized signs and symptoms compared to adult OSA. Consequently, many patients with pediatric OSA remain undiagnosed. Risk factors include
adenotonsillar hypertrophy, craniofacial anomalies, retrognathia, nasal obstruction, macroglossia, nasal septal deviation, and obesity. Orthodontist
as a healthcare provider could have a significant role in screening, diagnostic referral, and treatment. The management approach for pediatric
OSA requires multidisciplinary collaboration to obtain an optimal treatment outcome. Currently, adenotonsillectomy is recommended as first-line
therapy. However, the treatment success varies considerably among patients. Children with OSA are often found to have narrow and constricted
maxilla, mandibular retrognathia, and posterior rotation of mandible. Therefore, orthodontic treatment such as rapid maxillary expansion (RME),
functional jaw orthopedic appliances, and protraction facemask could improve pediatric OSA with proper case selections. Additional maxillary
expansion can also be performed in conjunction with adenotonsillectomy regardless of treatment sequence. The present article reviewed the
currently available literature on the efficacy of various orthodontic treatments on pediatric OSA. Additional high-quality evidence is required to
further substantiate the effectiveness of these orthodontic therapy.
Received 22 June 2020 | Revised 29 September 2020 | Accepted 29 September 2020
doi.org/10.35755/jmedassocthai.2021.02.11603
Keywords :
Pediatric OSA, Orthodontic treatment, Rapid Maxillary Expansion (RME), Functional jaw orthopedic appliances, Protraction facemask
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