Current principles in the management of obstructive sleep apnoea with mandibular advancement appliances

RETRACTED ARTICLE: Management of obstructive sleep apnea in an edentulous patient with a combination of mandibular advancement splint and tongue-retaining device: a clinical report

“…The treatment modalities consist of both surgical and nonsurgical methods. The nonsurgical approaches to treatment include weight loss and reduction in smoking and alcohol consumption in combination with continuous positive airway pressure and intra-oral device therapy [2,3]. Treatment of OSA in dentate patients with mandibular advancement splint (MAS) is well-documented [4][5][6][7], but for edentulous patients, a search of literature revealed few reports [8].…”

“…MAS functions to repose and maintain the mandible in a protruded position during sleep [2,3,7,9]. This position serves to open the airway in several different ways: by indirectly pulling the tongue forward by virtue of its attachment to the geniotubercles, by increasing the baseline genioglossus muscle activity, and by stabilizing the mandible and hyoid bone to prevent jaw opening and retrolapse of the tongue [2,3,7,9].…”

“…The most common complaints are loud snoring, disrupted sleep, and excessive daytime sleepiness. Patients with apnea may develop cardiovascular abnormalities, such as coronary heart disease, hypertension, and stroke because of the recurrent nocturnal hypoxemia and hypercapnia [2,3].…”

“…Occasionally, an enlarged tongue may cause obstruction. In this setting, obstruction occurs when the base of the tongue impinges on the airway just above the glottis [2,3].…”

“…MAS functions to repose and maintain the mandible in a protruded position during sleep [2,3,7,9]. This position serves to open the airway in several different ways: by indirectly pulling the tongue forward by virtue of its attachment to the geniotubercles, by increasing the baseline genioglossus muscle activity, and by stabilizing the mandible and hyoid bone to prevent jaw opening and retrolapse of the tongue [2,3,7,9]. TRD functions by directly holding the tongue in a forward position and opening the airway by accomplishing forward movement of the base of the tongue, increasing the baseline genioglossus muscle activity, stabilizing the tongue to prevent obstructive collapse during sleep [10][11][12][13].…”