Sleep, Upper Airway and Dental Occlusion in Children With Large Overjet

NCT ID: NCT04964830

Last Updated: 2024-03-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

69 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-04-01

Study Completion Date

2025-12-31

Brief Summary

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This project examines sleep (e.g. prevalence of obstructive sleep apnea(OSA)), dimension of upper airway, jaw function, well-being and quality of life in children with large overjet compared to a control group. In addition, the effect of treatment with a mandibular advancement device (MAD) on sleep, upper airway and jaw function are examined, and how these factors affect the children's well-being and quality of life.

Detailed Description

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Sleep is very important for children's growth, development and learning. The anatomy and size of the airway and position of the jaw can affect children's sleep. Children with large overjet due to a posterior position of the mandible have smaller airways compared to children with neutral occlusion. Reduced dimensions of the upper airways may increase the risk of impaired sleep quality and the sleep related breathing disorder obstructive sleep apnoea (OSA), which causes symptoms e.g. failure to thrive, irritability, behavioural disorders, fatigue, which affects the children's growth, development, and learning negatively.

Children with large overjet due to mandibular retrognathia in Denmark are offered orthodontic treatment in municipal dental care and are in most cases treated with a mandibular advancement device (MAD) keeping the mandible in a forward position relative to the maxilla. MADs are also used to treat adults with mild-moderate obstructive sleep apnoea while they sleep. This can reduce the number of apnoea periods by up to 75% as well as preventing daytime sleepiness.

No previous study have examined sleep, upper airway, jaw function, well-being and quality of life in children with large overjet before, during and after MAD treatment compared to a control group with normal occlusion.

Conditions

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Overjet, Dental

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Children with large overjet

Overjet ≥6 mm, planned orthodontic treatment with functional appliance

Group Type ACTIVE_COMPARATOR

Orthodontic treatment with functional appliance (MAD)

Intervention Type DEVICE

Expansion plate and z-activator (MAD)

Control group

Neutral occlusion, no indication for orthodontic treatment, no prior orthodontic treatment

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Orthodontic treatment with functional appliance (MAD)

Expansion plate and z-activator (MAD)

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

Overjet group:

* Horizontal maxillary overjet ≥ 6 mm and need of orthodontic treatment according to the Danish procedure for screening the child population for malocclusion involving health risk.
* Informed consent from parent(s)/guardian(s)

Control group:

* Neutral occlusion
* No history of orthodontic treatment
* Informed consent from parent(s)/guardian(s)

Exclusion Criteria

* Known general and/or craniofacial syndromes/diseases
* Known sleep disorders, included bruxism during sleep
* Chronic respiratory diseases and asthma6/12
* Adenoid vegetations, hypertrophic tonsils and significantly reduces airflow through the nose (mouth breather), which need primary treatment.
* Dysfunction of masticatory muscles and temporomandibular joint, which need primary treatment.
Minimum Eligible Age

9 Years

Maximum Eligible Age

14 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Postgraduate Programme in Orthodontics, Copenhagen

UNKNOWN

Sponsor Role collaborator

Sygekassernes Helsefond

OTHER

Sponsor Role collaborator

The Danish Dental Association

UNKNOWN

Sponsor Role collaborator

Københavns Kommune

OTHER

Sponsor Role collaborator

Hørsholm Kommune

UNKNOWN

Sponsor Role collaborator

Rødovre Kommune

UNKNOWN

Sponsor Role collaborator

Hvidovre Kommune

UNKNOWN

Sponsor Role collaborator

Høje-Taastrup Kommune

UNKNOWN

Sponsor Role collaborator

University of Copenhagen

OTHER

Sponsor Role lead

Responsible Party

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Camilla Hansen

PhD student

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Camilla Hansen, DDS, PhD student

Role: PRINCIPAL_INVESTIGATOR

Section of Orthodontics, Department of Odontology, University of Copenhagen

Locations

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University of Copenhagen, Department of Odontology

Copenhagen, , Denmark

Site Status

Countries

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Denmark

References

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Knappe SW, Sonnesen L. The Reliability and Influence of Body Position on Acoustic Pharyngometry and Rhinometry Outcomes. J Oral Maxillofac Res. 2020 Dec 31;11(4):e1. doi: 10.5037/jomr.2020.11401. eCollection 2020 Oct-Dec.

Reference Type BACKGROUND
PMID: 33598109 (View on PubMed)

Kaditis AG, Alonso Alvarez ML, Boudewyns A, Alexopoulos EI, Ersu R, Joosten K, Larramona H, Miano S, Narang I, Trang H, Tsaoussoglou M, Vandenbussche N, Villa MP, Van Waardenburg D, Weber S, Verhulst S. Obstructive sleep disordered breathing in 2- to 18-year-old children: diagnosis and management. Eur Respir J. 2016 Jan;47(1):69-94. doi: 10.1183/13993003.00385-2015. Epub 2015 Nov 5.

Reference Type BACKGROUND
PMID: 26541535 (View on PubMed)

Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove EL, John MT, Schiffman EL. Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Jun;107(6):844-60. doi: 10.1016/j.tripleo.2009.02.023.

Reference Type BACKGROUND
PMID: 19464658 (View on PubMed)

Hansen C, Markstrom A, Bakke M, Sonnesen L. Sleep-Disordered Breathing and Dimensions of The Maxillary Dental Arch and Hard Palate in Children With Class II and Large Overjet-A Case-Control Study. J Oral Rehabil. 2025 Mar;52(3):367-374. doi: 10.1111/joor.13911. Epub 2024 Dec 8.

