Potential impact of pediatric obstructive sleep apnea on mandibular cortical width dimensions

Study Objectives: To analyze differences in mandibular cortical width (MCW) among children diagnosed with obstructive sleep apnea (OSA) or at high- or lowrisk for OSA. Methods: A total of 161 children were assessed: 60 children with polysomnographically diagnosed OSA, 56 children presenting symptoms suggestive of highrisk for OSA, and 45 children at low risk for OSA. Children at high- and low-risk for OSA were evaluated through the Pediatric Sleep Questionnaire. MCW was calculated using ImageJ software from panoramic radiograph images available from all participants. Differences between MCW measurements in the 3 groups were evaluated using analysis of covariance and Bonferroni post-hoc tests, with age as a covariate. The association between MCW and specific cephalometric variables was assessed through regression analysis. Results: The participants' mean age was 9.6 ± 3.1 years (59% male and 41% female). The mean body mass index z-score was 0.62 ± 1.3. The polysomnographically diagnosed OSA group presented smallerMCWthan the group at low-risk for OSA (mean difference = -0.385mm, P =.001), but no difference with the group at high-risk for OSA (polysomnographically diagnosed OSA vs high-risk OSA: P =.085). In addition, the MCW in the group at high-risk for the OSA was significantly smaller than thegroupat low-risk for theOSA(meandifference=-0.301mm, P =.014). The cephalometric variables (Sella-Nasion-A point angle (SNA) and Frankfort - Mandibular Plane angle (FMA)) explained only 8% of the variance in MCW. Conclusions: Reductions in MCW appear to be present among children with OSA or those at high-risk for OSA, suggesting potential interactions between mandibular bone development and/or homeostasis and pediatric OSA.