Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
권호 표지
DOI QR코드

DOI QR Code

Effects of Myofunctional Appliance in Children with Sleep-Disordered Breathing: Two Case Reports

수면호흡장애 어린이의 근기능 장치 효과 증례 보고

  • Shim, Hojin (Department of Pediatric Dentistry, School of Dentistry, Pusan National University) ;
  • Jeong, Taesung (Department of Pediatric Dentistry, School of Dentistry, Pusan National University) ;
  • Kim, Shin (Department of Pediatric Dentistry, School of Dentistry, Pusan National University) ;
  • Kim, Jiyeon (Department of Pediatric Dentistry, School of Dentistry, Pusan National University)
  • 심호진 (부산대학교 치과대학 소아치과학교실) ;
  • 정태성 (부산대학교 치과대학 소아치과학교실) ;
  • 김신 (부산대학교 치과대학 소아치과학교실) ;
  • 김지연 (부산대학교 치과대학 소아치과학교실)
  • Received : 2018.08.16
  • Accepted : 2018.10.29
  • Published : 2019.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

Sleep-disordered breathing (SDB) induces dysfunction of the orofacial muscles, leading to morphologic alteration of the face and dental malalignment. Early diagnosis and treatment of SDB is required in pediatric patients to ensure normal facial growth. Myofunctional therapy (MFT) is a modality for the treatment of SDB and prefabricated appliances can be used. Herein 2 cases of malocclusion with SDB, in which MFT with a prefabricated appliance was used for orthodontic treatment, have been described. SDB was diagnosed based on clinical symptoms taken by interview and home respiratory polygraphy. In both cases, SDB was improved using prefabricated appliance for MFT. However, resolution of crowding depended on the degree of crowding.

수면호흡장애는 구강악안면 근육 기능부전을 유발하여 안모의 형태이상 및 부정교합을 유발할 수 있다. 소아치과 영역에서 수면호흡장애의 조기 진단과 치료는 이러한 합병증을 차단하여 정상적인 안모 성장을 유지할 수 있다는 점에서 중요하다. 수면호흡장애의 치료법 중에 하나로 근기능요법이 있으며 기성 근기능 장치가 보조적으로 사용될 수 있다. 본 증례들에서는 수면호흡장애가 있는 부정교합 환자들에게 기성 근기능 장치를 사용하여 수면호흡장애를 해소하는 결과를 얻었기에 보고하는 바이다. 하지만 총생의 개선 효과는 그 정도에 따라 차이가 발생할 수 있으므로 이에 대한 한계점은 고려할 필요가 있다.

