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Breathing obstruction in relation to craniofacial and dental arch morphology in 4-year-old children
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
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1999 (English)In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 21, no 4, 323-332 p.Article in journal (Refereed) Published
Abstract [en]

The prevalence of breathing obstruction was determined in a cohort of 4-year-old children. Craniofacial morphology was studied in obstructed children and compared with data from a control group of 4-year-old children with ideal occlusion. Dental arch morphology was compared in obstructed and non-obstructed children in the group. Parents of 95.5 per cent of the study base of 644 children answered a questionnaire concerning their child's nocturnal behaviour and related questions. The 48 children who, based on parental report, snored every night or stopped breathing when snoring (the 'snoring group'), showed a higher rate of disturbed sleep, mouth-breathing, and a history of throat infections as compared with the rest of the cohort. These children were examined by both an orthodontist and an otorhinolaryngologist and, when indicated, they were also monitored in a sleep laboratory. Twenty-eight of the children were diagnosed as having a breathing obstruction (4.3 per cent of the cohort) and six children (0.9 per cent) had sleep apnoea (mean apnoea-hypopnoea index of 17.3), using the same definition as that for adults. Cephalometric values among the obstructed children differed from those of a Swedish sample of the same age with ideal occlusion. Thy had a smaller cranial base angle and a lower ratio of posterior/anterior total face height. Small, but not significant differences were seen for NSL-ML and NL-ML. Compared with 48 asymptomatic children from the same cohort, the obstructed children had a narrower maxilla, a deeper palatal height, and a shorter lower dental arch. In addition, the prevalence of lateral crossbite was significantly higher among the obstructed children.

Place, publisher, year, edition, pages
1999. Vol. 21, no 4, 323-332 p.
National Category
URN: urn:nbn:se:uu:diva-107989PubMedID: 10502895OAI: oai:DiVA.org:uu-107989DiVA: diva2:233852
Available from: 2009-09-02 Created: 2009-09-02 Last updated: 2010-09-13Bibliographically approved
In thesis
1. Sleep Disordered Breathing and Orofacial Morphology in Relation to Adenotonsillar Surgery: Development from 4-12 Years in a Community Based Cohort
Open this publication in new window or tab >>Sleep Disordered Breathing and Orofacial Morphology in Relation to Adenotonsillar Surgery: Development from 4-12 Years in a Community Based Cohort
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Objective: To follow a cohort of children from age 4-6-12 with respect to sleep disordered breathing (SDB) and orofacial development. Questionnaires were completed about sleep, snoring, apneas, enuresis, sucking habits, and adenotonsillar surgery and, from age 12, about allergies, asthma, and general health. Children snoring regularly had an ENT- examinations including sleep studies (at ages 4 and 12) and an orthodontic evaluation. Development of biometric data in snoring children and not snoring controls was studied in relation to adenotonsillar surgery.

Result: Of the original group of 615 children, 509 (83%) participated at age 6 and 393 (64%) at age 12. 27 snored regularly and 231 did not snore at age 12. Differences between groups were seen on all answers. From age 4–12 the prevalence of OSA decreased from 3.1% to 0.8%, and the minimum prevalence of snoring regularly from 5.3% to 4.2%. The odds for a child who snored regularly at four or six to be snoring regularly at age 12 was 3.7 times greater than for a not snoring child in spite of surgery (OR 3.7, 95% CI 2.4-5.7). 63 children were operated for snoring by age 12, of them 14 never snored and 17 snored regularly at age 12. Cross-bite was more common among snoring children at ages 4, 6 and 12 as was a narrower maxilla. In most cases, surgery cured the snoring temporarily, but the maxillar width was still smaller by age 12—even when nasal breathing was attained.

Children snoring regularly at age 12, operated or not operated, showed long face anatomy and were oral breathers; the seven cases who were not operated and the five who were still snoring in spite of surgery, did not have reduced maxillary arch width.

Conclusion: The prevalence of children snoring regularly is about the same from age four to twelve in a cohort where adenotonsillar surgery has been performed on obstructed cases, but the prevalence of OSA decreases considerably. The children snoring regularly have a more narrow maxilla compared to children not snoring—a condition that is not changed by adenotonsillar surgery regardless of symptom relief.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2009. 57 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 480
snoring, children, epiddemiology, adenotonsilloectomy, craniofacial development
National Category
Research subject
urn:nbn:se:uu:diva-108031 (URN)978-91-554-7600-7 (ISBN)
Public defence
2009-10-10, Skoogsalen, Akademiska Sjukhuset ingång 79, Uppsala, 09:15 (Swedish)
Available from: 2009-09-18 Created: 2009-09-03 Last updated: 2009-10-08Bibliographically approved

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