Assessment of sagittal and vertical skeletal patterns in Romanian patients with obstructive sleep apnea

Vol. 51 No. 3, 2010


Aurelia Magdalena Enache, Vanda Roxana Nimigean, Fl. Mihaltan, Andreea Cristiana Didilescu, Ioana Munteanu, V. Nimigean

Objective: To establish the sagittal and vertical skeletal pattern of the Romanian patients with obstructive sleep apnea (OSA). Patients and Methods: Lateral cephalograms of forty patients, divided in two groups, group I - twenty patients with OSA (15 males and five females) and aged between 34-76 years and group II (control group) - twenty patients with class II malocclusion (eight males and 12 females), aged between 22-40 years, were analyzed for linear and angular skeletal parameters. Results: For group I - most often, the mandible was in posterior position, the mean value for SNB angle being 76.77 degrees; maxilla tended to be retruded, too. The maxillo-mandibular antero-posterior (AP) relationship was class II in 90% of the cases. A clockwise rotation of the mandible was registered in a vertical plane (mean value SN, ML: 29.82 degrees), the facial height ratio being in a normal range of values. There was a medium positive correlation between ANB angle and apnea/hypopnea index (AHI), while SNA showed a quadratic relationship with AHI. Using t-test, in order to compare the sagittal and vertical skeletal pattern of the two groups, it can be stated that there is a statistical significant difference for antero-posterior (AP) position of the mandible, for the group II mandible retrognathia being more pronounced than in group I. Conclusions: Romanian patients with OSA had a retrognathic sagittal pattern with a class II antero-posterior relationship. A statistical significant positive correlation between AHI and ANB suggests that the class II antero-posterior maxillomandibular relationship can predispose to OSA.

Corresponding author: Magdalena Enache, Assistant Lecturer, DDS, PhD, e-mail:

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