Correlation between Malocclusions, Tonsillar Grading and Mallampati Modified Scale: A Retrospective Observational Study.

AIM: to investigate the correlation between growth tendency and different patient malocclusion, tonsillar grading, and tongue size (Mallampati index). MATERIALS AND METHODS: The sample is composed of 64 males and 40 females; patients aged between 6 and 16 years (median age 11 years, IQR 9-13) were included. The final sample is therefore 104 patients. After the first orthodontic visit, all the children underwent a collection of documentation (photographs, digital arch models, and X-rays). Patients were classified according to their malocclusion, palatal conformation, tonsillar grading, and Mallampati index. Group comparisons were performed using Fisher's test. A p-value less than 0.05 was considered statistically significant. RESULTS: The narrow palate was more frequent in those with Angle class III (p = 0.04), while the other variables considered (tonsillar grading, Mallampati, and lingual frenulum) were not significantly associated with dental class (p > 0.05). Furthermore, a different distribution of tonsillar grading was observed between subjects with normal palate and subjects with narrow palate, while no statistically significant association was found between the palatal shape and Mallampati index (p = 0.88). CONCLUSIONS: This study found that children with higher tonsillar grading had a higher prevalence of crossbite or narrow palate compared to other children at the same developmental stage. However, we did not observe any association between tonsil hyperplasia and the prevalence of class II malocclusion, anterior open bite, or patient divergence in this sample. Furthermore, no correlation was found between the Mallampati index and patients' dental class, narrow palate, or divergence in this study.

Anatomical determinants of upper airway collapsibility in obstructive sleep apnea: A systematic review and meta-analysis.

Upper airway (UA) collapsibility is one of the key factors that determine the severity of obstructive sleep apnea (OSA). Interventions for OSA are aimed at reducing UA collapsibility, but selecting the optimal alternative intervention for patients who fail CPAP is challenging because currently no validated method predicts how anatomical changes affect UA collapsibility. The gold standard objective measure of UA collapsibility is the pharyngeal critical pressure (Pcrit). A systematic literature review and meta-analysis were performed to identify the anatomical factors with the strongest correlation with Pcrit. A search using the PRISMA methodology was performed on PubMed for English language scientific papers that correlated Pcrit to anatomic variables and OSA severity as measured by the apnea-hypopnea index (AHI). A total of 29 papers that matched eligibility criteria were included in the quantitative synthesis. The meta-analysis suggested that AHI has only a moderate correlation with Pcrit (estimated Pearson correlation coefficient r = 0.46). The meta-analysis identified four key anatomical variables associated with UA collapsibility, namely hyoid position (r = 0.53), tongue volume (r = 0.51), pharyngeal length (r = 0.50), and waist circumference (r = 0.49). In the future, biomechanical models that quantify the relative importance of these anatomical factors in determining UA collapsibility may help identify the optimal intervention for each patient. Many anatomical and structural factors such as airspace cross-sectional areas, epiglottic collapse, and palatal prolapse have inadequate data and require further research.

Oral findings as predictors of obstructive sleep apnea- A case-control study.

Objective: To evaluate the role of dental parameters that may contribute to increasing apneic activity in patients with or without obstructive sleep apnea (OSA). Materials and Method: The study comprises a total of 120 patients (60 diagnosed with sleep apnea visiting a sleep center at Delhi and 60 controls). Patients were assessed based on body mass index, age, neck circumference, and gender (BANG), which were recorded for both the patients and controls. Oral and general examination was carried out using predetermined criteria for Angle's class of malocclusion, maxillary arch constriction, facial profile, Mallampati score for uvula, tongue size, depth of palatal vault, mouth breathing, and periodontitis. Results: Among 120 study subjects, 92 were males and 28 females, with a mean age of 49.08 + 13.13 years in the study group and 45.28 + 14.78 years in the control group. All the variables except Angle's class of malocclusion, periodontitis, mouth breathing, and hypertension showed significant differences in the study group. Multivariate analysis for patients with OSA revealed that obese patients were almost 1.5 times more possibly to report OSA symptoms than their non-obese counterparts. It was also found that patients with OSA were 4.12 times more likely to have neck circumference >40 cm, 2.25 times more likely to have maxillary arch constriction, 1.43 times deeper palatal vault, 8.7 times macroglossia, and 1.7 times class III & IV Mallampati score for uvula. Conclusion: The oral structural findings appear to be more closely related with OSA.

Relationship between bite size per mouthful and dental arch size in healthy subjects.

