Changes in Upper Airway Volume in Edentulous Obstructive Sleep Apnea Patients Treated with Modified Mandibular Advancement Device

2015 ◽  
Vol 25 (6) ◽  
pp. 453-458 ◽  
Author(s):  
Arvind Tripathi ◽  
Ashutosh Gupta ◽  
Sabyasachi Sarkar ◽  
Suryakant Tripathi ◽  
Narendra Gupta
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Mandibular Advancement Device ◽  
Mandibular Advancement ◽  
Obstructive Sleep

Mandibular Advancement Device use for therapy of simple snoring: mini review

2021 ◽  
Vol 11 (41) ◽  
pp. 30-33
Author(s):  
Erdem Atalay Cetinkaya
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Mandibular Advancement Device ◽  
Mandibular Advancement ◽  
Treatment Modalities ◽  
Upper Airways ◽  
Obstructive Sleep ◽  
Surgical Methods ◽  
Simple Snoring

AbstractOral devices that treat obstructive sleep apnea are an easy and influential option to protect the upper airways from sleep obstructions. One example is the mandibular advancement device (MAD), which is a non-invasive apparatus specified in adults with simple snoring and mild obstructive sleep apnea. Recently, due to the constraints of other therapies, like positive airway pressure treatment and surgical methods, there has been growing interest in the use of oral appliance for simple snoring patients. MAD is managed to improve the upper airway volume, minimize upper airway collapse and reduce snoring. On the other hand, it remains inferior to CPAP in the reduction of the apnea-hypopnea scores, with therapy success varying from 24% to 72%. The treatment modalities include skilled physicians and multidisciplinary strategies to treat patients with snoring and obstructive sleep apnea (OSA) effectively. Some researchers also suggest potential predictors of progress in care, but specific criteria for patient selection and predictive clinical principles for effectiveness in all treatment modalities are still needed. The aim of this brief clinical Study is to review MAD brief history, design, indications, contraindications, therapy efficiency, side effects, and current perspectives.

scholarly journals Correlation between Polysomnographic Parameters and Tridimensional Changes in the Upper Airway of Obstructive Sleep Apnea Patients Treated with Mandibular Advancement Devices

2021 ◽  
Vol 10 (22) ◽  
pp. 5255
Author(s):  
Sara Camañes-Gonzalvo ◽  
Rocío Marco-Pitarch ◽  
Andrés Plaza-Espín ◽  
Javier Puertas-Cuesta ◽  
Rubén Agustín-Panadero ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Oxygen Saturation ◽  
Upper Airway ◽  
Mandibular Advancement Device ◽  
Mandibular Advancement ◽  
Apnea Hypopnea Index ◽  
Percentage Increase ◽  
Obstructive Sleep ◽  
Mandibular Advancement Devices

Background. The effectiveness of mandibular advancement devices has been solidly demonstrated in the past. They are considered a valid alternative treatment to continuous positive airway pressure for patients with obstructive sleep apnea. Nevertheless, the relationship between polysomnographic parameters and the increase in the volume of the upper airway in patients with obstructive sleep apnea syndrome has not been clearly established so far. This study aimed to determine the impact of these oral appliances upon the volume of the airway after the device titration phase and correlate it with the degree of mandibular advancement and the improvement of polysomnographic parameters. Methods. All patients were diagnosed by polysomnography and were treated with a customized, titratable mandibular advancement device. Three-dimensional volumetric measurements were performed using cone beam computed tomography. Results. The present study included 45 patients diagnosed with obstructive sleep apnea hypopnea syndrome (mild in 23 patients, moderate in 11 and severe in 11). Forty-four percent of the patients presented with an apnea hypopnea index <5/h at the end of treatment. The volume of the upper airway increased an average of 4.3 ± 5.9 cm3, this represents a percentage increase of 20.9%, which was significantly correlated with an apnea hypopnea index and a minimum oxygen saturation improvement. Conclusions. The mandibular advancement device used was found to be effective in improving polysomnographic parameters. Moreover, the oral appliance was able to significantly increase the tridimensional dimensions of the upper airway. Moreover, this finding was correlated with a reduction in the apnea hypopnea index (p = 0.007) and an increase on minimum oxygen saturation (p = 0.033).

