Abstract：
Obstructive sleep apnea (OSA) can affect children and adults, and, if left untreated, could have a major impact on the general and overall well-being of the patient. Dental health care providers and orthodontists have an interdisciplinary role in screening patients at risk for OSA and make a referral to establish a definitive diagnosis by a sleep physician. The gold standard of diagnostic testing is polysomnography. The adeno-tonsillar hypertrophy is the primary cause of sleep apnea in children; therefore, adeno-tonsillectomy must be the first line of treatment. Post adeno-tonsillectomy, if there is residual OSA due to underlying skeletal discrepancy, the patient may be referred to an orthodontist for appropriate management. Currently the evidence in the literature for prophylactic growth modification in children to prevent OSA is weak. In adults, the gold standard for managing OSA is Positive Airway Pressure (PAP) therapy; however, adherence to this treatment is rather low. The oral appliance (OA) therapy is an alternate for PAP intolerant patients and for mild to moderate OSA patients. The OA therapy has to be administered by a qualified dentist or orthodontist after careful examination of dental and periodontal health as well as any pre-existing joint conditions. The OA therapy could cause OA-associated malocclusion and patients have to be made aware of prior to initiating treatment. In patients with severe OSA, surgical maxilla-mandibular advancement (MMA) is highly effective.
摘要：
阻塞性睡眠呼吸暂停（OSA）可影响儿童和成人，and,如果不及时治疗，可能会对患者的总体和整体健康产生重大影响。牙科保健提供者和正畸医生在筛查有OSA风险的患者中具有跨学科的作用，并由睡眠医生进行转诊以建立明确的诊断。诊断测试的黄金标准是多导睡眠图。腺扁桃体肥大是儿童睡眠呼吸暂停的主要原因；因此，腺扁桃体切除术必须是一线治疗。腺体扁桃体切除术后,如果由于潜在的骨骼差异而存在残留的OSA，病人可以转介给正畸医生进行适当的管理。目前，文献中关于儿童预防性生长修饰以预防OSA的证据很少。在成年人中,管理OSA的黄金标准是气道正压（PAP）治疗；然而，对这种治疗的依从性相当低。口腔矫治器（OA）疗法是PAP不耐受患者和轻度至中度OSA患者的替代疗法。在仔细检查牙齿和牙周健康以及任何预先存在的关节状况后，必须由合格的牙医或正畸医生进行OA治疗。OA治疗可能导致OA相关的咬合不正,并且在开始治疗之前必须使患者意识到。重度OSA患者,手术上颌下颌前移（MMA）是非常有效的。
