Changes in airway patency and sleep-breathing in healthy skeletal Class II children undergoing functional activator therapy

Eur Oral Res. 2022 Jan 1;56(1):1-9. doi: 10.26650/eor.2022807392.

Abstract

Purpose: Several studies agree that an abnormal maxilla-mandible relationship correlates better as an Obstructive Sleep Apnea (OSA) predictor, rather than obesity. One of the orthodontic therapies recommended for this kind of craniofacial deformity is to advance the mandible forward with an orthodontic activator, therefore, the aim of this study is to determine if healthy children that use this appliance experience a widening of the upper airway as well as an improvement in their sleep-breathing patterns.

Materials and methods: 39 healthy children, 20 for activator group (10 boys and 10 girls, 4 mean age 10.9 + 0.9; BMI 16.2 + 1.4), 19 for control group (13 boys and 6 girls, mean age 5 9.8 + 1.4; BMI 17.6 + 2.1) participated in this study. They were required to submit 2 lateral cephalometric radiographs both at initial and final stages of evaluation, and finally three at- home sleep-breathing monitoring results for the activator group and one for the control group.

Results: After radiographic evaluation, it was found that children in the activator group experienced an increase in all measured variables. After evaluation with the sleep monitor, an improvement of sleep-breathing was found in children from the activator group (p<0.05).

Conclusion: The activator not only provides a harmonious occlusion and proper development of the mandible, but it also helps improve the quality of sleep-breathing through widening of the upper airway and reducing the number of disordered breathing events in children that undergo this therapy.

Keywords: Orthodontic activator; at-home sleep monitoring; retrognathic mandible; sleep-breathing; upper airway.