scholarly journals Management of Obstructive Sleep Apnea in an Edentulous Lower Jaw Patient with a Mandibular Advancement Device

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Filiz Keyf ◽  
Bülent Çiftci ◽  
Selma Fırat Güven
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Oral Appliance ◽  
Mandibular Advancement Device ◽  
Mandibular Advancement ◽  
Clinical Report ◽  
Oral Appliances ◽  
Lower Jaw ◽  
Obstructive Sleep ◽  
Mandibular Advancement Devices

Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder with periodic reduction or cessation of airflow during sleep. It is associated with loud snoring, disrupted sleep, and witnessed apneas. Treatment of OSA varies from simple measures such as oral appliances and nasal continuous positive airway pressure (CPAP) to surgical procedures like uvulopalatopharyngoplasty and tracheostomy. Oral appliances are a viable nonsurgical treatment alternative in patients with OSA, of which mandibular advancement devices are most common. Edentulism which contributes to the worsening of OSA reduces the number of available therapeutic strategies and is considered a contraindication to oral appliance therapy. This clinical report describes the treatment of a 63-year-old edentulous OSA patient for whom a mandibular advancement device was designed.

scholarly journals Oral Appliances in Obstructive Sleep Apnea

Healthcare ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. 141 ◽  
Author(s):  
Dieltjens ◽  
Vanderveken
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Oral Appliance ◽  
Mandibular Advancement ◽  
Oral Appliances ◽  
Invasive Treatment ◽  
Oral Appliance Therapy ◽  
Obstructive Sleep ◽  
Custom Made ◽  
Mandibular Advancement Devices

Oral appliance therapy is increasingly prescribed as a non-invasive treatment option for patients diagnosed with obstructive sleep apnea. The custom-made titratable mandibular advancement devices (MAD) are the recommended type of oral appliances. Mandibular advancement devices are efficacious in reducing the severity of obstructive sleep apnea, however, only to a lesser extent than standard therapy using continuous positive airway pressure (CPAP). Although oral appliance therapy is known to reduce the severity of obstructive sleep apnea in most of the patients, one out of three patients still show negligible improvement under MAD therapy. Therefore, the selection of the appropriate candidates for this therapy is imperative and several upfront prediction tools are described. Overall, the health outcome of mandibular advancement device therapy is similar to that of CPAP, probably due to the inferior compliance of CPAP compared to MAD therapy, resulting in similar clinical effectiveness.

Design and Development of Oral Appliance for Obstructive Sleep Apnea

2013 ◽  
Vol 284-287 ◽  
pp. 1540-1546
Author(s):  
Yu Bin Lai ◽  
Durn Yuan Huang ◽  
Sheng Jye Hwang ◽  
Huei Huang Lee ◽  
Yi San Chang
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Oral Appliance ◽  
Mandibular Advancement Device ◽  
Mandibular Advancement ◽  
Innovative Design ◽  
Obstructive Sleep ◽  
Different Types ◽  
New Type ◽  
Mandibular Advancement Devices

There are more than 20 different types of current commercially available mandibular advancement devices (MAD). Although there are so many different types of MAD available in the market, these designs are often not flexible enough to be adjusted to fit these devices to all possible cases. The aim of this study was to design and develop a new type of mandibular advancement device which used friction effect to achieve mandibular forward, and ensure it would not slide back during sleeping. The new type of mandibular advancement device could be quickly adjusted, and had 3-degree of freedom. ANSYS software was used to simulate whether the new design was strong enough. From the simulation it was found that the new innovative design was reliable and easy to be used for obstructive sleep apnea patients.

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).

