Sleep and Breathing

, Volume 15, Issue 2, pp 163–171 | Cite as

The correlation between craniofacial morphology and sleep-disordered breathing in children in an undergraduate orthodontic clinic

  • Hiroko Tsuda
  • Sandra Fastlicht
  • Fernanda R. Almeida
  • Alan A. Lowe
Original Article



The aim of this study was to assess children in an orthodontic teaching clinic to determine the relationship between sleep-disordered breathing (SDB) symptoms and craniofacial morphology.


All parents were asked to complete a SDB questionnaire at the commencement of orthodontic therapy. A cephalometric analysis included face heights, hyoid position, soft palate lengths, mandibular, vertical airway, overjet, and overbite. Study model measurements included dental width, depth, and palatal height. The subjects were divided into two groups according to their dentition stage: early or late mixed.


Data from 173 children (male 50.3%, mean age 10.1 ± 1.7 years) that completed the OSA-18 questionnaire and the cephalometric (CA) and model (MA) analyses were evaluated. The questionnaire suggested that only two children in the orthodontic pool had an increased chance of exhibiting SDB. However, loud snoring, mouth breathing, and difficulty awakening were reported in more than 20% of the children. Overall, a higher total score correlated with retroclined upper incisors (CA) and high palatal height (MA, p < 0.05). Although there was no significant score differences between the groups, a higher total score correlated with a long soft palate (CA, p < 0.05) in the early mixed dentition group and a high palatal height (MA) in the late mixed dentition group (p < 0.05).


Even though few patients were suspected as having SDB, symptoms were related to many cephalometric variables and study model measurements. Since the etiology of SDB is believed to involve multiple factors, such patients may exhibit some risk of developing SDB in the future.


Sleep apnea Orthodontics Questionnaire Cephalometric analysis Model analysis 



The authors would like to thank Mrs. Ingrid Ellis for her editorial assistance in the final presentation of this manuscript. Financial support for this study was received from MITACS Graduate Research Internship Program and from Klearway royalties paid to the University of British Columbia.


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Hiroko Tsuda
    • 1
  • Sandra Fastlicht
    • 1
  • Fernanda R. Almeida
    • 2
  • Alan A. Lowe
    • 1
  1. 1.Department of Oral Health SciencesThe University of British ColumbiaVancouverCanada
  2. 2.Department of Oral Biological and Medical SciencesThe University of British ColumbiaVancouverCanada

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