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Oral Appliance for Sleep Apnea

Nancy J Carballo, Cathy A Alessi, Jennifer L Martin, Michael N Mitchell, Ron D Hays, Nananda Col, Emily S Patterson, Stella Jouldjian, Karen Josephson, Constance H Fung
PURPOSE: Obstructive sleep apnea is a prevalent sleep disorder among older adults. Oral appliances are increasingly prescribed as therapy for obstructive sleep apnea. Adherence to oral appliance therapy is highly variable. Based on value-expectancy theory and other social-psychological theories, adherence to oral appliance therapy may be influenced by patients' perceived effectiveness of the therapy, self-efficacy, and availability of social support. We examined these perceptions among older adults with obstructive sleep apnea who were prescribed oral appliance therapy...
October 14, 2016: Clinical Therapeutics
Anthony Dioguardi, Moh'd Al-Halawani
Oral appliance therapy (OAT) has become an increasingly popular nonsurgical option for the treatment of obstructive sleep disorders. Recent research supports its efficacy and high levels of compliance for patients with obstructive sleep disorders. Common side effects of OAT include temporomandibular joint-related symptoms, bite changes, and tooth movement. These side effects can be minimized by the use of exercises. The American Academy of Dental Sleep Medicine and the American Academy of Sleep Medicine have released joint clinical practice guidelines for the treatment of obstructive sleep apnea and snoring with OAT...
October 6, 2016: Otolaryngologic Clinics of North America
Li-Chuan Chuang, Yun-Chia Lian, Michèle Hervy-Auboiron, Christian Guilleminault, Yu-Shu Huang
BACKGROUND/PURPOSE: Myofunctional therapy is one of the recommended treatments for obstructive sleep apnea, but the level of compliance has often been low in children. This study aims to investigate the therapeutic effect of passive myofunctional therapy using an oral appliance during sleep in children suffering from obstructive sleep apnea. METHODS: Twenty-nine children who suffered from obstructive sleep apnea were divided into two groups: premature children and full-term children...
October 3, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
J Kostrzewa-Janicka, P Śliwiński, M Wojda, D Rolski, E Mierzwińska-Nastalska
A combination of abnormal anatomy and physiology of the upper airway can produce its repetitive narrowing during sleep, resulting in obstructive sleep apnea (OSA). Treatment of sleep-breathing disorder ranges from lifestyle modifications, upper airway surgery, continuous positive airway pressure (CPAP) to the use of oral appliances. A proper treatment selection should be preceded by thorough clinical and instrumental examinations. The type and number of specific oral appliances are still growing. The mandibular advancement appliance (MAA) is the most common type of a dental device in use today...
September 20, 2016: Advances in Experimental Medicine and Biology
Hamad S AlRumaih, Nadim Z Baba, Abdulkareem AlShehri, Abdulaziz AlHelal, Abdulkareem Al-Humaidan
PURPOSE: Different approaches have been proposed to treat obstructive sleep apnea (OSA). This article reviews a synopsis of the available literature regarding the management of OSA. METHODS: A comprehensive review of the literature on the management of OSA began with a search of English-language peer-reviewed manuscripts using PubMed and MEDLINE. The focus was on clinical research articles published between 1996 and 2016. A search of relevant dental journals was also completed...
September 6, 2016: Journal of Prosthodontics: Official Journal of the American College of Prosthodontists
Michael Semelka, Jonathan Wilson, Ryan Floyd
Obstructive sleep apnea is a common disorder that causes patients to temporarily stop or decrease their breathing repeatedly during sleep. This results in fragmented, nonrestful sleep that can lead to symptoms such as morning headache and daytime sleepiness. Obstructive sleep apnea affects persons of all ages, with an increasing prevalence in those older than 60 years. The exact prevalence is unknown but is estimated to be between 2% and 14%. There are many health conditions associated with obstructive sleep apnea, including hypertension, coronary artery disease, cardiac arrhythmias, and depression...
