Update on Current Knowledge of Paediatric Obstructive Sleep Apnoea: From Animal to Human Studies
Bibliographic record
Abstract
Orthodontists' interest in paediatric obstructive sleep apnoea (PedOSA) has grown in popularity recently. We have seen growth modification treatment modalities, including maxillary expansion, promising the prevention or cure of PedOSA. Clinical approaches such as palatal expansion and mandibular and maxillary complex advancement have been proposed to manage PedOSA. These hypotheses should be adequately tested before clinical recommendations are formulated. This review aimed to narratively synthesise our current understanding of PedOSA management with craniofacial growth modification alternatives. Basic research on the biological basis of PedOSA has been conducted in animal models. Laboratory-based PedOSA studies wish to provide insight into the molecular biological mechanisms by which human PedOSA affects growth-associated structural and emotional growth and development. In the proposed IH animal model, mandibular growth (especially posterior anteroposterior and transverse dimensions) and condylar head bone density were more sensitive to IH exposure in adolescents but less in juvenile rats. Nevertheless, clear-cut statistical growth differences were limited. This suggests that IH, in this rat model, influenced mandibular morphology and metabolism later than earlier craniofacial growth stages. No impact was found for the maxillofacial complex in any plane of space. The existing human studies on the causes, risk factors, consequences, symptomatology, diagnosis and effects of PedOSA are discussed. However, there is a pressing need for further research to clarify whether craniofacial disturbances are consequences or facilitators of PedOSA. Several hypotheses about the potential impact of impaired craniofacial growth as a facilitator for PedOSA currently circulate.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.006 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".