Effect of a Mandibular Advancement Device on the Upper Airway in a Patient With Obstructive Sleep Apnea

2020 ◽  
Vol 31 (1) ◽  
pp. e32-e35 ◽  
Author(s):  
Elan Ignacio Flores-Orozco ◽  
Gaby Esthela Tiznado-Orozco ◽  
Rogelio Díaz-Peña ◽  
Esteban Isaí Flores Orozco ◽  
Cosimo Galletti ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Mandibular Advancement Device ◽  
Mandibular Advancement ◽  
Obstructive Sleep

scholarly journals Management of Obstructive Sleep Apnea with Implant Retained Mandibular Advancement Device

2014 ◽  
Vol 5 (3) ◽  
pp. 184-189 ◽  
Author(s):  
Pokpong Amornvit ◽  
Sahana Bajracharya ◽  
Dinesh Rokaya ◽  
Konrawee Keawcharoen ◽  
Walop Supavanich
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Case Reports ◽  
Upper Airway ◽  
The Elderly ◽  
Oral Appliance ◽  
Mandibular Advancement Device ◽  
Mandibular Advancement ◽  
Edentulous Patient ◽  
Obstructive Sleep

ABSTRACT Obstructive sleep apnea (OSA) is a condition which occurs from the narrowing of the upper airway. Obstructive sleep apnea in the edentulous patient can be caused by the anatomical obstruction of oropharyngeal space. In the elderly patients, the muscles of soft palate can easily be collapsed which can result in obstruction in respiratory passage. Oral appliance, namely, mandibular advancement device (MAD) is the recommended treatment appliance for the patient with mild to moderate OSA. In the elderly edentulous patients, OSA is worsening as these patients are difficult to treat with oral appliance due to with diminished vertical dimension and lack of retention for MAD. The use of osseointegrated dental implants and the locator attachments aid in the retention of the appliance provides support to the denture and the device, and also prevent trauma to the underlying mucosa. This case reports the technique of fabrication of MAD with elastic mandibular advancement (EMA) device to treat moderate OSA from implant retained complete dentures in maxilla and mandible in complete edentulous patient. How to cite this article Amornvit P, Rokaya D, Bajracharya S, Keawcharoen K, Supavanich W. Management of Obstructive Sleep Apnea with Implant Retained Mandibular Advancement Device. World J Dent 2014;5(3):184-189.

scholarly journals Continuous Positive Airway Pressure-Mandibular Advancement Device Combination Therapy for Moderate-to-Severe Obstructive Sleep Apnea: A Preliminary Study

2021 ◽  
Author(s):  
Thyagaseely Sheela Premaraj ◽  
Jacob Stadiem ◽  
Shyamaly Arya Premaraj ◽  
Charles R. Davies ◽  
Matthew Dennis ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Daytime Sleepiness ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Mandibular Advancement Device ◽  
Mandibular Advancement ◽  
Severe Obstructive Sleep Apnea ◽  
Obstructive Sleep ◽  
The Mean

Abstract Objectives The purpose of this pilot study was to determine whether compliance to auto-adjusting positive airway pressure (APAP) improves with the addition of a mandibular advancement device (MAD). Secondary outcome measures included were APAP pressure, subjective daytime sleepiness, apnea–hypopnea index (AHI), and mask leaks. Setting and Sample Population Participants included were diagnosed with moderate-to-severe obstructive sleep apnea (OSA) and became noncompliant to prescribed APAP. Thirteen participants with a mean age of 61.6 years were recruited for this study. Materials and Methods All participants were given a MAD to use with their APAP. Parameters measured included APAP pressure, AHI, mask leak reported via ResMed AirViewTM software, and self-reported daytime sleepiness (Epworth Sleepiness Scale [ESS]). A paired two-sample for mean t-test was performed to determine significance. Results The mean difference of pre- and postintervention APAP compliance was 23.1%, which was statistically significant (p = 0.015). The mean APAP air pressures were unchanged. The difference between pre- and postintervention mean ESS scores was 1.4 and was statistically significant (p = 0.027). The mean difference between pre- and postintervention AHI values and mask leak showed no significant difference. Conclusion This study showed that combination of APAP-MAD therapy, for patients with moderate-to-severe OSA who were noncompliant to APAP use, significantly increased compliance with APAP therapy, and significantly decreased the daytime sleepiness of participants.

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