Domenico Ciavarella, Laura Guida, Giovanni Battista, Mario Dioguardi, Roberto Sabato, Maria Pia Foschino Barbaro, Donato Lacedonia, Claudio Chimenti, Letizia Perillo, Letizia Perillo, Mario Mastrovincenzo, Lorenzo Lo Muzio
Department of Surgical
Sciences, Faculty of Medicine, School of Dentistry, University of Foggia,
Via Rovelli 28, 71121 Foggia, Italy.
Obstructive sleep apnea (OSA) is a common disease that is estimated to affect 2% of middle-aged
women and 4% of middle-aged men. Reported risk factors include obesity, increased neck circumference, male sex and
anatomical abnormalities of the face. Although edentulism is reported to change the anatomy and also impair the function
of the upper airway, it has not been typically recognized as a risk factor for sleep-related breathing disorders.
Methods: The subject of this report is a 55 years old man with a body mass index (BMI) of 33 kg/m2. Cephalometric
assessments of head radiographs taken in the lateral plane with and without dentures were performed; mandible planehyoid
(MP-H) distance and the posterior airway space (PAS) were measured. Oxygen saturation (SaO2) and
apnea/hypopnea index (AHI) were evaluated.
A comparison of the polysomnographies taken with and without wearing the dentures during the night showed
that AHI was reduced (from 20.0/h to 5.7/h) and mean SaO2 increased (from 94.0% to 96.0%). Cephalometric analysis
showed that the removal of dentures led to a striking increase in the anteroposterior oropharyngeal wall distance from 5
mm to 10 mm, while the mandible plane-hyoid distance does not change.
These findings were consistent with the hypothesis that edentulism not always worse OSA by an
oropharyngeal collapse. Given the common occurrence of both conditions among the elderly, such as the reduction of
obstructive sleep apneas with or without dentures, the observed relationship requires further investigations on the
mechanisms through which the loss of teeth could help upper airway collapse during the night. In the present paper a case
of reduction of OSA without dentures during sleep is shown.