Relationship between Obstructive Sleep Apnea and Extraction Teeth in Orthodontic Treatment
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Abstract
Obstructive sleep apnea is a common upper airway disorder that, if left untreated, could occur complications including physical, mental, and psychosocial problems. Dentists should be knowledgeable with obstructive sleep apnea and screen patients for the condition by completing an oral examination and administering a questionnaire that includes Berlin questionnaire, Epworth sleepiness scale, and STOP-Bang questionnaire. Additionally, lateral cephalometric radiographs or cone beam computed tomography were examined. Mandibular micrognathism, a hyperdivergent pattern, midface hypoplasia, a decrease in the thyromental distance, and a low hyoid position are all characteristics that are frequently seen in patient with obstructive sleep apnea. Currently, the role of obstructive sleep apnea in orthodontic treatment is more recognized. Both orthodontic treatment combined with tooth extraction and orthodontic treatment combined with mandibular setback surgery require an appropriate treatment. The tooth extraction and mandibular setback will decrease the tongue’s surface area. The tongue is positioned more backward. As a result, the upper airway becomes smaller due to an increase in the contact distance between the soft palate and the tongue. This may lead to the development of obstructive sleep apnea. However, it is unclear from previous studies that orthodontic treatment combined with tooth extraction and orthodontic treatment combined with mandibular setback surgery directly contributes to obstructive sleep apnea. Most of the previous studies may focused on changes in the upper airway spaces without sleep test, a gold standard diagnostic test for diagnosing and describing the severity of obstructive sleep apnea. Therefore, this article presents an overview for orthodontists to realize the importance of obstructive sleep apnea and develop appropriate treatment plans.
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