Reference Type DERIVED
PMID: 39648069 (View on PubMed)

Hansen C, Sonnesen L, Bakke M, Markstrom A. Prevalence of sleep-disordered breathing in children and adolescents with large horizontal maxillary overjet due to mandibular retrognathia: a case-control study. J Clin Sleep Med. 2024 Dec 1;20(12):1871-1878. doi: 10.5664/jcsm.11248.

Reference Type DERIVED
PMID: 38958059 (View on PubMed)

Hansen C, Sonnesen L, Markstrom A. Signal quality of home polygraphy in children and adolescents. Acta Paediatr. 2023 Dec;112(12):2583-2588. doi: 10.1111/apa.16964. Epub 2023 Sep 4.

Reference Type DERIVED
PMID: 37661830 (View on PubMed)

Anandarajah S, Dudhia R, Sandham A, Sonnesen L. Risk factors for small pharyngeal airway dimensions in preorthodontic children: A three-dimensional study. Angle Orthod. 2017 Jan;87(1):138-146. doi: 10.2319/012616-71.1. Epub 2016 Jun 15.

Reference Type BACKGROUND
PMID: 27304232 (View on PubMed)

Abdalla Y, Brown L, Sonnesen L. Effects of a fixed functional appliance on upper airway volume: A 3-dimensional cone-beam computed tomography study. Am J Orthod Dentofacial Orthop. 2020 Jul;158(1):40-49. doi: 10.1016/j.ajodo.2019.07.013. Epub 2020 May 7.

Reference Type BACKGROUND
PMID: 32389570 (View on PubMed)

Petri N, Christensen IJ, Svanholt P, Sonnesen L, Wildschiodtz G, Berg S. Mandibular advancement device therapy for obstructive sleep apnea: a prospective study on predictors of treatment success. Sleep Med. 2019 Feb;54:187-194. doi: 10.1016/j.sleep.2018.09.033. Epub 2018 Nov 12.

Reference Type BACKGROUND
PMID: 30580193 (View on PubMed)

Andersson H, Sonnesen L. Sleepiness, occlusion, dental arch and palatal dimensions in children attention deficit hyperactivity disorder (ADHD). Eur Arch Paediatr Dent. 2018 Apr;19(2):91-97. doi: 10.1007/s40368-018-0330-3. Epub 2018 Mar 14.

Reference Type BACKGROUND
PMID: 29542042 (View on PubMed)

Knappe SW, Sonnesen L. Mandibular positioning techniques to improve sleep quality in patients with obstructive sleep apnea: current perspectives. Nat Sci Sleep. 2018 Feb 2;10:65-72. doi: 10.2147/NSS.S135760. eCollection 2018.

Reference Type BACKGROUND
PMID: 29440942 (View on PubMed)

Sonnesen L, Petersson A, Berg S, Svanholt P. Pharyngeal Airway Dimensions and Head Posture in Obstructive Sleep Apnea Patients with and without Morphological Deviations in the Upper Cervical Spine. J Oral Maxillofac Res. 2017 Sep 30;8(3):e4. doi: 10.5037/jomr.2017.8304. eCollection 2017 Jul-Sep.

Reference Type BACKGROUND
PMID: 29142656 (View on PubMed)

Anandarajah S, Abdalla Y, Dudhia R, Sonnesen L. Proposal of new upper airway margins in children assessed by CBCT. Dentomaxillofac Radiol. 2015;44(7):20140438. doi: 10.1259/dmfr.20140438. Epub 2015 Mar 25.

Reference Type BACKGROUND
PMID: 25806863 (View on PubMed)

Sonnesen L, Bakke M. Molar bite force in relation to occlusion, craniofacial dimensions, and head posture in pre-orthodontic children. Eur J Orthod. 2005 Feb;27(1):58-63. doi: 10.1093/ejo/cjh069.

Reference Type BACKGROUND
PMID: 15743864 (View on PubMed)

Sonnesen L, Bakke M, Solow B. Malocclusion traits and symptoms and signs of temporomandibular disorders in children with severe malocclusion. Eur J Orthod. 1998 Oct;20(5):543-59. doi: 10.1093/ejo/20.5.543.

Reference Type BACKGROUND
PMID: 9825557 (View on PubMed)

Lin SY, Su YX, Wu YC, Chang JZ, Tu YK. Management of paediatric obstructive sleep apnoea: A systematic review and network meta-analysis. Int J Paediatr Dent. 2020 Mar;30(2):156-170. doi: 10.1111/ipd.12593. Epub 2019 Nov 22.

Reference Type BACKGROUND
PMID: 31680340 (View on PubMed)

Fagundes NCF, Flores-Mir C. Pediatric obstructive sleep apnea-Dental professionals can play a crucial role. Pediatr Pulmonol. 2022 Aug;57(8):1860-1868. doi: 10.1002/ppul.25291. Epub 2021 Mar 1.

Reference Type BACKGROUND
PMID: 33501761 (View on PubMed)

Jennum P, Ibsen R, Kjellberg J. Morbidity prior to a diagnosis of sleep-disordered breathing: a controlled national study. J Clin Sleep Med. 2013 Feb 1;9(2):103-8. doi: 10.5664/jcsm.2398.

Reference Type BACKGROUND
PMID: 23372461 (View on PubMed)

Related Links

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Other Identifiers

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H-17011521

Identifier Type: -

Identifier Source: org_study_id

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