Study On Cranio-facial Structure In Adolescents With Obstructive Sleep Disordered Breathing By Jarabak Analysis

Objective:In this study,120 children and adolescents with obstructive sleep dis-ordered breathing were selected.Jarabak cephalometric analysis was used to analyze the facial,skeletal,dental and predict growth type.To study the hazard of obstructive sleep disordered breathing on the growth and development of cranio-facial in adolescents,and to analyze the mechanism of malocclusion,so as to provide evidences for early treatment and diagnosis of malocclusion associated with obstructive sleep disordered breathing,and to guide clinical diagnosis and formulate treatment plan.Methods:The cases of 8?12-year-old adolescent patients with a history of mouth breathing who hospitalized in the Departments of Orthodontics the Affiliated Stomatology Hospital of Kunming Medical University from 2016 to 2018 were collected.Through clinical examination,medical history collection,X-ray examination and polysomnography,120 subjects with obstructive sleep disordered breathing were screened out.There were 61 females and 59 males.The X-ray lateral radiographs were taken under uniform conditions and were introduced into Dolphin software.The saddle angle,Jarabak ratio(anterior height/posterior height),articular angle and anterior cranial base length were measured by Jarabak analysis to response condylar position,growth type,growth direction and so on.SPSS 21.0 statistical software was used to analyze the data,and to analyze the variation degree of each measurement item relative to the normal value in children and adolescents with obstructive sleep disordered breathing.Results:The 120 subjects in this study contains 61 female and 59 male,with age:8?12.1.Analysis of skeletal patterns:70 patients(58%)were Angle skeletal class ?;37 patients(31%)were Angle skeletal class I;and 13 patients(11%)were Angle skeletal class ?.2.Growth type measurement:clockwise growth type 74 patients(62%);normal growth type 33 patients(27%);counterclockwise growth type 13 patients(1 1%);3.The position of the condyle:the position of the condyle was normal in 74 patients(62%);the position of the condyle was posterior in 26 patients(21%);and the position of the condyle was anterior in 20 patients(17%).4.The length of anterior cranial base(S-N)decreased(P<0.01);the relationship between cranial base and mandibular position,the mean values of articular angle(S-Ar-Go),Jarabak's Sum,MP-SN,anterior facial height(N-Me),Y-SN and S-Ar/Ar-Go were higher than those of the normal group(P<0.05);the posterior height and SN-NP angle were lower than normal(P<0.05);the mandibular corpus(Go-Gn),ramus height(Ar-Go),SNA,SNB and upper gonial angle(Ae-Go-N)decreased(P<0.01),while the angles of NA-APog,Gonial angle(Ar-Go-Me)and lower gonial angle(N-Go-Me)increased(P<0.01);dentition and soft tissue measurements:U1-SN,U1-NPog,OP-GoGn and TUL-E were higher than normal group(P<0.05),and L1-MP angle was lower than normal group(P<0.05).There was no significant difference in other measurement indicators.Conclusions:1.The skeletal malocclusion of children with obstructive sleep dis-ordered breathing is mainly Angle skeletal class ?,but a small number of patients show type ? and type ? malocclusion;2.Children and adolescents with obstructive sleep disordered breathing are mainly clockwise growth type;3.Children and adolescents with obstructive sleep disordered breathing,most of the condyles are normal,and a small number of patients exist abnormal change.4.Compared with normal children,the anterior cranial base and upper and lower jaw are underdeveloped,the mandibular ramus and mandibular corpus are shortter,the gonial angle,the lower gonial angle,and the mandibular plane are enlarged.The mandiblular rotates clockwise and the chin is underdeveloped.The retrusion of the lower incisors,the protrusion of the upper incisors,the function plane is rotated clockwise,and the upper lip is protrusion.