September 1, 2016: American Family Physician
Chloé Kastoer, Marijke Dieltjens, Eline Oorts, Evert Hamans, Marc J Braem, Paul H Van de Heyning, Olivier M Vanderveken
STUDY OBJECTIVES: To perform a review of the current evidence regarding the use of a remotely controlled mandibular positioner (RCMP) and to analyze the efficacy of RCMP as a predictive selection tool in the treatment of obstructive sleep apnea (OSA) with oral appliances that protrude the mandible (OAm), exclusively relying on single-night RCMP titration. METHODS: An extensive literature search is performed through, (CENTRAL only), Embase...
August 22, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Keisuke Nishigawa, Rika Hayama, Yoshizo Matsuka
PURPOSE: Oral appliances (OAs) are commonly used as a noninvasive treatment for obstructive sleep apnea syndrome (OSAS). These devices are worn during sleep and create mandibular anterior traction to enlarge the upper airway. Continuous use of the device is essential for the success of OA therapy, but some patients stop using the OA for various reasons. The purpose of this research was to investigate complications in OA therapy that might prevent continuous use of these devices. METHODS: The progress of 90 OSAS patients who visited Tokushima University Hospital and underwent OA therapy was investigated with a mailed questionnaire...
August 20, 2016: Journal of Prosthodontic Research
J Kostrzewa-Janicka, P Śliwiński, M Wojda, D Rolski, E Mierzwińska-Nastalska
A combination of abnormal anatomy and physiology of the upper airway can produce its repetitive narrowing during sleep, resulting in obstructive sleep apnea (OSA). Treatment of sleep-breathing disorder ranges from lifestyle modifications, upper airway surgery, continuous positive airway pressure (CPAP) to the use of oral appliances. A proper treatment selection should be preceded by thorough clinical and instrumental examinations. The type and number of specific oral appliances are still growing. The mandibular advancement appliance (MAA) is the most common type of a dental device in use today...
July 29, 2016: Advances in Experimental Medicine and Biology
Thikriat S Al-Jewair
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: The effectiveness of oral appliances for obstructive sleep apnea syndrome: a meta-analysis. Zhu Y, Long H, Jian F, Lin J, Zhu J, Gao M, Lai W. J Dent 2015;43:1394-1402. SOURCE OF FUNDING: The review was supported by the National Natural Science Foundation of China and by the Orthodontic National Key Clinical Specialty Construction Program of China TYPE OF STUDY/DESIGN: Systematic review and meta-analysis...
June 2016: Journal of Evidence-based Dental Practice
Göran Isacsson, Clara Fodor, Magnus Sturebrand
PURPOSE: The primary purpose of this hypothesis-generating retrospective study was to compare the effect of monobloc and bibloc (Narval™) appliances on the apnea-hypopnea index (AHI) and the total cost of treatment during the first year of treatment. METHODS: Obstructive sleep apnea (OSA) subjects treated with a monobloc or bibloc during two different time periods were identified from medical records and data were extracted. Subjects treated with either of the appliances passed the same primary examination, follow-up visits, and follow-up polygraphic examination...
July 5, 2016: Sleep & Breathing, Schlaf & Atmung
Ryan J Soose
Novel approaches to upper airway anatomic phenotyping, more reconstructive upper airway surgical techniques, and new implantable hypoglossal neurostimulation technology have very favorable potential to improve symptoms and quality-of-life measures, to reduce obstructive sleep apnea (OSA) disease severity and associated cardiovascular risk, and to serve as an adjunct to continuous positive airway pressure, oral appliances, and other forms of OSA medical therapy. Successful surgical therapy depends critically on accurate diagnosis, skillful knowledge and examination of the upper airway anatomy, proper procedure selection, and proficient technical application...
June 2016: Sleep Medicine Clinics
Bradley A Edwards, Christopher Andara, Shane Landry, Scott A Sands, Simon A Joosten, Robert L Owens, David P White, Garun S Hamilton, Andrew Wellman
BACKGROUND: Oral appliances (OA) are commonly utilized as an alternative treatment to continuous positive airway pressure for obstructive sleep apnea (OSA) patients. However, OA have variable success at reducing the apnea-hypopnea index (AHI) and predicting responders is challenging. Understanding this variability may lie with the recognition that OSA is a multifactorial disorder and that OA may affect more than just upper-airway anatomy/collapsibility. The objectives of this study were to determine 1) how OA alters AHI and four phenotypic traits (upper-airway anatomy/collapsibility and muscle function, loop gain, arousal threshold) and 2) baseline predictors of which patients gain the greatest benefit from therapy...
