Changes in the Upper Airway Dimension Following the Use of Functional Appliances in Children with Obstructive Sleep Apnea: A Systematic Review

<b>Introduction</b>: Obstructive Sleep Apnea Syndrome (OSAS) is a sleep-related breathing disorder common in children, often linked to craniofacial anomalies like retrognathic mandibles in Class II malocclusions. Functional appliances (FAs) have been proposed as non-invasive treatments t...

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Main Authors: Andrea Scribante, Maurizio Pascadopoli, Paolo Zampetti, Chiara Rocchi, Francesca Falsarone, Maria Francesca Sfondrini
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/12/2/227
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author Andrea Scribante
Maurizio Pascadopoli
Paolo Zampetti
Chiara Rocchi
Francesca Falsarone
Maria Francesca Sfondrini
author_facet Andrea Scribante
Maurizio Pascadopoli
Paolo Zampetti
Chiara Rocchi
Francesca Falsarone
Maria Francesca Sfondrini
author_sort Andrea Scribante
collection DOAJ
description <b>Introduction</b>: Obstructive Sleep Apnea Syndrome (OSAS) is a sleep-related breathing disorder common in children, often linked to craniofacial anomalies like retrognathic mandibles in Class II malocclusions. Functional appliances (FAs) have been proposed as non-invasive treatments to improve OSAS symptoms by modifying upper airway dimensions. Objective: this systematic review evaluates the effectiveness of functional appliances in improving upper airway structures in children with OSAS. <b>Materials and Methods</b>: the study was conducted according to PRISMA guidelines, analyzing studies published between 2004 and 2024 on PubMed, Scopus, Web of Science, Embase, and Cochrane Library databases. Inclusion criteria focused on growing patients (≤14 years) with OSAS and Class II skeletal malocclusions treated with FAs. <b>Results</b>: Of 1298 articles screened, four studies met the inclusion criteria. All studies reported a significant increase in upper airway dimensions of approximately 21% after treatment with FAs. Specifically, the cephalometric and tomographic evaluations revealed a clear enlargement of the superior posterior airway space of about 0.5 mm and a consequent improvement of the respiratory function. Discrepancies arose regarding changes in soft palate length and hyoid bone position, perhaps due to the measurement methods’ variation. <b>Conclusions</b>: Functional appliances appear effective in improving upper airway dimensions and alleviating OSAS symptoms in children. However, the limited number of studies, small sample sizes, and short follow-up periods emphasize the need for further research to confirm long-term efficacy and standardize evaluation protocols.
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spelling doaj-art-22ea209ce9d0448cb19e4f58a86ca7322025-08-20T03:12:18ZengMDPI AGChildren2227-90672025-02-0112222710.3390/children12020227Changes in the Upper Airway Dimension Following the Use of Functional Appliances in Children with Obstructive Sleep Apnea: A Systematic ReviewAndrea Scribante0Maurizio Pascadopoli1Paolo Zampetti2Chiara Rocchi3Francesca Falsarone4Maria Francesca Sfondrini5Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, ItalyUnit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, ItalyUnit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, ItalyUnit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, ItalyUnit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, ItalyUnit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy<b>Introduction</b>: Obstructive Sleep Apnea Syndrome (OSAS) is a sleep-related breathing disorder common in children, often linked to craniofacial anomalies like retrognathic mandibles in Class II malocclusions. Functional appliances (FAs) have been proposed as non-invasive treatments to improve OSAS symptoms by modifying upper airway dimensions. Objective: this systematic review evaluates the effectiveness of functional appliances in improving upper airway structures in children with OSAS. <b>Materials and Methods</b>: the study was conducted according to PRISMA guidelines, analyzing studies published between 2004 and 2024 on PubMed, Scopus, Web of Science, Embase, and Cochrane Library databases. Inclusion criteria focused on growing patients (≤14 years) with OSAS and Class II skeletal malocclusions treated with FAs. <b>Results</b>: Of 1298 articles screened, four studies met the inclusion criteria. All studies reported a significant increase in upper airway dimensions of approximately 21% after treatment with FAs. Specifically, the cephalometric and tomographic evaluations revealed a clear enlargement of the superior posterior airway space of about 0.5 mm and a consequent improvement of the respiratory function. Discrepancies arose regarding changes in soft palate length and hyoid bone position, perhaps due to the measurement methods’ variation. <b>Conclusions</b>: Functional appliances appear effective in improving upper airway dimensions and alleviating OSAS symptoms in children. However, the limited number of studies, small sample sizes, and short follow-up periods emphasize the need for further research to confirm long-term efficacy and standardize evaluation protocols.https://www.mdpi.com/2227-9067/12/2/227orthodontic appliancessleep apnea syndromessleep disordersrespiration disorders
spellingShingle Andrea Scribante
Maurizio Pascadopoli
Paolo Zampetti
Chiara Rocchi
Francesca Falsarone
Maria Francesca Sfondrini
Changes in the Upper Airway Dimension Following the Use of Functional Appliances in Children with Obstructive Sleep Apnea: A Systematic Review
Children
orthodontic appliances
sleep apnea syndromes
sleep disorders
respiration disorders
title Changes in the Upper Airway Dimension Following the Use of Functional Appliances in Children with Obstructive Sleep Apnea: A Systematic Review
title_full Changes in the Upper Airway Dimension Following the Use of Functional Appliances in Children with Obstructive Sleep Apnea: A Systematic Review
title_fullStr Changes in the Upper Airway Dimension Following the Use of Functional Appliances in Children with Obstructive Sleep Apnea: A Systematic Review
title_full_unstemmed Changes in the Upper Airway Dimension Following the Use of Functional Appliances in Children with Obstructive Sleep Apnea: A Systematic Review
title_short Changes in the Upper Airway Dimension Following the Use of Functional Appliances in Children with Obstructive Sleep Apnea: A Systematic Review
title_sort changes in the upper airway dimension following the use of functional appliances in children with obstructive sleep apnea a systematic review
topic orthodontic appliances
sleep apnea syndromes
sleep disorders
respiration disorders
url https://www.mdpi.com/2227-9067/12/2/227
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