Posted by sleepsurgeon on April 04, 2009 at 08:38:02:In Reply to: Re: Comments from the sleep surgeon posted by Captin Cannuck on April 02, 2009 at 19:56:49:
There are numerous analyses out there. No one is better than the other. Cephalometric analysis identifies the “landmarks” on the skull and plot out where the “normal” landmarks should be. The initial cephalometric analysis used healthy, young dental hygienists as “normal” subjects to determine “normal” or ideal landmark positions. I have real problems with using cephalemetric analyses to treatment sleep apnea patients. First, what is “normal” or “ideal”? Second, they focus on bony points as oppose to soft tissue points on the face and people have variability in the soft tissue thickness of their faces. Moving the bone to the “ideal” position does not translate to placing the soft tissue to the “ideal” position. Third, there are no “normal” airway landmarks. “Normal” airway appears on the cephalometric radiograph does not mean “normal” airway. I have seen too many patients with sleep apnea that have “normal” appearing airway on an xray. Lastly, just because a patient has “excessive” cephalometric landmarks does not mean that this patient is not attractive or beautiful. This last point is well support in the literature and many years ago I wrote a paper on a survey study on patients 6-12 months after MMA. All of the patients were found to have larger cephalometric landmarks than “normal”. However, most of them perceived themselves as having “improved” esthetics following MMA. I have seen too many patients that come to me for second opinion that were insufficiently treated with MMA because of the dependence of cephalometric analyses. The use of cephalometric analyses to guide advancement is a REAL mistake but it is entrenched in the minds of too many dental surgeons.
- Re: Comments from the sleep surgeon Captin Cannuck 09:56 4/04/09 (1)
- Re: Comments from the sleep surgeon sleepsurgeon 17:04 4/07/09 (0)