Combined Surgical and Orthodontic Treatments in Children with OSA: A Systematic Review.

Obstructive sleep apnea (OSA) is a sleeping breathing disorder. In children, adenotonsillar hypertrophy remains the main anatomical risk factor of OSA. The aim of this study was to assess the current scientific data and to systematically summarize the evidence for the efficiency of adenotonsillectomy (AT) and orthodontic treatment (i.e., rapid maxillary expansion (RME) and mandibular advancement (MA)) in the treatment of pediatric OSA. A literature search was conducted in several databases, including PubMed, Embase, Medline, Cochrane and LILACS up to 5th April 2020. The initial search yielded 509 articles, with 10 articles being identified as eligible after screening. AT and orthodontic treatment were more effective together than separately to cure OSA in pediatric patients. There was a greater decrease in apnea hypoapnea index (AHI) and respiratory disturbance index (RDI), and a major increase in the lowest oxygen saturation and the oxygen desaturation index (ODI) after undergoing both treatments. Nevertheless, the reappearance of OSA could occur several years after reporting adequate treatment. In order to avoid recurrence, myofunctional therapy (MT) could be recommended as a follow-up. However, further studies with good clinical evidence are required to confirm this finding.

Attractive perception of profile class II patients treated with extractions versus dentoalveolar mandibular advancement devices

Aim: This study aimed to compare the esthetic perception of profile silhouette of pictures of class II patients before and after treatment (extractions or mandibular advancement), according to a visual analog scale (VAS) among orthodontists, general dentists and lay people. Methods: A presentation of 18 class II adult patients silhouette was shown to three groups of participants (25 orthodontists, 25 general dentists, and 25 lay people) in two phases in an cross-sectional survey study. An initial presentation pre-treatment and a second one post-treatment, one month later. The presentation consisted of nine pictures of four extractions orthodontic cases (two maxillary premolars and two mandibular premolars): five males, four females, and other nine pictures with a dentoalveolar mandibular advance (Forsus® and/or class II elastics): four males, five females. To compare pre and post-treatment scores, an ANOVA test was performed. Independent variables studied were: sex, age, and previous or present orthodontic treatment of participants. Results:A total of 75 of evaluators scored 18 patient profiles before and after treatment. In the three groups, the post treatment silhouette scored significantly higher. Advancement treatment scored significantly higher than extractions, especially among lay people. Orthodontist gave the lowers score regardless of treatment. No differences were found between male and female scoring (p>0.05). The participants between 30-39 years old gave higher scores than other age groups(p<0,05). Conclusion: In our sample, class II orthodontic treatments did always improve esthetic perception of patients profile. Advancement treatment achieved a better esthetic perception than extractions, especially among lay people

Prevalence of Hypodontia in a Sample of Spanish Dental Patients.

OBJECTIVES: The aim of this retrospective study was to evaluate the prevalence of hypodontia in a sample of dental patients, aged between seven and eleven years at University Alfonso X in Madrid (Spain). MATERIALS AND METHODS: The number of hypodontia cases and the most affected teeth were evaluated in 2500 panoramic radiographs in a random sample of dental patients consisting of 1235 females and 1265 males. We divided them according to age, number of hypodontia present in each patient (multiple or single), each side, each quadrant either in the upper jaw or in the mandible. The chi-square test (P <0.05) was used to compare the differences in agenesis among males and females. RESULTS: The sample of 2500 patients who were studied consisted of 1235 women, out of which 41 presented hypodontia (3.31%) and 1265 men, out of which 46 had at least a dental absence (3.63%). There was no significant difference in the proportion of hypodontia between men and women (p> 0.05). CONCLUSION: The percentage of total agenesis of 2500 patients studied was 3.48%.