Three-dimensional assessment of the upper airway after treatment of Class II malocclusion with obstructive sleep apnea using a wear time monitoring device

André Pinheiro de Magalhães BERTOZ, Ana Laura Modesto de Albuquerque DONINE, Mariana Santos DEMARTINE, Silke Anna Theresa WEBER

Introduction: Obstructive Sleep Apnea Syndrome (OSAS) is defined by recurrent episodes of airway obstruction during sleep. Its etiology is multifactorial and may be associated with exogenous, pathological or anatomical upper airway factors. Clinical history, as well as complementary exams such as computed tomography and polysomnography (PSG), are crucial for the definitive diagnosis. Methods: The therapy was designed with the objective of increasing transverse dimension of the maxilla through the RME, with the increase of nasal air capacity and a subsequent advancement of the mandible using the Balters’ Bionator functional orthopedic appliance. The insertion of the TheraMon microsensor inside the acrylic structure of the appliance was programmed for the analysis of the usage time. Results: The results showed an improvement in apnea/hypopnea index from 6.6/hour to 5.3/hour. The number of respiratory events went from 42 to 37, with a reduction of 16 obstructive episodes, being 1 central and 13 mixed. In the tomographic exam, it was observed that the present air volume went from 15,275 to 73,832 mm3. Conclusion: The association of rapid maxillary expansion with therapeutic mandibular advancement as an option for Angle Class II malocclusion treatment provided a volumetric increase of the airways, with consequent improvement in the patients apnea/hypopnea index and in the number of respiratory events. The time-usage monitoring device was also found to be effective for improving patient cooperation during treatment with the removable orthopedic appliance.

Keywords: Tomography. Sleep apnea syndrome. Mandibular advancement. Palatal expansion technique.

How to cite: Bertoz APM, Donine ALMA, Demartine MS, Weber SAT. Three-dimensional assessment of the upper airway after treatment of Class II malocclusion with obstructive sleep apnea using a wear time monitoring device. Clin Orthod. 2020 Dez-2021 Jan;19(6):85-100.

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