Viet Nghiem & Steven Hou
Lecture #310


This presentation is a “structural screening” to determine propensities for the disruptive factors of Obstructive Sleep Apnea (OSA) and Temporomandibular Joint Dysfunction (TMD) in prospective orthodontic patients. Diagnosis and treatment planning for orthodontic cases should include cephalometric screening for propensities for the disrupting factors in TMD and OSA, because, failure to recognize these conditions will greatly diminish chances of successful and stable results. The screening factors used in the Sassouni-Plus Cephalometric Analysis are the same for both the propensity to OSA and the propensity to TMD. Knowing in advance the propensity toward joint problems is essential, because patients with subclinical radiographic signs often develop joint problem symptoms during or after orthodontic treatment. Furthermore, while patients with airway condition often present many symptoms, sometimes they are asymptomatic, and yet they still present “structural signs” of potential underlying problems. Knowing in advance the propensity toward airway problems, including OSA, is essential as patients often develop symptoms during or after Orthodontic Treatment. The objective of this presentation is to teach how to recognize particular signs by using “structural screening”. Recognition of specific cephalometric signs will allow clinicians to design a treatment plan to eliminate those factors that complicate cases, hinder treatment success and limit case stability.

Drs. Viet Nghiem and Steven Hou trained with Dr. Richard Beistle, who is the originator of the Sassouni Plus Cephalometric Analysis. They have since used this Cephalometric Analysis for comprehensive diagnostic and treatment planning in every case of full mouth reconstruction, functional orthodontic, orthopedic, TMD and SBD in their professional TMD/Orofacial Pain/Sleep practices in southern California. Around the year 2000, alongside Dr. Beistle, Doctors Nghiem and Hou identified two important cephalometric factors that have the ability to give any clinician a simple yet powerful screening tool for OSA. The presentation focuses on these findings, their significance and clinical applications.

Learning Outcomes:

– Identy radiological signs of sleep disorders in cases where a sleep center is not available.
– Identify two features on Lat Cephs that will help in monitoring the OSA/TMD treatment outcome.
– Use an accurate and reliable method to diagnose and follow up treatment progress of OSA /TMD cases through Lateral Cephalometrics.