Efficacy of a modified mandibular advancement device for a totally edentulous patient with severe obstructive sleep apnea

Abstract

This clinical case shows fabrication method and treatment efficacy of a modified MAD, which is aiming to displace bulky masseter muscles laterally, to provide more space for tongue on totally edentulous patient with severe OSA.

Treatment of obstructive sleep apnea with mandibular advancement appliance over prostheses: A case report

“…There are few studies in the literature that address the treatment of edentulous individuals using a MAD, and those that do exist are limited to case reports. The majority of the studies support the device on the alveolar ridge [12–14] or on the tongue retainer flange [15] . Others build the device over a complete upper prosthesis [16] or on complete upper and lower prostheses [17] .…”

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

“…The literature revealed a fewer numbers of therapeutic strategies used in the treatment of edentulous patients with OSA [3–5, 7, 8]. This paper describes the clinical procedure of fabrication of a modified MAD for edentulous lower jaw patient with OSA and evaluates these results.…”

“…Kurtulmus and Cotert [3] described a new functional splint combining a MAD and a TRD. Piskin et al [5] reported modified MAD which displaces bulky masseter muscles laterally to provide more space for the tongue in edentulous patients. Arisaka et al [7] indicated that just wearing the complete dentures during sleep improved the AHI in some edentulous OSA patients by restoring the vertical mandibular position without change in the horizontal mandibular position.…”

“…The most common complaints are loud snoring and disrupted sleep. Of the many oral appliances designed for use in the treatment of OSA, mandibular advancement devices (MAD) have been the most intensely researched [1–5]. …”

“…Edentulism itself in turn contributes to the worsening of OSA and reduces the number of available treatment options. However, a search of the literature reveals only a few reports describing the treatment of edentulous patients with OSA using MAD [2–5]. …”