ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Low level Evidence Shows That the Cross Sectional Area of the Oral Pharynx Measured with Cone Beam Computed Tomography Can Distinguish Obstructive Sleep Disordered Patients From Patients Without That Condition
Clinical Question Are cone beam computed tomography measurements of the oral pharynx accurate in identifying obstructive sleep apnea patients compared with normal patients?
Clinical Bottom Line Low-level evidence suggests that an oral-pharynx cross sectional area greater than 105 mm2and less than 46 mm2 characterize normal patients and those with OSA, respectively. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 19716716Tso/200910 random patientsRetrospective chart review
Key resultsThe cross sectional areas of 10 randomly selected patients ranged from 90mm2 to 360mm2.
#2) 17178502Ogawa/200710 OSA and 10 non-OSA patientsCase control
Key resultsThe mean cross sectional area for the non-OSA group was 146.9mm2 and 45.8mm2 for the OSA group.
Evidence Search Cone beam computed tomography and airway obstruction
Comments on
The Evidence
Validity: Tso study: A retrospective chart review of 10 subjects randomly chosen from convenience sample of 196 patients presenting for dental care at a dental school pain clinic was done to determine the range of values for the minimal cross sectional area of non-OSA patients. Ogawa study: a prospective study was done in which 10 OSA and 10 non OSA subjects were selected to identify the range of values for both categories of subjects. Standardized cone beam computed tomographic technique was used in both projects. In both studies, the sample sizes were small, no gold standard was used, no sensitivity or specificity values were reported and a wide range of resulting values were seen. No competing interests were noted. These studies are considered low level evidence. Perspective: these studies should be considered preliminary and the correlation of radiographic information with clinical diagnostic tests is needed to confirm the diagnosis of OSA and assess the effectiveness of treatment outcomes.
Applicability Cone beam computed tomographic examination of the oral pharynx may be useful for dentists and physicians for the diagnosis and the determination of treatment outcomes of OSA.
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (General Dentistry) (Oral Surgery) (Orthodontics) (Prosthodontics)
Keywords Cone beam computed tomography, obstructive sleep apnea, airway, pharynx
ID# 2341
Date of submission: 03/07/2013spacer
E-mail Matteson@uthscsa.edu
Author Stephen R. Matteson, DDS
Co-author(s) Ju Ri Juri
Co-author(s) e-mail HURJ@LIVEMAIL.UTHSCSA.EDU
Faculty mentor/Co-author
Faculty mentor/Co-author e-mail
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Ju Ri Hur (San Antonio, Texas) on 05/13/2013
This search was conducted in May 12, 2013. The articles listed in the CAT are of the most recent evidence on this topic. These publications do not list sensitivity or specificity values, provide small sample size, and do not have a gold standard. But they still provide a general range of values that categorize patients into two groups, OSA and normal.
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