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

Abstract

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.

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 edentulous patients: an overview of the literature

“…The authors did mention that periodical dental care was required to maintain proper oral health. Keyff et al [ 45 ] used MAD therapy in a patient with mandibular edentulism suffering from mild OSA resulting in improvement of AHI and SaO 2 levels. No problems were reported regarding retention or stability of the device.…”

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

“…4,[7][8][9][10][11] Although CPAP is proved to be more efficient in treatment, it is not tolerated well by patients; therefore, intraoral appliances are frequently preferred 3,5,[12][13][14][15][16] as in this patient. Treatment success is commonly defined by a reduction in RDI to <5 or <10 in addition to a <50% reduction in baseline RDI.…”