Difference in dental arch size between obese and non-obese patients with obstructive sleep apnoea
Difference in dental arch size between obese and non-obese patients with obstructive sleep apnoea
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DOI：
10.1111/j.1365-2842.2011.02243.x
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发表时间：
2012-02-01
影响因子：
2.9
通讯作者：
Inoue, Y.
中科院分区：
文献类型：
--
作者：
Maeda, K.;Tsuiki, S.;Inoue, Y.
在阻塞性睡眠呼吸暂停（OSA）患者中，大舌头被认为是增加上呼吸道塌陷的一个因素。我们假设，如果被认为有大舌头的肥胖OSA患者的牙弓扩大，可以将发展为严重OSA的倾向降至最低。因此，我们比较了肥胖和非肥胖OSA患者的牙弓大小。使用侧位脑电图和研究模型，我们比较了23名肥胖和23名非肥胖的日本男性OSA患者的舌头和牙弓的大小，他们的年龄、呼吸暂停低通气指数（AHI）和上颌下颚大小相匹配。肥胖组和非肥胖组的中位年龄（岁）和AHI（每小时事件数）分别为36.5和39.0,13.4和14.3。上颌下颌骨的大小与颅侧测量得到的SNA、SNB和下面部笼相匹配。研究模型测量的参数包括牙弓宽度、牙弓长度、牙弓覆盖和牙合覆盖。肥胖OSA患者舌长（P < 0.05）、上牙弓宽度（P < 0.01）、下牙弓宽度（P < 0.05）均明显大于非肥胖OSA患者，两组OSA严重程度差异无统计学意义。这些发现表明，在相同的疾病严重程度下，肥胖患者的舌头和牙弓比非肥胖患者更大。肥胖OSA患者的牙弓较宽有助于抵消舌部增大对上气道通畅的影响。
A large tongue is recognised as a factor that increases the collapsibility of the upper airway in obstructive sleep apnoea (OSA) patients. We hypothesised that the propensity to develop severe OSA could be minimised if the dental arches were enlarged in obese OSA people who are thought to have a large tongue. We therefore compared the size of the dental arches in obese and non-obese OSA patients. Using a lateral cephalogram and study models, we compared the sizes of the tongue and dental arches in 23 obese and 23 non-obese Japanese male OSA patients, who were matched for age, apnoea hypopnea index (AHI) and maxillomandibular size. The median age (years) and AHI (events per hour) for the obese and non-obese groups were 36.5 and 39.0, and 13.4 and 14.3, respectively. The maxillomandibular size was matched with regard to SNA, SNB and lower face cage obtained from cephalometric measurements. The parameters that were measured for the study model included dental arch width, dental arch length, overjet and overbite. Tongue size (P < 0.05) and both upper (P < 0.01) and lower (P < 0.05) dental arch widths were significantly larger in obese than in non-obese OSA patients, and there was no difference in the severity of OSA between the two groups. These findings suggest that the tongue was larger and dental arches were enlarged in obese patients compared with non-obese patients under the same disease severity. Wider dental arches in obese OSA patients may help to offset the impact of the enlarged tongue on upper airway patency.