Stomatologist № 2 (37) – 2020, pp. 14-18                                                                                                                              SCIENTIFIC PUBLICATION

Apnea-Bel – domestic computer program for determining the condition of the maxillofacial region and upper respiratory tract

S.P. Rubnikovicha, I.S. Abelskayaa, Yu.L. Denisovab, V.G. Shishovc, К.L. Shalkevichc

aMD, PhD, DMSci, Professor, Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus
bMD, PhD, DMSci, Professor, Belarusian State Medical University, Minsk, Belarus
cBelarusian Medical Academy of Postgraduate Education, Minsk, Belarus

https://doi.org/10.32993/stomatologist.2020.2(37).3

ABSTRACT
The article presents the analysis of data obtained by cone beam computed tomography (CBCT) in patients with dentition system diseases (partial secondary adentia and generalized chronic periodontitis combined with obstructive sleep apnea syndrome) and defines the disorders of the upper respiratory tract in such patients using the domestic Apnea-Bel computer program.
The aim of the study. To develop a method for determining the condition of the maxillofacial region and upper respiratory tract using the domestic Apnea-Bel computer program based on the analysis of CBCT data, which allows automatic calculations and measurements of the anatomical structures of the maxillofacial region and upper respiratory tract.
Objects and methods. The object of the study when developing a special computer program was CBCT data of 162 patients aged 31–65 years, the average age of which was 44.7 ± 10.9 years. For the study, CBCT data were used for patients who came for various diagnostic reasons, in particular, with diseases of the temporomandibular joint, with partial secondary adentia, with chronic generalized periodontitis, as well as patients with obstructive sleep apnea.
Results and discussion. As a result of the study, a special Apnea-Bel computer program was developed. The analysis of the condition of the maxillofacial region and upper respiratory tract is determined on the basis of six diagnostic criteria: the total volume of the respiratory tract of the oropharynx, the cross-sectional area of the oropharynx, the minimum cross-sectional area, the anteroposterior and lateral dimensions of the minimum cross-sectional area, and the localization of the minimum cross-sectional area sections in the upper or lower region of the oropharynx, configuration 3D reconstruction of the studied respiratory tract.
Conclusion. Using the developed method based on the special Apnea-Bel computer program, it was found that in 39.1% of patients with diseases of the dentition, in particular diseases of the temporomandibular joint, partial secondary adentia, and chronic generalized periodontitis, signs of airway obstruction are determined. This is a risk of developing respiratory distress in a dream.

Keywords: sleep apnea, cone beam computed tomography, periodontitis, adentia, upper respiratory tract

References 

  1. Koljadich Zh.V., Kalinkin A.L., Sindrom obstruktivnogo apnoje sna: vzgljad otorinolaringologa i somnologa [Obstructive sleep apnea syndrome: a view of an otorhinolaryngologist and somnologist]. Terapija. – Therapy. 2016, vol. 2, no. 1, pp. 42–50.
  2. Zatoloka D.A., Furmanchuk D.A., Koljadich Zh.V., Tishkevich E.S., Andrianova T.D., Frolov Ju.Ju., Makarin-Kibak A.S., Sovremennye podhody k diagnostike sindroma obstruktivnogo apnoje sna [Modern approaches to the diagnosis of obstructive sleep apnea syndrome]. Vestn. otorinolaringologii. – Bulletin of otorhinolaryngology. 2013, no. 1, pp. 58–60.
  3. Rubnikovich S.P., Baradina I.N., Denisova Ju.L., Prognoz i lechenie pacientov s disfunkciej visochno-nizhnecheljustnyh sustavov [Prognosis and treatment of patients with temporomandibular joint dysfunction]. Voennaja medicina. ‒ Military medicine. 2015, no. 1 (34), pp. 47–52.
  4. Shhetinin E.V., Sirak S.V., Rubnikovich S.P., Kochkarova Z.M., Andreev A.A., Muratova A.Ju., Perikova M.G., Petrosjan G.G. Morfometricheskie pokazateli reparativnoj regeneracii kostnoj tkani v uslovijah lekarstvennogo ul’trafonoforeza gidrokortizonom i gialuronovoj kislotoj [Morphometric parameters of reparative regeneration of the bone tissue in terms of medicinal phonophoresis with hydrocortisone and hyaluronic acid]. Medicinskij vestnik Severnogo Kavkaza. – Medical News of North Caucasus. 2019, no. 14 (4), pp. 660–663. doi: https://doi.org/10.14300/mnnc.2019.14163
  5. Holty J.E., Guilleminault C. Maxillomandibular advancement for the treatment of obstructive sleep apnea: a systematic review and metaanalysis. Sleep Med Rev., 2010, no. 14, pp. 287–297.
  6. Susarla S.M., Thomas R.J., Abramson Z.R., Kaban L.B. Biomechanics of the upper airway: changing concepts in the pathogenesis of obstructive sleep apnea. Int J Oral Maxillofac Surg., 2010, no. 39, pp. 1149–1159.
  7. Ogawa T., Enciso R., Shintaku W.H., Clark G.T. Evaluation of cross-section airway configuration of obstructive sleep apnea. Oral Surg Oral Med Oral Pathol Oral Radiol Endod., 2007, no. 103, pp. 102–108.
  8. Schwab R.J., Pasirstein M., Pierson R., Mackley A., Hachadoorian R., Arens R. [et al.] Identification of upper airway anatomic risk factors for obstructive sleep apnea with volumetric magnetic resonance imaging. Am J Respir Crit Care Med., 2003, no. 168, pp. 522–530.
  9. Park J.G., Ramar K., Olson E.J. Updates on definition, consequences, and management of obstructive sleep apnea. Mayo Clin Proc., 2011, no. 86, pp. 549–555.
  10. Enciso R., Nguyen M., Shigeta Y., Ogawa T., Clark G.T. Comparison of cone-beam CT parameters and sleep questionnaires in sleep apnea patients and control subjects. Oral Surg Oral Med Oral Pathol Oral Radiol Endod., 2010, no. 109, pp. 285–293.
  11. Alsufyani N.A., Al-Saleh M.A., Major P.W. CBCT assessment of upper airway changes and treatment outcomes of obstructive sleep apnoea: a systematic review. Sleep Breath, 2013, no. 17, pp. 911–923.
  12. Denisova Y.L., Bazylev N.B., Fomin N.A., Rubnikovich S.P. Laser speckle technology in stomatology. diagnostics of stresses and strains of hard biotissues and orthodontic and orthopedic structures. Journal of Engineering Physics and Thermophysics, 2013, vol. 86, no. 4, pp. 940–951.
  13. Rubnikovich S.P., Denisova Y.L., Fomin N.A. Digital Laser Speckle Technologies in Measuring Blood Flow in Biotissues and the Stressed-Strained State of the Maxillodental System. Journal of Engineering Physics and Thermophysics, 2017, vol. 90, no. 6, pp. 1513–1523.
  14. Bazylev N.B., Rubnikovich S.P. Investigation of the stressed-strained state of cermet dentures using digital laser speckle-photographic analysis. Journal of Engineering Physics and Thermophysics, 2009, vol. 82, no. 4, pp. 789–793.
  15. Fomin N., Hirano T., Bazylev N., Rubnikovich S., Lavinskaya E., Mizukaki T., Nakagawa A., Takayama K. Quasi-Real Time Bio-Tissues Monitoring using Dynamic Laser Speckle Photography. Journal of Visualization, 2003, vol. 6, no. 4, pp. 371–380.

Correspondence to:  Е-mail: rubnikovichs@yandex.ru