# Myofunctional Responses in Obstructive Sleep Apnea Syndrome in Children Following the Use of Two Oral Orthopedic Devices

## TL;DR

This study evaluates how two oral devices affect sleep apnea in children, finding they improve symptoms safely.

## Contribution

The study introduces a non-invasive treatment approach for obstructive sleep apnea in children using oral orthopedic devices.

## Key findings

- Polysomnography data showed a reduction in sleep apnea severity from severe to moderate or mild.
- Electromyography revealed increased muscle activity in specific jaw muscles during rest and chewing.
- Questionnaires indicated significant improvements in sleep disturbance and OSAS-related symptoms.

## Abstract

Rapid maxillary expansion (RME) is less invasive and an efficient method of treatment for obstructive sleep apnea syndrome (OSAS).
Objective: To assess the therapeutic impact of oral orthopedic appliances in the treatment of obstructive sleep apnea syndrome with polysomnography (PSG), electromyography (EMG), bite force measurement (BFM), questionnaires, and cephalometric analysis.

Eleven children (aged seven to eleven years) underwent three months of treatment with the Hyrax device, followed by the installation of the Balter´s Bionator appliance. Quality analysis, type III polysomnography (PSG), electromyography (EMG), and bite force measurement (BFM) were conducted. The analysis were performed through eleven months of treatment. The distributional normality were verified by the Kolmogorov–Smirnov, For these data, the Student test was performed. For data with non-normal distribution, the Wilcoxon test was performed. All analyzes were performed with a significance level of 5%.

Polysomnography data showed that severe scores became moderate or mild with the use of the devices. Electromyography, during rest periods, demonstrated that only the right temporal muscle exhibited increased electrical activity, while both muscles showed increased activity during dental clenching. There was an increase in the masseter and right temporalis during grape chewing. Bite Force Measurement (BFM) did not reveal any statistical difference before and after treatment. Questionnaire responses showed a statistically significant difference in the Sleep Disturbance Scale and OSA-18-PV.

It can be concluded that the use of the Balters Hyrax and Bionator devices in class II children and children with OSAS is a safe and effective treatment alternative.

Key words:Sleep apnea obstructive, bite force, polysomnography, electromyography, oral health, children.