Keywords

References

  1. Simmons MS, Clark GT : The potentially harmful medical consequences of untreated sleep-disordered breathing: the evidence supporting brain damage. J Am Dent Assoc, 140:536-542, 2009. https://doi.org/10.14219/jada.archive.2009.0221
  2. Castronovo V, Zucconi M, Ferini-Strambi L, et al. : Prevalence of habitual snoring and sleep-disordered breathing in preschool-aged children in an Italian community. J Pediatr, 142:377-382, 2003. https://doi.org/10.1067/mpd.2003.118
  3. Gislason T, Benediktsdottir B : Snoring, apneic episodes, and nocturnal hypoxemia among children 6 months to 6 years old. An epidemiologic study of lower limit of prevalence. Chest, 107:963-966, 1995. https://doi.org/10.1378/chest.107.4.963
  4. Marcus CL, Brooks LJ, Spruyt K, et al. : Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatr, 130:714-755, 2012. https://doi.org/10.1542/peds.2012-1672
  5. Amin R, Somers VK, Daniels S, et al. : Activity-adjusted 24-hour ambulatory blood pressure and cardiac remodeling in children with sleep disordered breathing. Hypertension, 51:84-91, 2008. https://doi.org/10.1161/HYPERTENSIONAHA.107.099762
  6. Sans Capdevila O, Crabtree VM, Kheirandish-Gozal L, Gozal D : Increased morning brain natriuretic peptide levels in children with nocturnal enuresis and sleep-disordered breathing: a community-based study. Pediatr, 121:1208-1214, 2008. https://doi.org/10.1542/peds.2007-2049
  7. Gozal D : Sleep-disordered breathing and school performance in children. Pediatr, 102:616-620, 1998. https://doi.org/10.1542/peds.102.3.616
  8. Gozal D, Kheirandish-Gozal L, Dayyat E, et al. : Obstructive sleep apnea and endothelial function in school-aged nonobese children: effect of adenotonsillectomy. Circulation, 116:2307-2314, 2007. https://doi.org/10.1161/CIRCULATIONAHA.107.696823
  9. Sateia MJ : International classification of sleep disordersthird edition (ICSD-3). Chest, 146:1387-1394, 2014. https://doi.org/10.1378/chest.14-0970
  10. Guilleminault C, Huang YS, Lin CH, et al. : Critical role of myofascial reeducation in pediatric sleep-disordered breathing. Sleep Med, 14:518-525, 2013. https://doi.org/10.1016/j.sleep.2013.01.013
  11. Guilleminault C, Li KK, Martinez S, et al. : Sleep disordered breathing: surgical outcomes in prepubertal children. Laryngoscope , 114:132-137, 2004. https://doi.org/10.1097/00005537-200401000-00024
  12. Huang YS, Guilleminault C : Pediatric obstructive sleep apnea and the critical role of oral-facial growth: evidences. Front Neurol, 3:184, 2013.
  13. Katz MI : Angle classification revisited 2: a modified Angle classification. Am J Orthod Dentofacial Orthop, 102:277-284, 1992. https://doi.org/10.1016/S0889-5406(05)81064-9
  14. Villa MP, Bernkopf E, Ronchetti R, et al. : Randomized controlled study of an oral jaw-positioning appliance for the treatment of obstructive sleep apnea in children with malocclusion. Am J Respir Crit Care Med, 165:123-127, 2002. https://doi.org/10.1164/ajrccm.165.1.2011031
  15. Wise MS, Nichols CD, Hoban TF, et al. : Executive summary of respiratory indications for polysomnography in children: an evidence-based review. Sleep, 34:389-398, 2011. https://doi.org/10.1093/sleep/34.3.389
  16. Flemons WW, Littner MR, Loube DI, et al. : Home diagnosis of sleep apnea: a systematic review of the literature. An evidence review cosponsored by the American Academy of Sleep Medicine, the Americn College of Chest Physicians, and the American Thoracic Society. Chest, 124:1543-1579, 2003. https://doi.org/10.1378/chest.124.4.1543
  17. Chuang LC, Lian YC, Huang YS, et al. : Passive myofunctional therapy applied on children with obstructive sleep apnea: a 6-month follow-up. J Formos Med Assoc, 116:536-541, 2017. https://doi.org/10.1016/j.jfma.2016.08.002
  18. Caples SM, Garcia-Touchard A, Somers VK : Sleep-disordered breathing and cardiovascular risk. Sleep, 30:291-303, 2007. https://doi.org/10.1093/sleep/30.3.291
  19. Pirila-Parkkinen K, Pirttiniemi P, Lopponen H, et al. : Dental arch morphology in children with sleep-disordered breathing. Eur J Orthod, 31:160-167, 2009. https://doi.org/10.1093/ejo/cjn061
  20. Flores-Mir C, Korayem M, Major PW, et al. : Craniofacial morphological characteristics in children with obstructive sleep apnea syndrome: a systematic review and metaanalysis. J Am Dent Assoc, 144:269-277, 2013. https://doi.org/10.14219/jada.archive.2013.0113
  21. Benkert KK : The effectiveness of orofacial myofunctional therapy in improving dental occlusion. Int J Orofacial Myology, 23:35-46, 1997.
  22. Ramirez-Yanez G, Sidlauskas A, Junior E, Fluter J : Dimensional changes in dental arches after treatment with a prefabricated functional appliance. J Clin Pediatr Dent, 31:279-283, 2007. https://doi.org/10.17796/jcpd.31.4.d7p31201572n72h2
  23. Kau CH, Durning P, Harzer W, et al. : Extractions as a form of interception in the developing dentition: a randomized controlled trial. J Orthod, 31:107-114, 2004. https://doi.org/10.1179/146531204225020391
  24. Ramirez-Yanez GO, Faria P : Early treatment of a Class II, division 2 malocclusion with the Trainer for Kids (T4K): a case report. J Clin Pediatr Dent, 32:325-329, 2008. https://doi.org/10.17796/jcpd.32.4.8833x52755364hx4
  25. Keski-Nisula K, Keski-Nisula L, Varrela J, et al. : Dentofacial changes after orthodontic intervention with eruption guidance appliance in the early mixed dentition. Angle Orthod, 78:324-331, 2008. https://doi.org/10.2319/012607-37.1