Sleep Quality Upper Airway and Dental Occlusion in Children With Large Overjet

  • End date
    Mar 29, 2024
  • participants needed
  • sponsor
    University of Copenhagen
Updated on 23 July 2021


This project examines sleep quality (e.g. prevalence of obstructive sleep apnea(OSA)), dimension of upper airway, jaw function, well-being and quality of life in children with large overjet compared to a control group. In addition, the effect of treatment with a mandibular advancement device (MAD) on sleep quality, upper airway and jaw function are examined, and how these factors affect the children's well-being and quality of life.


Sleep is very important for children's growth, development and learning. The anatomy and size of the airway and position of the jaw can affect children's sleep. Children with large overjet due to a posterior position of the mandible have smaller airways compared to children with neutral occlusion. Reduced dimensions of the upper airways may increase the risk of impaired sleep quality and the sleep related breathing disorder obstructive sleep apnoea (OSA), which causes symptoms e.g. failure to thrive, irritability, behavioural disorders, fatigue, which affects the children's growth, development, and learning negatively.

Children with large overjet due to mandibular retrognathia in Denmark are offered orthodontic treatment in municipal dental care and are in most cases treated with a mandibular advancement device (MAD) keeping the mandible in a forward position relative to the maxilla. MADs are also used to treat adults with mild-moderate obstructive sleep apnoea while they sleep. This can reduce the number of apnoea periods by up to 75% as well as preventing daytime sleepiness.

No previous study have examined sleep quality, upper airway, jaw function, well-being and quality of life in children with large overjet before, during and after MAD treatment compared to a control group with normal occlusion.

Condition Overbite
Treatment Orthodontic treatment with functional appliance (MAD)
Clinical Study IdentifierNCT04964830
SponsorUniversity of Copenhagen
Last Modified on23 July 2021


Yes No Not Sure

Inclusion Criteria

Overjet group
ANB angle 3 degrees (ANB are three marking points, which produce an angle describing the skeletal relationship between the maxilla and mandible)
Horizontal maxillary overjet 6 mm and need of orthodontic treatment according to the Danish procedure for screening the child population for malocclusion involving health risk
Informed consent from parent(s)/guardian(s)
Control group
Neutral occlusion
No history of orthodontic treatment
Informed consent from parent(s)/guardian(s)

Exclusion Criteria

Known general and/or craniofacial syndromes/diseases
Known sleep disorders, included bruxism during sleep
Chronic respiratory diseases and asthma6/12
Adenoid vegetations, hypertrophic tonsils and significantly reduces airflow through the nose (mouth breather), which need primary treatment
Dysfunction of masticatory muscles and temporomandibular joint, which need primary treatment
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