Tooth Wear Score Of OSA Patients According To OSA Severity

Study objectives:1.To evaluate the association between the tooth wear score and obstructive sleep apnea(OSA)through classifying OSA patients diagnosed by PSG using inter-oral pictures and clinical examination.2.To determine the variable of two-dimensional dentofacial morphology that contributes to OSA and tooth wear using the cephalometric X-rays.3.To observe the impact that BMI has on OSA and tooth wear.Study methods:Adult patients with chief complaint of snoring or sleep apnea(n=76,age range,20-57 years,median age,37.5 years,BMI range,20-38.9 kg/m2,mean BMI,27.58±3.68 kg/m2)were diagnosed with OSA based on PSG findings through Chinese National Health and Medical Committee Key Laboratory of Otorhinolaryngology.Patients were recruited continuously through March 2017 to January 2019.Exclusion criteria are any of the followings:(1)have taken OSA treatment(2)had been taken ENT surgery before(3)severe malocclusion or have been through orthodontic treatment(4)less than 20 teeth(5)more than 4 tooth prostheses(6)tooth fluorosis or other tooth enamel hypoplasia(7)long history of drinking carbonated beverages.Patients were divided into two groups according to AHI,moderate and mild group(5?AHI<30)as well as severe group(AHI)30).Tooth wear score was recorded through clinical examination and inter-oral pictures.Cephalometric measurements were analysed using Dolphin system based on Jarabak analysis.BMI was also detected in this study to find out its impact on AHI and tooth wear score.Dentofacial morphology comparation was done among different BMI groups.Quantitative data were described by the calculation of the mean and typical deviation.Quantitative variables were expressed in number of events and were compared with)?2 test.The correlation was evaluated by Spearman correlation test.Wilcoxon test was used to compare these two groups.Statistical analysis was performed using SPSS 23.0.Results:1.There was a significantly higher score of tooth wear in severe OSA group comparing to that of moderate and mild group.A statistically significant association was found between AHI severity and tooth wear score(Spearman R=0.26,P=0.026)This association was affected by age variables.Tooth wear was significantly positively related with age.2.A significant positive correlation was found between AHI and mandible ramus height(Spearman R=0.265,P=0.021).Severe OSA patients tended to have longer mandible ramus than mild and moderate OSA patients(52.32±6.11 mm vs 49.52±5.37 mm).There were no other measurements related to AHI.3.There were no significant correlation in tooth wear and OSA patients' dentofacial morphology.However,statistically significant associations were found between mild-moderate tooth wear group and moderate-severe tooth wear group.Moderate tooth wear group was more likely to be Class II skeletal type,with shorter mandible body(75.41±6.30 mm vs 80.61±5.48 mm),larger ANB angle(5.34=12.81° vs 2.54±1.93?)and larger convexity of face(10.42±6.11° vs 3.78±4.82°)than mild one.4.There was a significant positive correlation between BMI and AHI.BMI,however,had no significant impact on tooth wear score.There was no difference in two-dimensional dentofacial morphology in different BMI groups.Conclusion:1.Tooth wear was related to the severity of OSA,while impacted by age.Tooth wear score could be a supplementary tool identifying the severity of OSA.2.We did not find signi:ficant correlation between dentofacial morphology and OSA,only to find mandible ramus height weakly correlated.3.There was no correlation between tooth wear and OSA patients'dentofacial morphology.Moderate tooth wear group was more likely to be Class ? skeletal type4.BMI was positively related with the severity of OSA,but it had no impact on tooth wear.