Class II malocclusion and sleep-disordered breathing

A selection of abstracts of clinically relevant papers from other journals. The abstracts on this page have been chosen and edited by John R. Radford.

Abstract

'...we have to be mindful of the impact our treatment may have on their airway in the long term.'

Main

Kandasamy S, Goonewardene M. Semin Orthod 2014; 20: 316–323

This narrative review focuses on links between orthodontic treatment for those with a Class II malocclusion and sleep-disordered breathing. On one hand the authors argue that there is no evidence that a non-extraction approach maintains airway spaces but then urge caution when using camouflage treatment (extraction of either upper first or second premolar teeth and retraction of incisors) for those with a Class II malocclusion and sleep-disordered breathing. This is because the patient may be 'committed to both maxillary and mandibular advancement' surgery. The authors, of course, concede that orthognathic surgery is invasive. A middle ground, that may meet the patient's dental aesthetic requirement without potentially compromising airway space, is to accept a residual overjet at the completion of orthodontic treatment. Management of sleep-disordered breathing should be in collaboration with the physician whose approach would be CPAP. Overnight polysomnography remains the gold standard for diagnosis of sleep-disordered breathing.