{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:33:08Z","timestamp":1780965188462,"version":"3.54.1"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This study aimed to investigate craniofacial skeletal morphology in pediatric obstructive sleep apnea-hypopnea syndrome (OSAHS) patients with different malocclusion types.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      A retrospective cross-sectional analysis study was conducted at Chengdu Second People's Hospital from 2023 to 2024. A total of 299 children diagnosed with OSAHS (aged 10\u201312 years) were included. Craniofacial structures were assessed using Jarabak and Ricketts methods. Patients were divided by malocclusion type: Class II (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009150, 56.7% male, mean age 11.2\u2009\u00b1\u20090.6) and Class III (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009149, 50.3% male, mean age 11.4\u2009\u00b1\u20090.8). Group differences in cephalometric parameters were compared using independent samples t-tests and Mann\u2013Whitney U tests, as appropriate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant differences were found between groups. Compared to Class II, Class III patients had lower ANB angle (\u22122.8\u2009\u00b1\u20092.6\u00b0 vs. 5.6\u2009\u00b1\u20091.9\u00b0, Cohen's d\u2009=\u20091.23), Wits appraisal (\u20132.9\u2009\u00b1\u20093.7\u2005mm vs. 2.6\u2009\u00b1\u20090.7\u2005mm, Cohen's d\u2009=\u20092.02), SN:GoMe (103.1\u2009\u00b1\u20096.0% vs. 106.7\u2009\u00b1\u20099.0%, Cohen's d\u2009=\u20090.48), MP\/FH (32.9\u2009\u00b1\u20092.99\u00b0 vs. 37.3\u2009\u00b1\u20092.65\u00b0, Cohen's d\u2009=\u20091.57), Xi-Pm\/DC-Xi (29.3\u2009\u00b1\u20092.1\u00b0 vs. 24.6\u2009\u00b1\u20093.1\u00b0, Cohen's d\u2009=\u20091.81), and ANS-Xi-Pm (47.8\u2009\u00b1\u20092.9\u00b0 vs. 50.7\u2009\u00b1\u20092.4\u00b0, Cohen's d\u2009=\u20091.11) (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). Class III patients showed higher S-Ar:Ar-Go (75.9\u2009\u00b1\u20097.2% vs. 80.9\u2009\u00b1\u200913.0%, Cohen's d\u2009=\u20090.48), NP\/FH (88.1\u2009\u00b1\u20092.9\u00b0 vs. 83.1\u2009\u00b1\u20091.86\u00b0, Cohen's d\u2009=\u20092.14), Pt-Gn\/Ba-N (92.2\u2009\u00b1\u20092.1\u00b0 vs. 79.6\u2009\u00b1\u20092.4\u00b0, Cohen's d\u2009=\u20095.44), and Hy-C3 distance (5.8\u2009\u00b1\u20090.9\u2005mm vs. 3.4\u2009\u00b1\u20090.4\u2005mm, Cohen's d\u2009=\u20093.26) (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). No significant differences were observed in other parameters (N-S-Ar, S-Ar-Go;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Distinct craniofacial skeletal patterns exist in pediatric OSAHS patients with different malocclusions. Class III patients demonstrate mandibular growth restriction with compensatory protrusion, while Class II patients display high-angle, long-face morphology with clockwise growth rotation. These findings have important clinical implications for individualized orthodontic and surgical planning in the management of pediatric OSAHS, highlighting the need for early assessment of craniofacial structure in affected children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1682284","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T06:56:34Z","timestamp":1772693794000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of craniofacial skeletal morphology in pediatric obstructive sleep apnea-hypopnea syndrome patients with class II and class III malocclusions: a retrospective cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Lijia","family":"Deng","sequence":"first","affiliation":[{"name":"Department of Stomatology, Chengdu Second People\u2019s Hospital","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongjie","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Chengdu Second People\u2019s Hospital","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1186\/s12888-024-05772-6","article-title":"Implications of depressive mood in OSAHS patients: insights from event-related potential","volume":"24","author":"Li","year":"2024","journal-title":"BMC Psychiatry"},{"key":"B2","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1016\/j.sleep.2024.05.010","article-title":"Obstructive sleep apnea hypopnea syndrome and vascular lesions: an update on what we currently know","volume":"119","author":"Mao","year":"2024","journal-title":"Sleep Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s11325-025-03288-1","article-title":"Management of obstructive sleep apnea-hypopnea syndrome in children: what is the role of orthodontics? 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