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Abstract(s)
Introdução: A Síndrome da Apneia/Hipopneia Obstrutiva do Sono (SAHOS) tem vindo a tornar-se uma constante em pacientes pediátricos, pelo que o interesse pela investigação deste tema tem vindo a crescer nos últimos tempos. O aumento de casos pediátricos poderá ser o espelho da evolução do diagnóstico da Síndrome. Na prática clínica, a escolha do tratamento ortodôntico intercetivo mais adequado deve basear-se num diagnóstico corretamente realizado e completo e fundamentado pelas evidências científicas disponíveis.
Objetivos: O principal objetivo é comparar a eficácia entre as terapêuticas Expansão Maxilar Rápida, Dispositivo de Avanço Mandibular e Distração Osteogénica Mandibular no que toca à melhoria e/ou desaparecimento dos sinais e sintomas clínicos característicos da Síndrome da Apneia/Hipopneia Obstrutiva do Sono, em pacientes pediátricos.
Material e Métodos: Criação de um protocolo de pesquisa, do qual faz parte a formulação da questão de investigação PICO (População, Intervenção, Comparação e Outcome) e definição dos objetivos de trabalho; recolha de dados utilizando a base de dados online da Medline (Pubmed®); filtros e termos de pesquisa e critérios de inclusão/exclusão aplicados de forma a obter os artigos mais relevantes sobre o tema; leitura integral dos artigos obtidos e utilização da meta-análise para analisar os dados obtidos.
Resultados: Relativamente à Expansão Maxilar Rápida e à Distração Osteogénica Mandibular, não se observou a existência de diferenças significativas entre os tratamentos na diminuição média do IAH, nem no aumento médio do Lowest SaO2. No que toca à Expansão Maxilar Rápida e ao Dispositivo de Avanço Mandibular, não se observou a existência de diferenças significativas entre os tratamentos na diminuição do risco relativo de Apneas, Daily sleeping, Restless sleep e Snoring. Conclusões: Todas as opções terapêuticas se revelaram similares no que toca à eficácia na melhoria e/ou desaparecimento dos sinais e sintomas clínicos característicos da SAHOS.
Introduction: The Sleep Apnea has become common disease in pediatric patients and the interest in this Syndrome pathology as well as its research have increased enormously these days. This pediatric increase can be the mirror of the Syndrome evolution. In clinic practice, the most suitable interceptive orthodontic treatment should be practiced on an accurate based scientific evidence treatment. Aims: The major aim of this paper is to compare the efficiency between the rapid maxillary expansion, the mandibular advancement device and distraction osteogenesis in what concerns the improvement and/or disappearance of the characteristic clinical signs and symptoms of the sleep apnea. Material and methods: Creation of a research protocol which includes the formulation of the investigation question PICO (population, intervention, comparation and outcome) and work aims definition. Data collection using the online database of Medline (Pubmed®). Filters and research and inclusion/exclusion criteria applied in a way to obtain the most relevant articles about the subject. Integral reading of the articles obtained. Use of the meta-analysis to analyze the obtained data. Results: As far as the Rapid Maxillary Expansion and the Distraction Osteogenesis is concerned, there were no significant differences between the treatments to the medium decrease of the AHI or in the medium increase of Lowest SaO2. In what concerns the Rapid Maxillary Expansion and Mandibular Advancement Device, no significant existence was observed between the treatments in reducing the relative risk of Apneas, Daily Sleeping, Restless Sleep and Snoring. Conclusions: All the therapeutical options revealed themselves similar in terms of effectiveness, improvement and/or disappearance of sleep apnea sings and clinical characteristic symptoms.
Introduction: The Sleep Apnea has become common disease in pediatric patients and the interest in this Syndrome pathology as well as its research have increased enormously these days. This pediatric increase can be the mirror of the Syndrome evolution. In clinic practice, the most suitable interceptive orthodontic treatment should be practiced on an accurate based scientific evidence treatment. Aims: The major aim of this paper is to compare the efficiency between the rapid maxillary expansion, the mandibular advancement device and distraction osteogenesis in what concerns the improvement and/or disappearance of the characteristic clinical signs and symptoms of the sleep apnea. Material and methods: Creation of a research protocol which includes the formulation of the investigation question PICO (population, intervention, comparation and outcome) and work aims definition. Data collection using the online database of Medline (Pubmed®). Filters and research and inclusion/exclusion criteria applied in a way to obtain the most relevant articles about the subject. Integral reading of the articles obtained. Use of the meta-analysis to analyze the obtained data. Results: As far as the Rapid Maxillary Expansion and the Distraction Osteogenesis is concerned, there were no significant differences between the treatments to the medium decrease of the AHI or in the medium increase of Lowest SaO2. In what concerns the Rapid Maxillary Expansion and Mandibular Advancement Device, no significant existence was observed between the treatments in reducing the relative risk of Apneas, Daily Sleeping, Restless Sleep and Snoring. Conclusions: All the therapeutical options revealed themselves similar in terms of effectiveness, improvement and/or disappearance of sleep apnea sings and clinical characteristic symptoms.
Description
Keywords
Síndrome da Apneia/Hipopneia Obstrutiva do Sono Ortodontia intercetiva Expansão maxilar rápida Dispositivo de avanço mandibular Distração osteogénica mandibular Sleep apnea Orthodontic Rapid maxillary expansion Mandibular advancement device Mandibular distraction osteogenesis