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Title Having An Angle Class II Malocclusion Is Associated With A Higher Incidence Of Obstructive Sleep Apnea
Clinical Question Is a patient with Class II malocclusion at a higher risk of having a higher apnea-hypopnea index than a patient with Class I occlusion?
Clinical Bottom Line While the development and causes of obstructive sleep apnea is multi-factorial, having a Class II malocclusion is associated with a higher incidence of obstructive sleep apnea.
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) 18797115Miyao/200897 Japanese males with obstructive sleep apneaCohort
Key resultsAHI (Apnea-hypopnea index) was significantly correlated with severe overjet (>6mm) in non-obsese obstructive sleep apnea patients (p = 0.022). Regression analysis showed overjet was a significant factor contributing to increased AHI in OSA patients.
#2) 21763049Kim/2012210 patients with OSA who underwent multilevel phase I surgeryCohort
Key resultsPeople who responded poorly (0-50% decrease or an increase in apnea-hypopnea index) to the surgery were skeletal class II with a more retrognathic mandible.
#3) 19852637Banabilh/2010120 Malays 18-65Comparative Study
Key resultsA convex facial profile and Class II malocclusion were statistically significantly more common in the OSA group. Clinical examination showed that the most frequent findings among OSA groups when compared with the control group were convex profiles (71.7%), Class II malocclusion (51.7%), and V palatal shape (53.3%).
Evidence Search Search “Malocclusion, Angle Class II” [MeSH] and “Sleep Apnea, Obstructive/etiology, diagnosis*” [MeSH]
Comments on
The Evidence
The validity of these studies could be higher since they are all observational cohort or comparative studies. The study done on Japanese males lacked a control or gold standard to compare against but the results were still statistically significant.
Applicability The demographics of these particular studies may limit the applicability since the first study involves only Japanese males, another involves patients who underwent surgery and the final one involves only people of Malaysian ancestry. However, the findings of Class II malocclusion in obstructive sleep apnea appear consistent enough to give strong consideration in the etiology/pathology of obstructive sleep apnea.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Orthodontics) (Prosthodontics)
Keywords Obstructive sleep apnea, class II malocclusion, overjet
ID# 2364
Date of submission: 02/20/2013spacer
E-mail patelnk@livemail.uthscsa.edu
Author Niraj Patel
Co-author(s) Marian Nagle, DDS
Co-author(s) e-mail marianlnagle@gmail.com
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