May 15, 2016: American Journal of Respiratory and Critical Care Medicine
Hiromitsu Sekizuka, Naohiko Osada, Yoshihiro J Akashi
OBJECTIVE: Obstructive sleep apnea (OSA) treatment in patients with OSA and hypertension reduces blood pressure (BP). Oral appliance (OA) therapy is nowadays prescribed for patients with mild to moderate OSA. This study aimed to clarify the effect of OA therapy on BP reduction in Japanese patients with mild to moderate OSA. METHODS: Polysomnography was employed to detect sleep-disordered breathing. Totally, 237 patients without cardiac and/or cerebrovascular diseases and those with apnea-hypopnea index (AHI) ≥ 5/h-< 30/h were enrolled...
2016: Clinical and Experimental Hypertension: CHE
Michael W Calik
OBJECTIVE: To review the efficacy of current treatment options for adults with obstructive sleep apnea (OSA). METHODS: Review of the literature. RESULTS: OSA, characterized by repetitive ≥ 10-second interruptions (apnea) or reductions (hypopnea) in airflow, is initiated by partial or complete collapse in the upper airway despite respiratory effort. When left untreated, OSA is associated with comorbid conditions, such as cardiovascular and metabolic diseases...
April 2016: Journal of Clinical Outcomes Management: JCOM
G Van Haesendonck, M Dieltjens, E Hamans, M J Braem, O M Vanderveken
PURPOSE: This prospective clinical trial assessed the therapeutic outcomes of patients with obstructive sleep apnea (OSA) treated with a novel duobloc custom-made titratable mandibular advancement device (OAm). MATERIAL AND METHODS: The modular Somnomed G2® OAm (Somnomed Europe AG, Zurich, Switzerland) with 'click-to-fit' adjustability provides instant feedback on the mandibular advancement. 161 consecutive patients with established diagnoses of OSA. Dental impressions were made and a bite registration in 75% of the maximal protrusion being the starting protrusion...
2016: B-ENT
Luca Levrini, Franco Sacchi, Francesca Milano, Antonella Polimeni, Paolo Cozza, Edoardo Bernkopf, Marzia Segù, Marco Zucconi, Claudio Vicini, Enrico Brunello
BACKGROUND: The aim of the present article is to present a set of proposed clinical recommendations aimed at Italian dentists involved in the management of patients with obstructive sleep apnea syndrome or snoring. METHODS: With the purpose of creating a study group, some of the most important Italian scientific societies operating in fields relevant to the issue of sleep medicine in dentistry were asked to appoint a representative. Each member of the study group was required to answer questions regarding the clinical management of OSAS and snoring...
July 2015: Annali di Stomatologia
Ronald S Prehn, Tom Colquitt
The development of the positive airway pressure custom mask (TAP-PAP CM) has changed the treatment of obstructive sleep apnea. The TAP-PAP CM is used in continuous positive airway pressure therapy (CPAP) and is fabricated from the impression of the face. This mask is then connected to a post screwed into the mechanism of the TAP3 (Thornton Anterior Positioner) oral appliance. This strapless CPAP face mask features an efficient and stable CPAP interface with mandibular stabilization (Hybrid Therapy). A technique with a 2-stage polyvinyl siloxane face impression is described that offers improvements over the established single-stage face impression...
May 2016: Journal of Prosthetic Dentistry
Kentaro Okuno, Benjamin T Pliska, Mona Hamoda, Alan A Lowe, Fernanda R Almeida
While oral appliances (OA) have demonstrated good efficacy in patients ranging from mild to severe levels of obstructive sleep apnea (OSA), this form of treatment is not completely effective in all patients. As a successful treatment response is not dependent solely on apnea hypopnea index severity, the prediction of OA treatment efficacy is of key importance for efficient disease management. This systematic review aims to investigate the accuracy of a variety of clinical and experimental tests for predicting OA treatment outcomes in OSA...
December 8, 2015: Sleep Medicine Reviews
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