{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T19:28:11Z","timestamp":1783798091231,"version":"3.55.0"},"reference-count":21,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:00:00Z","timestamp":1732147200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Background: This study aimed to examine the connection between craniofacial morphology, particularly the horizontal and vertical dimensions of the mandible, and the severity of obstructive sleep apnea (OSA) in non-obese adult males by utilizing a cephalometric analysis and introducing a new skeletal ratio index. Methods: A cohort of 44 non-obese adult males with OSA, diagnosed via the apnea\u2013hypopnea index (AHI) from polysomnographic recordings, was evaluated using a lateral cephalometric analysis. OSA severity was classified as mild (5 \u2264 AHI &lt; 15) in 19 patients, moderate (15 \u2264 AHI &lt; 30) in 15 patients, and severe (AHI \u2265 30) in 10 patients. The S-Go distance divided by the N-Me distance (S-Go\/N-Me) was used as a vertical ratio of craniofacial morphology, the Go-Me distance divided by the S-N distance (Go-Me\/S-N) was used as a horizontal ratio, and the results were compared between groups. Correlations between each ratio and craniofacial morphology based on the five factors from the Ricketts analysis were examined for each group. Results: A significant difference was found in the horizontal ratio Go-Me\/S-N between the mild and moderate groups (p &lt; 0.05) and the mild and severe groups (p &lt; 0.05). However, no significant differences in Ricketts analysis factors were observed across OSA severity groups. Correlations between the Go-Me\/S-N and Ricketts factors were identified in the mild and moderate groups but not in the severe group. The horizontal skeletal dimension Go-Me\/S-N was strongly associated with OSA severity. Conclusions: The horizontal mandibular ratio Go-Me\/S-N, independent of body shape, may offer a valuable morphological marker for differentiating OSA severity in non-obese males.<\/jats:p>","DOI":"10.3390\/dj12120374","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T12:25:42Z","timestamp":1732191942000},"page":"374","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluating Craniofacial Morphology Ratios as Predictors of Obstructive Sleep Apnea Severity in Non-Obese Adult Males"],"prefix":"10.3390","volume":"12","author":[{"given":"Masasuke","family":"Shimatsu","sequence":"first","affiliation":[{"name":"Isdorly Orthodontic Office, Tokyo 101-0047, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeto","family":"Kawashima","sequence":"additional","affiliation":[{"name":"Isdorly Orthodontic Office, Tokyo 101-0047, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9969-3454","authenticated-orcid":false,"given":"Mitsuyoshi","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Juntendo University, Tokyo 113-8421, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1046\/j.1365-2796.2001.00787.x","article-title":"Sleep-disordered breathing and glucose metabolism in hypertensive men: A population-based study","volume":"249","author":"Elmasry","year":"2001","journal-title":"J. Intern. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1093\/ajh\/hpu023","article-title":"Prevalence and associated factors of obstructive sleep apnea in patients with resistant hypertension","volume":"27","author":"Muxfeldt","year":"2014","journal-title":"Am. J. Hypertens."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1111\/crj.13278","article-title":"Effects of smoking on patients with obstructive sleep apnea syndrome","volume":"15","author":"Yosunkaya","year":"2021","journal-title":"Clin. Respir. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e14069","DOI":"10.1111\/jsr.14069","article-title":"Healthy lifestyle is associated with reduced cardiovascular disease, depression and mortality in people at elevated risk of sleep apnea","volume":"33","author":"Melaku","year":"2024","journal-title":"J. Sleep Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"479","DOI":"10.5664\/jcsm.6506","article-title":"Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline","volume":"13","author":"Kapur","year":"2017","journal-title":"J. Clin. Sleep Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.1097\/00005537-199912000-00007","article-title":"A comparison of Asian and white patients with obstructive sleep apnea syndrome","volume":"109","author":"Li","year":"1999","journal-title":"Laryngoscope"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1164\/ajrccm.165.2.2009032","article-title":"Contribution of body habitus and craniofacial characteristics to segmental closing pressures of the passive pharynx in patients with sleep-disordered breathing","volume":"165","author":"Watanabe","year":"2002","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1097\/ALN.0b013e318173f103","article-title":"Anatomical balance of the upper airway and obstructive sleep apnea","volume":"108","author":"Tsuiki","year":"2008","journal-title":"Anesthesiology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1097\/ALN.0b013e31819b5d57","article-title":"Three-dimensional morphological analyses of positional dependence in patients with obstructive sleep apnea syndrome","volume":"110","author":"Saigusa","year":"2009","journal-title":"Anesthesiology"},{"key":"ref_10","first-page":"230","article-title":"Evaluation of the upper airway in obstructive sleep apnoea","volume":"131","author":"Togeiro","year":"2010","journal-title":"Indian J. Med. Res."},{"key":"ref_11","first-page":"101","article-title":"Relationship between cephalometric parameters and the apnoea-hypopnoea index in OSA patients: A retrospective cohort study","volume":"42","author":"Stipa","year":"2020","journal-title":"Eur. J. Orthod."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e999","DOI":"10.4317\/jced.61104","article-title":"Craniofacial morphology in Obstructive Sleep Apnea patients","volume":"15","author":"Ciavarella","year":"2023","journal-title":"J. Clin. Exp. Dent."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1111\/joor.13616","article-title":"Gender differences in the upper airway, craniofacial morphological and polysomnographic parameters in patients with obstructive sleep apnoea","volume":"51","author":"Udayakumar","year":"2024","journal-title":"J. Oral Rehabil."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1017\/S0022215100108734","article-title":"Cephalometric analysis in patients with obstructive sleep apnoea syndrome. I. Skeletal morphology","volume":"103","author":"Lyberg","year":"1989","journal-title":"J. Laryngol. Otol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1007\/s00247-004-1168-x","article-title":"Craniofacial differences according to AHI scores of children with obstructive sleep apnoea syndrome: Cephalometric study in 39 patients","volume":"34","author":"Ozdemir","year":"2004","journal-title":"Pediatr. Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"805","DOI":"10.2169\/internalmedicine.44.805","article-title":"Facial axis angle as a risk factor for obstructive sleep apnea","volume":"44","author":"Kubota","year":"2005","journal-title":"Intern. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1055\/s-0036-1584295","article-title":"Craniocervical Posture in Patients with Obstructive Sleep Apnea","volume":"20","author":"Piccin","year":"2016","journal-title":"Int. Arch. Otorhinolaryngol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"(1999). Sleep-related breathing disorders in adults: Recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep, 22, 667\u2013689.","DOI":"10.1093\/sleep\/22.5.667"},{"key":"ref_19","first-page":"408","article-title":"Cephalometric characteristics of nonobese patients with severe OSA","volume":"69","author":"Pae","year":"1999","journal-title":"Angle Orthod."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1046\/j.1440-1819.2001.00850.x","article-title":"Comparison of Ricketts analysis and Downs-Northwestern analysis for the evaluation of obstructive sleep apnea cephalograms","volume":"55","author":"Higurashi","year":"2001","journal-title":"Psychiatry Clin. Neurosci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1046\/j.1440-1819.2002.01002.x","article-title":"Facial pattern categories of sleep breathing-disordered children using Ricketts analysis","volume":"56","author":"Kikuchi","year":"2002","journal-title":"Psychiatry Clin. Neurosci."}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/12\/12\/374\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:36:53Z","timestamp":1760114213000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/12\/12\/374"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,21]]},"references-count":21,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["dj12120374"],"URL":"https:\/\/doi.org\/10.3390\/dj12120374","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,21]]}}}