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 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.

scholarly journals Obstructive sleep apnea syndrome (OSA) in adolescents: therapeutic management

2018 ◽  
Vol 21 (1) ◽  
pp. 107
Author(s):  
A. Amaddeo ◽  
L. Griffon ◽  
B. Thierry ◽  
V. Couloigner ◽  
A. Joly ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Positive Airway Pressure ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Maxillary Expansion ◽  
Obstructive Sleep ◽  
Osa Treatment ◽  
Type 3

Obstructive sleep apnea (OSA) in adolescents is characterized by a predominance of OSA type 2 which is associated with overweight/obesity. The treatment of OSA in adolescents depends on the cause of OSA and its risk and / or precipitating factors. Adenotonsillectomy is the cornerstone of OSA treatment in case of hypertrophy of the adenoids and/or tonsils. An anti-inflammatory treatment has proven its efficacy in mild to moderate or mild residual OSA after adenotonsillectomy. Orthodontic treatments such as rapid maxillary expansion or jaw positioning are indicated in case of dentofacial disharmonies. Continuous positive airway pressure (CPAP), is mainly indicated in type-3 OSA, which is associated with craniofacial or upper airway malformations or anomalies and should be performed by a pediatric multidisciplinary team having an expertise in sleep and OSA. Finally, maxillofacial or craniofacial surgery may be indicated in adolescents with type-3 OSA. In conclusion, the treatment of OSA in adolescents is based on the type of OSA, its severity and the medical characteristics of each patient.

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 Comparison of Titratable Oral Appliance and Mandibular Advancement Splint in the Treatment of Patients with Obstructive Sleep Apnea

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Emel Sari ◽  
Steven Menillo
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Success Rate ◽  
Upper Airway ◽  
Oral Appliance ◽  
Mandibular Advancement ◽  
Apnea Hypopnea Index ◽  
Similar Reduction ◽  
Mandibular Advancement Splint ◽  
Obstructive Sleep

Objective. To compare the effect of two intraoral devices (titratable oral appliance-Klearway (KW) and mandibular advancement splint (MAS)) in mild and moderate obstructive sleep apnea (OSA) patients. Method and Materials. The study group was comprised of twenty-four adult volunteer patients with OSA. Twelve subjects were fitted with a titratable oral appliance (group KW) protruding the mandible (85% of maximum protrusion). The other 12 subjects received MAS with 75% protrusion of the mandible (group MAS). Baseline, (“0.PSG”), first week (K1.PSG for KW group and M1.PSG for MAS group), and after the first month (K2.PSG for KW group and M2′. PSG for MAS group). Results. Both groups produced similar reduction in apnea-hypopnea index (AHI) from baseline till the end of the first week and first month (P<.05). However, the success rate of both groups at the end of the first month was found to be statistically different from the success rate of the first week (P<.05). The reduction in mean AHI of group KW-moderate (KW-mo) was significantly different from the mean AHI of group MAS-moderate (MAS-mo) at the end of the first month (P<.05). Conclusion. This study suggests that Klearway appliance was more effective in treating moderate OSA patients than MAS appliance. It was concluded that an appliance that provides 85% mandibular advancement to open the upper airway was more effective in reducing the number of high apneic events during sleep in comparison to the one which provides 75%.

scholarly journals A singular oral appliance to treat obstructive sleep apnea in CPAP non-adherent patients

2020 ◽  
Vol 25 (5) ◽  
pp. 44-50
Author(s):  
Denise Fernandes Barbosa ◽  
Lilian Chrystiane Giannasi ◽  
Liege Maria Di Bisceglie Ferreira ◽  
Miguel Meira e Cruz ◽  
Marcelo Corrêa Alves ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Oral Appliance ◽  
Mandibular Advancement ◽  
Occlusal Plane ◽  
Apnea Hypopnea Index ◽  
Study Objective ◽  
Airway Patency ◽  
Obstructive Sleep

ABSTRACT Introduction: The most prescribed treatment option for Obstructive Sleep Apnea (OSA) is CPAP; however, its adherence is limited. Oral Appliance therapy (OAT) is frequently an option or even an adjuvant, being the mandibular advancement Oral Appliance (OAm) the most used prescription. It modifies the upper airway, improving the airway patency. OAm construction is based on the occlusal plane to disocclusion. In this study, the DIORS® appliance was used, a singular OAm, based on Neuro-Occlusal Rehabilitation concepts, that uses Camper’s plane as a disocclusion reference, in order to achieve neuromuscular balance and functional stability. Objective: This study primarily aimed to assess the DIORS® effectiveness in relation to clinical and polysomnographic outcomes. It was also evaluated if the use of DIORS® is as effective as titrated CPAP to treat CPAP non-adherent patients. Methods: Twenty patients were included in this study. Objective and subjective clinical data were assessed at a sleep laboratory using all-night polysomnography, and Epworth Sleepiness Scale (ESS), taken at three moments: Baseline, CPAP titration, and using DIORS®. Analysis of respiratory parameters as apnea/hypopnea index (AHI), oxyhemoglobin saturation levels, the arousal index and daytime sleepiness were taken as criteria for a successful OAT. Results: Respiratory and arousal parameters improved in both therapies, while DIORS® promoted a better ESS. Conclusion: Results from the present work support that DIORS® is a viable and effective adjuvant therapy for patients with moderate to severe OSA non-adherent to CPAP.

scholarly journals The impact of oral appliance therapy with moderate mandibular advancement on obstructive sleep apnea and upper airway volume

2019 ◽  
Vol 24 (3) ◽  
pp. 865-873 ◽  
Author(s):  
Riitta Pahkala ◽  
J. Seppä ◽  
R. Myllykangas ◽  
J. Tervaniemi ◽  
V. M. Vartiainen ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Oral Appliance ◽  
Mandibular Advancement ◽  
Oral Appliance Therapy ◽  
Obstructive Sleep ◽  
The Impact
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