Abstract

Sleep-disordered breathing (SDB) and obstructive sleep apnea (OSA) are very common in the pediatric/adolescent orthodontic population and are frequently linked to cranio-facial anomalies, e.g., mandibular retrognathia, maxillary constriction, Class II malocclusions. Non-invasive strategies have also been suggested to enhance the patency of the airways and to minimize the severity of SDB through orthodontic interventions. The current systematic review aimed to examine recent clinical data regarding the impact of orthodontic intervention on the quality of sleep and SDB in children/adolescents in terms of airway dimensions, apnea-hypopnea index (AHI), and functional sleep outcomes. A thorough search of the literature was performed on clinical studies published between 2017 and 2025. Articles that assessed the effects of orthodontic therapy on pediatric and adolescent patients using pre-intervention and post-intervention data on the quality of sleep or dimensions of the airways were incorporated. Seven studies of a total of 556 subjects were reviewed. It was demonstrated that orthodontic measures were linked to a significant increase in the size of the upper airways, a decrease in AHI, and an improvement in the quality of sleep. The greatest benefits were observed in children with mandibular retrognathia or maxillary constriction with functional appliances and rapid maxillary expansion. The impact of treatment therapy was more pronounced among younger patients who received early intervention therapy. There were no major reported effects of the short-term on the dental or skeletal structures. Orthodontic intervention proved to be effective in enhancing sleep quality and decreasing SDB in children and adolescents.

Key words: Orthodontic treatment, malocclusion, sleep quality, sleep-disordered breathing, obstructive sleep apnea, systematic review.