Monoblock appliance for treatment of children with sleep disordered breathing

Abstract

Aim: To evaluate the impact of monobloc treatment on upper airway dimensions, polysomnography(PSG), behavioural problems and sleep quality in mandibular retrognathic class II children with primary snoring or OSA.

Methods: Children with skeletal class II malocclusion who also had habitual snoring were recruited and all children were treated with monoblock appliance. Skeletal, dental and airway measurements were performed on lateral cephalograms before and after treatment. All children had initial PSG and second PSG were carried out for children with OSA after the treatment. 4 questionnaires including Strength and Difficulties Questionnaire, Inattention and Hyperactivity Assessment List, Pediatric Sleep Questionnaire and Pittsburh Sleep Quality Index were completed before and after the treatment.

Results: There were 14 children with primary snoring and 16 children with OSA who had skeletal class II malocclusion and were treated with monobloc appliance. Control group consisted of 10 children with skeletal class I pattern. Skeletal class II malocclusion has improved with an increase in SNB angle(p<0,01) and with a reduction in ANB angle(p<0,01) and overjet(p<0,01), airway dimensions has increased. 15 children had mild and 1 child had severe OSA. Apnea-hypopnea index decreased(p<0,05) in all children with OSA. Sleep quality and behaviour improved in both OSA and primary snoring groups with treatment(p<0.05).

Conclusion: Monoblock appliance is an important treatment option for children with mild to moderate OSA and skeletal class II maloclusion. It may also improve behaviour in children with primary snoring.