Document Type : Original Article

Authors

• . Imit P. Saluja ¹
• . Ananya Bhargava ²
• . Apoorva Bhargava ³
• . Darshan R. Prasad Hiremutt ⁴
• . Shobhit Saxena ⁵
• . Anagha Agrawal ⁶

¹ MDS, Oral Medicine and Radiology, Associate Professor (Department of Dentistry), Ruxmaniben Deepchand Gardi Medical College, Ujjain (M.P), India

² MDS, Orthodontics and Dentofacial Orthopedics, Senior Resident (Department of Dentistry), Ruxmaniben Deepchand Gardi Medical College, Ujjain (M.P), India

³ MDS, Conservative Dentistry and Endodontics, Consultant Endodontist, Delhi, India

⁴ MDS, Oral Medicine and Radiology, Assistant Professor, Bharati Vidhyapeeth Dental College and Hospital, Pune (Maharashta), India

⁵ MDS, Orthodontics and Dentofacial Orthopedics, Professor, College of Dental Sciences and Hospital, Bhavnagar (Gujarat) India

⁶ MDS, Public Health Dentistry, Reader, College of Dental Sciences and Hospital, Bhavnagar (Gujarat) India

Abstract

BACKGROUND: Obstructive sleep apnea (OSA) is a sleep disorder characterized by intermittent
complete and partial airway collapse, resulting in frequent episodes of apnea and hypopnea. The
Berlin questionnaire (BQ) is a simple, inexpensive instrument used to screen for OSA, which
is about risk factors for sleep apnea, namely, snoring behavior, daytime sleepiness or fatigue,
and the presence of obesity or hypertension. This 10‑question test has since then become well
known for its accuracy in predicting the presence of sleep apnea in patients. Cephalometry is a
relatively inexpensive method and it permits a good assessment of the soft tissue elements that
define the soft palate and its surrounding structures. Therefore, the present study aims to study
the morphology of the soft palate using lateral cephalometry and classify it into various types.
And to identify the individuals with OSA syndrome through a particular type of soft palate and
correlate it with the BQ.
MATERIAL AND METHODS: This prospective study was conducted in the Department of Oral
Medicine and Radiology of D.Y.Patil Dental College, Pune. About 150 subjects for the study were
selected by random sampling from the outpatient department of Oral Medicine and Radiology and
the patients were referred from the orthodontics department. Lateral cephalograms were assessed
for soft palate morphology types, and all participants filled the BQ. A Chi‑square test was applied.
The level of significance was set at P < 0.05.
RESULTS: Among six types of the soft palate, the maximum number of participants had type 2
(rat‑tail type) of the soft palate (26.0%). A highly significant association was found between the
BQ (positive and negative response) and soft palate morphology types (i.e., P < 0.01). A maximum
number of participants who responded to the BQ had type 5 (S type) of the soft palate (76.47%).
CONCLUSION: The type 2 (rat‑tail) soft palate was the most frequent type, while the type 4 (straight‑line)
shape was the least common among all the six types. The persons with type 5 (S‑shape) soft palate
responded more positively to the BQ as compared to other types of soft palate. This shows that a
particular type of soft palate could be responsible for causing OSA syndrome.
CLINICAL SIGNIFICANCE: Lateral cephalogram and BQ, which are relatively inexpensive and
widely available, can be used in resource‑limited and thickly populated countries like India to correctly
identify patients with OSA syndrome.

Keywords

• Berlin questionnaire
• lateral cephalogram
• obstructive sleep apnea syndrome
• soft palate