Dados do Trabalho

Título

EDENTULISM IN OBSTRUCTIVE SLEEP APNEA - A CASE REPORT.

Introdução

Edentulism has been considered an independent risk factor for obstructive sleep apnea because of its association with decreased retropharyngeal space and reduced pharyngeal muscle tone.

Objetivo

To describe the clinical, anthropometric and craniofacial evaluation of an edentulous patient with obstructive sleep apnea.

Métodos

A 67-year-old male patient with complaints of snoring and assisted sleep apnea. The diagnostic investigation was performed using the Pittsburgh Sleep Quality Index (PSQI), Stop Bang, Berlin Questionnaire (BQ), Epworth Sleepiness Scale (ESS), and type I polysomnography. The clinical evaluation included collecting demographic and anthropometric data: body mass index (BMI), neck circumference (NC), and abdominal circumference (AC). Extraoral dental protocol: Cranial Index (CI), Facial Index (FI), Thyromental Distance (TMD), Vertical Dimension of Occlusion (VDO) with and without dental prosthetics (Pts). Intraoral dental protocol: Modified Mallampati Index (MMI), Brodsky Palatine Tonsils Scale (BPTS), oral cavity and teeth evaluation.

Resultados

Polysomnography showed an AHI of 24.6 ev/h, the ODI in REM sleep of 28.4 ev/h and NREM sleep of 3.4 ev/h. Questionnaire scores were PSQI=3; Stop Bang=5; BQ=high risk; and ESS=3. Anthropometric parameters were BMI=31.7 kg/m2; NC=42cm; AC=111cm. The dental protocol measurements were: CI=83.9 (brachycephalic); FI=72.6 (hypereuriprosopic); TMD=7.5 cm; VDO with Pts=6.0 cm; VDO without Pts=5.7 cm; MMI= grade IV and BPTS= grade I. An intraoral examination showed an elongated soft palate, swollen and elongated uvula, and edentulism in the upper and lower arches.

Conclusões

In the individual mentioned, the tooth loss promoted vertical and horizontal alveolar ridge bone resorption, decreased vertical dimension of occlusion, decreased lower face height and relative macroglossia. These findings are described in studies in the literature as risk factors of edentulism for the pathogenesis of obstructive sleep apnea.

Palavras -chave

Sleep. Obstructive sleep apnea. Sleep apnea syndromes. Edentulous jaw.