Effects of Upper Airway Obstruction on Maxillofacial Dentition in Childhood and Contribution of Pediatric Dentistry to Treat Sleep Apnea

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  • IWASAKI Tomonori
    Department of Pediatric Dentistry Kagoshima University Graduate School of Medical and Dental Sciences

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  • 小児期の上気道通気障害がもたらす顎顔面歯列咬合形態への影響と小児歯科からの睡眠医療への貢献

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Abstract

<p>A number of previous studies have reported the effects of breathing on maxillofacial morphology in childhood. However, accurate findings for evaluating the airway are difficult to acquire because it analysis of upper airway ventilation condition can be problematic. To improve this situation, we developed a three-dimensional upper airway model using cone beam CT data for highly precise analysis of the upper airway with computational fluid dynamics used to assesses the flow of air. As a result,we found that the pharyngeal airway morphology in Class III children showed that the long diameter type of pharyngeal airway and wide diameter type of pharyngeal airway with low tongue posture were shown. On the other hand, in Class II children, upper airway obstruction can be a cause of excessive vertical maxillofacial growth, and that this may be attributed to various parts of the upper airway, such as the nasal, nasopharyngeal, oropharyngeal, and hypopharyngeal airway. It was also revealed that when nasal obstruction is improved by rapid maxillary expansion, the volume of the pharyngeal airway increases and low tongue posture is improved. Thus, we succeeded in clarifying the mechanism by which rapid maxillary expansion improves upper airway obstruction. Pediatric obstructive sleep apnea syndrome occurs at a high frequency, with a prevalence of 2% in otherwise health children. With use of available medical treatment, the success rate is 70%. In the future, we hope to examine the efficacy of application of orthodontic procedures for treatment, such as rapid maxillary expansion or mandibular forward induction, for social contributions from the field of pediatric dentistry.</p>

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