A Design of Oral Appliance for Obstructive Sleep Apnea (Preprint)

2020 ◽  
Author(s):  
Vikram Belkhode ◽  
Sharayu Nimonkar ◽  
Surekha Godbole ◽  
Pranali Nimonkar
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Adult Population ◽  
Oral Appliance ◽  
Epidemiological Studies ◽  
Mandibular Advancement ◽  
Obstructive Sleep ◽  
Alternative Treatment Option ◽  
Mandibular Advancement Devices ◽  
Maxillary Arch

BACKGROUND As per the current epidemiological studies, the prevalence of obstructive sleep apnea (OSA) among the adult population is very high. Oral appliances (OA) has emerged as the most recommended alternative treatment option for mild to moderate OSA. OBJECTIVE The objective of this article is to develop a new design of OA named “customized maxillary oral appliance”, for managing moderate obstructive sleep apnea (OSA) syndrome. METHODS The design proposed in this clinical technique is first of its kind that is fabricated on the maxillary arch. Customized maxillary oral appliance is developed by combining the principles of the three most popular OA’s used in OSA, namely soft palate lifters, tongue retaining devices, and mandibular advancement devices. RESULTS A new design of OA for the maxillary arch is proposed for managing moderate OSA. CONCLUSIONS Given the potential impact of OSA on general and mental health and the side effects of existing appliances there is a need for a new remedy to be introduced in the field of sleep medicine. This novel design can provide a new therapeutic op¬tion for patients with moderate OSA. CLINICALTRIAL Trial Registration: CTRI/2020/07/026936 Registered 31 July 2020, http://ctri.nic.in/Clinicaltrials/regtrial.php?modid=1&compid=19&EncHid=90265.33636

scholarly journals Treatment with Oral Appliances in Obstructive Sleep Apnea

2021 ◽  
Vol 1 (2) ◽  
pp. 1-6
Author(s):  
Palak Srivastava
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Oral Appliance ◽  
Mandibular Advancement ◽  
Oral Appliances ◽  
Invasive Treatment ◽  
Obstructive Sleep ◽  
Osa Treatment

Obstructive sleep apnea (OSA) is a disorder caused by a number of factors like an obstruction of the upper airway during sleep because of insufficient motor tone of the tongue and/or airway dilator muscles or inadequate growth of the maxillary jaw bone etc. Oral appliances (OAs) are commonly used as a non-invasive treatment for obstructive sleep apnea syndrome. The primary oral appliance (OA) used in obstructive sleep apnea (OSA) treatment is the mandibular advancement device (MAD). Tongue-retaining devices or tongue-stabilizing devices (TSDs) are a second type of OA, which displace the tongue anteriorly and may be customized or come in different stock sizes. This review article aims to examine the best in class on this particular subject of treatment of OSA with oral appliances, explaining acceptability of an appliance in patients on the basis of its construction and results, while providing enough cognizance regarding the diagnosis, management and causes of discontinuation.

scholarly journals Efficiency of Mandibular Advancement Device and Bilevel Positive Airway Pressure Treatment for Severe Obstructive Sleep Apnea

2017 ◽  
Vol 6 (1) ◽  
pp. 35-38
Author(s):  
Filiz Keyf ◽  
Selma Firat ◽  
Bulent Ciftci
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Oral Appliance ◽  
Mandibular Advancement Device ◽  
Mandibular Advancement ◽  
Pressure Treatment ◽  
Bilevel Positive Airway Pressure ◽  
Obstructive Sleep

ABSTRACT Recently, attention to oral appliance therapy, as mandibular advancement device (MAD), has increased. Mandibular advancement device is a popular alternative treatment, particularly for mild to moderate obstructive sleep apnea (OSA). Oral appliances for treating severe OSA are recommended for patients who failed to comply with continuous positive airway pressure treatment. This clinical report presents the treatment outcome of oral appliance therapy and bilevel device in a 70-year-old man with severe OSA and also having respiratory disturbance index (RDI) of 62.7. Polysomnographic (PSG) evaluation was performed before and about 1 week after continuous use of the MAD and then with bilevel device. The results were compared, and RDI decreased 27.5 per hour with the custom MAD, whereas RDI decreased 3.1 per hour with bilevel device. Improved PSG parameters showed that bilevel device was efficient in treatment. How to cite this article Keyf F, Firat S, Ciftci B. Efficiency of Mandibular Advancement Device and Bilevel Positive Airway Pressure Treatment for Severe Obstructive Sleep Apnea. Int J Experiment Dent Sci 2017;6(1):35-38.

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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