PDF(Pubmed)
Abstract：
BACKGROUND: The American Association of Orthodontists white paper on obstructive sleep apnea and orthodontics remains the most authoritative statement on the topic. This was produced in 2019 due to increasing orthodontic interest in obstructive sleep apnea (OSA) and the lack of formal guidelines for orthodontists. Since the white paper\'s release, advocacy for contrarian ideas and practices remain. Orthodontists are sometimes acting as primary care providers for OSA. Procedures appropriate only for screening are sometimes being used for diagnosis. The side effects of effective treatments such as mandibular advancement devices need further consideration. Also, research has clarified the effectiveness and ineffectiveness of treatments such as palatal expansion.
RESULTS: Part of an orthodontist\'s role is screening for OSA. The correct action when this is suspected remains referral to the appropriate physician specialist for diagnosis and treatment or coordination of treatment. Orthodontists may participate in the treatment of patients with OSA as a member of a multi-disciplinary team. Effective orthodontic treatments may include orthognathic surgery with maxillomandibular advancement and mandibular advancement devices. The negative effects of the latter make this a choice of last resort. Current research indicates that OSA alone is not sufficient indication for palatal expansion.
CONCLUSIONS: Orthodontists should appropriately screen for obstructive sleep apnea. This may be done as part of our health histories, our clinical examination, and review of radiographs taken for purposes other than the diagnosis and screening for OSA. Orthodontic treatment for OSA can be helpful and effective. However, this may be done only after referral to the appropriate physician specialist, as part of a multi-disciplinary team, with consideration of the likely effectiveness of treatment, and after all likely and potential negative consequences have been considered and thoroughly discussed with the patient.
RESULTS: Part of an orthodontist\'s role is screening for OSA. The correct action when this is suspected remains referral to the appropriate physician specialist for diagnosis and treatment or coordination of treatment. Orthodontists may participate in the treatment of patients with OSA as a member of a multi-disciplinary team. Effective orthodontic treatments may include orthognathic surgery with maxillomandibular advancement and mandibular advancement devices. The negative effects of the latter make this a choice of last resort. Current research indicates that OSA alone is not sufficient indication for palatal expansion.
CONCLUSIONS: Orthodontists should appropriately screen for obstructive sleep apnea. This may be done as part of our health histories, our clinical examination, and review of radiographs taken for purposes other than the diagnosis and screening for OSA. Orthodontic treatment for OSA can be helpful and effective. However, this may be done only after referral to the appropriate physician specialist, as part of a multi-disciplinary team, with consideration of the likely effectiveness of treatment, and after all likely and potential negative consequences have been considered and thoroughly discussed with the patient.
摘要：
背景：美国正畸医师协会关于阻塞性睡眠呼吸暂停和正畸的白皮书仍然是关于该主题的最权威的声明。这是由于对阻塞性睡眠呼吸暂停（OSA）的正畸兴趣增加以及缺乏正畸医生的正式指南而在2019年产生的。自白皮书发布以来，对逆向思想和做法的倡导仍然存在。正畸医生有时充当OSA的初级保健提供者。仅适用于筛查的程序有时被用于诊断。下颌前移装置等有效治疗的副作用需要进一步考虑。此外，研究阐明了腭扩张等治疗方法的有效性和无效性。
结果：正畸医生的部分作用是筛查OSA。当怀疑这一点时，正确的行动仍然是转诊给适当的医生专家进行诊断和治疗或协调治疗。正畸医生可以作为多学科团队的成员参与OSA患者的治疗。有效的正畸治疗可能包括具有上颌下颌前移和下颌前移装置的正颌手术。后者的负面影响使这成为最后的选择。目前的研究表明，单独的OSA不足以说明腭扩张。
结论：正畸医生应适当筛查阻塞性睡眠呼吸暂停。这可能是我们健康史的一部分，我们的临床检查,并审查除诊断和筛查OSA以外的其他目的的X光片。正畸治疗OSA是有帮助和有效的。然而,只有在转诊给适当的医生专家后才能这样做，作为多学科团队的一部分,考虑到治疗的可能有效性，在考虑了所有可能和潜在的负面后果并与患者进行了彻底讨论之后。
结果：正畸医生的部分作用是筛查OSA。当怀疑这一点时，正确的行动仍然是转诊给适当的医生专家进行诊断和治疗或协调治疗。正畸医生可以作为多学科团队的成员参与OSA患者的治疗。有效的正畸治疗可能包括具有上颌下颌前移和下颌前移装置的正颌手术。后者的负面影响使这成为最后的选择。目前的研究表明，单独的OSA不足以说明腭扩张。
结论：正畸医生应适当筛查阻塞性睡眠呼吸暂停。这可能是我们健康史的一部分，我们的临床检查,并审查除诊断和筛查OSA以外的其他目的的X光片。正畸治疗OSA是有帮助和有效的。然而,只有在转诊给适当的医生专家后才能这样做，作为多学科团队的一部分,考虑到治疗的可能有效性，在考虑了所有可能和潜在的负面后果并与患者进行了彻底讨论之后。
