Correlation between obstructive sleep-disordered breathing and temporomandibular joint condylar absorption in adolescents

doi:10.3969/j.issn.1674-8115.2026.02.006

Abstract

Abstract:

Objective ·To investigate the correlation between obstructive sleep-disordered breathing (OSDB) and temporomandibular joint (TMJ) condylar resorption in adolescents. Methods ·From September 2018 to December 2023, consecutive adolescents (aged 10 to 19 years) who visited the TMJ Clinic at Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine, were recruited in the present study. Patients were divided into the OSDB group and the non-OSDB group based on whether the frequency of snoring was ≥3 nights per week. Demographic information, history of upper airway-related diseases, tongue habits, and mouth-breathing habits were collected for both groups. The presence or absence of TMJ condylar absorption was assessed, and condylar height was measured. Intergroup differences in the above variables were compared. To further explore the association between various factors and OSDB, variables with statistical significance in the univariate analysis were included in a logistic regression model for multivariable analysis. Results ·A total of 439 adolescent patients were enrolled during the study period, including 30 cases in the OSDB group and 409 cases in the non-OSDB group. There was no significant difference in demographic information between the two groups (P>0.05). The proportions of patients with a history of adenoid and tonsil diseases and adverse tongue habits in the OSDB group were significantly higher than those in the non-OSDB group (P=0.001 and P=0.040, respectively). The incidence of TMJ condylar resorption was significantly higher in the OSDB group than that in the non-OSDB group (P=0.004), and condylar height in the OSDB group was significantly lower than that in the non-OSDB group (P<0.001). Multivariate logistic regression analysis revealed that condylar resorption (OR=4.837, 95%CI 1.889‒12.336, P<0.001) and decreased condylar height (OR=0.547, 95%CI 0.426‒0.678, P<0.001) were closely associated with the occurrence of OSDB. Conclusion ·These results suggest that TMJ condylar resorption is closely related to the occurrence of OSDB in adolescents.

Key words: temporomandibular joint, condylar resorption, obstructive sleep-disordered breathing, adolescent

CLC Number:

R782.4

Shen Pei, Zhang Dahe, Chen Xinwei, Zhang Shanyong, Yang Chi. Correlation between obstructive sleep-disordered breathing and temporomandibular joint condylar absorption in adolescents[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2026, 46(2): 181-187.