Although multiple factors influence food bite size, the relationship between food bite size per mouthful and mandible or tongue size remains poorly understood. Here, we examined the correlations between food bite size and the lower dental arch size (an indicator of tongue size) in human subjects with good oral and general health, using fish sausage and bread as test foods. Notably, bite size of both foods was significantly positively correlated with the lower dental arch size, whereas masticatory performance (measured in terms of glucose extraction from a gummy jelly) showed no dependence on bite size. Further, bite size was significantly positively correlated with the body mass index. Our findings suggest that larger bite size is associated with larger tongue size, which might be a contributory factor to obesity.

Which oropharyngeal factors are significant risk factors for obstructive sleep apnea? An age-matched study and dentist perspectives.

OBJECTIVE: Obstructive sleep apnea (OSA) is a common sleep breathing disorder. Untreated OSA may lead to a number of cardiovascular complications. Dentists may play an important role in OSA detection by conducting careful oral examinations. This study focused on the correlation of oral anatomical features in Thai patients who presented with OSA. METHODS: We conducted a prospective comparative study at a sleep/hypertension clinic and a dental clinic at Khon Kaen University in Thailand. Patients with OSA were enrolled in the study, along with age-matched patients with non-OSA (controls). Baseline characteristics, clinical data, and oropharyngeal data of all patients were compared between the two groups. Oropharyngeal measurements included tongue size, torus mandibularis, Mallampati classification, palatal space, and lateral pharyngeal wall area. Multivariate logistic regression analysis was used to identify the factors associated with OSA. RESULTS: During the study period, there were 156 patients who met the study criteria; 78 were patients with OSA and the other 78 were healthy control subjects. In the OSA group, there were 43 males with a mean age of 53 (standard deviation 12.29) years and a mean BMI of 30.86 kg/mm(2). There were 37 males in the control group with a mean age of 50 (standard deviation 12.04) years and a mean BMI of 24.03 kg/mm(2). According to multivariate logistic analysis, three factors were perfectly associated with OSA, including torus mandibularis class 6, narrow lateral pharyngeal wall, and Mallampati class 4. There were two other significant factors associated with having OSA, namely, BMI and Mallampati classification. The adjusted odds ratios (95% confidence interval) of these two factors were 1.445 (1.017, 2.052) and 5.040 (1.655, 15.358), respectively. CONCLUSION: Dentists may play an important role in the detection of OSA in patients with high BMI through careful oropharyngeal examination in routine dental treatment. A large torus mandibularis, Mallampati class 4, and a narrow lateral pharyngeal wall are important anatomical risk factors for OSA.

Measurement of human tongue by ultrasonic imaging / 实用口腔医学杂志

0.05). Conclusion: The tongue measurement with ultrasonic imaging is reproducible.

A study on the effect of the size and posture of tongue and craniofacial morphology on generalized spaced dentition / 대한치과교정학회지

This study was designed to evaluate the effect of the size and posture of tongue and craniofacial morphology on spaced dentition and compare the correlation between tongue size, craniofacial skeleton and dental arch size in generalized spaced and crowded group, The sample consisted of four groups, the 36 subjects of generalized spaced group(maxillary and mandibular spaced group), the 11 subjects of maxillary spaced group, the 8 subjects of mandibular spaced group and the 32 subjects of crowded group, Tongue size were measured on the lateral cephalometric radiograph, craniofacial skeleton were measured on the lateral and P-A cephalometric radiograph and dental arch size were measured on study casts, These data from lateral & P-A cephalometric radiograph and study casts were statistically analyzed to examine significant difference between groups and compare the correlation between each measurements. The results of this study were as follows.: 1. Length of the tongue was the largest in maxillary spaced group and the smallest in crowded group. Posture of the tongue was the highest in maxillary spaced group and the lowest in mandibular spaced group. Area of the tongue was larger in spaced group than in crowded group. 2. In comparison of the craniofacial skeleton and dental arch size, generalized spaced grouphad larger Mx. length, Mn. length, posterior cranial base length, craniofacial width anddental arch than crowded group. 3. The effect of the tongue on dental arch were larger in spaced group than in crowded group 4. In both groups, interjugal width and interantegonial width had large effect on dental archwidth, especially spaced group had higher correlation than crowded group 5. The effect of tongue on craniofacial skeleton were expected larger in spaced group than in crowded group, especially interjugal and interantegonial width showed high correlation with length, posture and area of tongue.