Association between obstructive sleep apnea syndrome and bone mineral density in adult orthodontic populations.

OBJECTIVE: To determine the association between obstructive sleep apnea syndrome (OSAS) and predicted bone mineral density (BMD) in adults presenting for orthodontic treatment. METHODS: This retrospective cross-sectional study included 38 adults divided into OSAS and non-OSAS groups. Using pre-treatment CBCT images, radiographic density (RD) of left and right lateral regions of the 1st cervical vertebrae and dens of the 2nd cervical vertebrae were measured as an indicator for BMD. RESULTS: When controlling for age, sex, and BMI, the mean RD was significantly lower in the OSAS group compared to the non-OSAS group (left CV1: 36.69 ± 84.50 vs. 81.67 ± 93.25 Hounsfield Units [HU], respectively, p = 0.031; right CV1: 30.59 ± 81.18 vs. 74.26 ± 91.81 HU, p = 0.045; dens: 159.25 ± 115.96 vs. 223.94 ± 106.09 HU, p = 0.038). CONCLUSION: Adults with OSAS have lower values for predicted BMD than those without OSAS.

Effects of clear aligner therapy for Class II malocclusion on upper airway morphology and daytime sleepiness in adults: A case series.

INTRODUCTION: To evaluate the effects of clear aligner therapy (CAT) on the upper airway dimensions and on daytime sleepiness in adults with dentoskeletal Class II malocclusion. METHODS: This study was conducted from August 2017 to February 2019. Inclusion criteria were healthy adults≥18years old, Angle Class II division 1 malocclusion, first-molar relationship of end-to-end or greater, overjet<10mm, and presenting for multi-arch comprehensive orthodontic treatment with aligners. Treatment mechanics included mandibular dentoalveolar advancement with Class II elastics without maxillary sequential distalization programmed into aligners. Post-treatment changes in dentoskeletal and upper airway dimensions were assessed using CBCT images. The treatment effect on daytime sleepiness was evaluated using an Epworth Sleepiness Scale (ESS). RESULTS: Eight subjects were included in this pilot study (mean age at treatment initiation=44.6years [SD=15.3]). The mean treatment duration was 12.2months (SD=3.4). No statistically significant treatment changes were observed in upper airway dimensions or dentoskeletal cephalometric analyses. Subjects with excessive daytime sleepiness at pre-treatment reported an improvement post-treatment, but no significant difference in the mean ESS score was found. CONCLUSION: Treatment of Class II division 1 malocclusion in adults by mandibular dentoalveolar advancement using CAT has no statistically significant effects on the airway and dentoskeletal measurements, or daytime sleepiness.