Figures/Tables 7

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References 25

[1]	Kaditis A G, Alonso Alvarez M L, Boudewyns A, et al. Obstructive sleep disordered breathing in 2- to 18-year-old children: diagnosis and management[J]. Eur Respir J, 2016, 47(1): 69-94.
[2]	Lo Bue A, Salvaggio A, Insalaco G. Obstructive sleep apnea in developmental age. A narrative review[J]. Eur J Pediatr, 2020, 179(3): 357-365.
[3]	Semelka M, Wilson J, Floyd R. Diagnosis and treatment of obstructive sleep apnea in adults[J]. Am Fam Physician, 2016, 94(5): 355-360.
[4]	中国儿童OSA诊断与治疗指南制订工作组, 中华医学会耳鼻咽喉头颈外科学分会小儿学组, 中华医学会儿科学分会呼吸学组, 等. 中国儿童阻塞性睡眠呼吸暂停诊断与治疗指南(2020)[J]. 中国循证医学杂志, 2020, 20(8): 883-900.
	Working Group of Chinese Guideline for the Diagnosis and Treatment of Childhood OSA, Subspecialty Group of Pediatrics, Society of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association, Subspecialty Group of Respiratory Diseases, Society of Pediatrics, Chinese Medical Association, et al. Chinese guideline for the diagnosis and treatment of childhood obstructive sleep apnea (2020)[J]. Chinese Journal of Evidence-Based Medicine, 2020, 20(8): 883-900.
[5]	Lumeng J C, Chervin R D. Epidemiology of pediatric obstructive sleep apnea[J]. Proc Am Thorac Soc, 2008, 5(2): 242-252.
[6]	Xu Z, Wu Y, Tai J, et al. Risk factors of obstructive sleep apnea syndrome in children[J]. J Otolaryngol Head Neck Surg, 2020, 49(1): 11.
[7]	Bhatt S P, Guleria R, Kabra S K. Metabolic alterations and systemic inflammation in overweight/obese children with obstructive sleep apnea[J]. PLoS One, 2021, 16(6): e0252353.
[8]	Chan K C, Au C T, Hui L L, et al. How OSA evolves from childhood to young adulthood: natural history from a 10-year follow-up study[J]. Chest, 2019, 156(1): 120-130.
[9]	Monzon A D, Patton S R, Koren D. Childhood diabetes and sleep[J]. Pediatr Pulmonol, 2022, 57(8): 1835-1850.
[10]	Mercuri L G, Handelman C S. Idiopathic condylar resorption: what should we do?[J]. Oral Maxillofac Surg Clin North Am, 2020, 32(1): 105-116.
[11]	Wolford L M, Galiano A. Adolescent internal condylar resorption (AICR) of the temporomandibular joint, part 1: a review for diagnosis and treatment considerations[J]. Cranio, 2019, 37(1): 35-44.
[12]	吕政展, 朱柏恺, 郑美里, 等. 55例特发性髁突吸收患者临床特点与颅颌面结构特征分析[J]. 中国口腔颌面外科杂志, 2022, 20(6): 541-547.
	Lyu Z Z, Zhu B K, Chung M, et al. Clinical features and cranio-maxillofacial structure in 55 patients with idiopathic condyle resorption[J]. China Journal of Oral and Maxillofacial Surgery, 2022, 20(6): 541-547.
[13]	Niu X, Moland J, Pedersen T K, et al. Restricted upper airway dimensions in patients with dentofacial deformity from juvenile idiopathic arthritis[J]. Pediatr Rheumatol Online J, 2022, 20(1): 32.
[14]	Wolford L M, Gonçalves J R. Condylar resorption of the temporomandibular joint: how do we treat it?[J]. Oral Maxillofac Surg Clin North Am, 2015, 27(1): 47-67.
[15]	Borgström A, Nerfeldt P, Friberg D. Questionnaire OSA-18 has poor validity compared to polysomnography in pediatric obstructive sleep apnea[J]. Int J Pediatr Otorhinolaryngol, 2013, 77(11): 1864-1868.
[16]	Marcus C L, Brooks L J, Draper K A, et al. Diagnosis and management of childhood obstructive sleep apnea syndrome[J]. Pediatrics, 2012, 130(3): 576-584.
[17]	Shen P, Xie Q, Ma Z, et al. Yang's classification of juvenile TMJ anterior disc displacement contributing to treatment protocols[J]. Sci Rep, 2019, 9(1): 5644.
[18]	Liu Z, Xie Q, Chen M, et al. Measurement of mandibular condylar height based on magnetic resonance imaging[J]. J Craniofac Surg, 2020, 31(4): e415-e418.
[19]	Neelapu B C, Kharbanda O P, Sardana H K, et al. Craniofacial and upper airway morphology in adult obstructive sleep apnea patients: a systematic review and meta-analysis of cephalometric studies[J]. Sleep Med Rev, 2017, 31: 79-90.
[20]	Lv R, Liu X, Zhang Y, et al. Pathophysiological mechanisms and therapeutic approaches in obstructive sleep apnea syndrome[J]. Signal Transduct Target Ther, 2023, 8(1): 218.
[21]	Mitsimponas K, Mehmet S, Kennedy R, et al. Idiopathic condylar resorption[J]. Br J Oral Maxillofac Surg, 2018, 56(4): 249-255.
[22]	Pereira L, Monyror J, Almeida F T, et al. Prevalence of adenoid hypertrophy: a systematic review and meta-analysis[J]. Sleep Med Rev, 2018, 38: 101-112.
[23]	Gulotta G, Iannella G, Vicini C, et al. Risk factors for obstructive sleep apnea syndrome in children: state of the art[J]. Int J Environ Res Public Health, 2019, 16(18): 3235.
[24]	Wang H, Qiao X, Qi S, et al. Effect of adenoid hypertrophy on the upper airway and craniomaxillofacial region[J]. Transl Pediatr, 2021, 10(10): 2563-2572.
[25]	Kumar S, Kelly A S. Review of childhood obesity: from epidemiology, etiology, and comorbidities to clinical assessment and treatment[J]. Mayo Clin Proc, 2017, 92(2): 251-265.

Characteristic	OSDB group (n=30)	non-OSDB group (n=409)	P value
Gender/n(%)			0.158
Male	9 (30.0)	79 (19.3)
Female	21 (70.0)	330 (80.7)
Age/year	17 (14, 19)	16 (14, 18)	0.397
Height/cm	162 (159, 169)	163 (159, 167)	0.867
Weight/kg	51.5 (45.0, 57.5)	50.1 (45.0, 56.2)	0.567
BMI/(kg·m^-2)	19.01 (17.64, 20.29)	19.00 (17.65, 20.31)	0.879

Characteristic	OSDB group (n=30)	non-OSDB group (n=409)	P value
Gender/n(%)			0.158
Male	9 (30.0)	79 (19.3)
Female	21 (70.0)	330 (80.7)
Age/year	17 (14, 19)	16 (14, 18)	0.397
Height/cm	162 (159, 169)	163 (159, 167)	0.867
Weight/kg	51.5 (45.0, 57.5)	50.1 (45.0, 56.2)	0.567
BMI/(kg·m^-2)	19.01 (17.64, 20.29)	19.00 (17.65, 20.31)	0.879

Characteristic	OSDB group (n=30)	non-OSDB group (n=409)	P value
Adenoid and tonsil diseases/n(%)	3 (10.0)	1 (0.2)	0.001
Mouth-breathing habits/n(%)	2 (6.7)	6 (1.5)	0.098
Adverse tongue habits/n(%)	4 (13.3)	16 (3.9)	0.040
Rhinitis/n(%)	2 (6.7)	15 (3.7)	0.326

Characteristic	OSDB group (n=30)	non-OSDB group (n=409)	P value
Adenoid and tonsil diseases/n(%)	3 (10.0)	1 (0.2)	0.001
Mouth-breathing habits/n(%)	2 (6.7)	6 (1.5)	0.098
Adverse tongue habits/n(%)	4 (13.3)	16 (3.9)	0.040
Rhinitis/n(%)	2 (6.7)	15 (3.7)	0.326

Characteristic	OSDB group (n=30)	non-OSDB group (n=409)	P value
Condylar resorption/n(%)	11 (36.7)	66 (16.1)	0.004
Condylar height/mm	18.19±1.80	21.20±2.69	<0.001