| 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 |
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| PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
| 18797115 | Miyao/2008 | 97 Japanese males with obstructive sleep apnea | Cohort | | Key results | AHI (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. | | 21763049 | Kim/2012 | 210 patients with OSA who underwent multilevel phase I surgery | Cohort | | Key results | People 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. | | 19852637 | Banabilh/2010 | 120 Malays 18-65 | Comparative Study | | Key results | A 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 |
(General Dentistry) (Oral Surgery) (Orthodontics) (Prosthodontics) |
| Keywords |
Obstructive sleep apnea, class II malocclusion, overjet
|
| ID# |
2364 |
| Date of submission |
02/20/2013 |
| E-mail |
patelnk@livemail.uthscsa.edu |
| Author |
Niraj Patel |
| Co-author(s) |
Marian Nagle, DDS |
| Co-author(s) e-mail |
marianlnagle@gmail.com |
| Faculty mentor |
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| Faculty mentor e-mail |
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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?) |
| None available | |
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
| None available | |