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

Guimarães, Thaís; Colen, Samia; Cunali, Paulo Afonso; Rossi, Rosa Carrieri; Dal-Fabbro, Cibele; Ferraz, Ottavio; Tufik, Sérgio; Bittencourt, Lia

doi:10.1016/j.slsci.2015.05.002

Cited by 6 publications

(5 citation statements)

References 15 publications

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“…Oxygen saturation showed a significant increase when using MAD, both, in REM and in non-REM sleep. Our data confirm results from other studies [28], [29], [30]. This fact supports our approach of using the SNP as an important measurement tool.…”

Section: Discussionsupporting

confidence: 91%

Decrease of respiratory events in patients with obstructive sleep apnea-hypopnea syndrome using a mandibular advancement device assessed with split night polysomnography

et al. 2016

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IntroductionMandibular advancement device (MAD) may represent a feasible choice in the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS), in well selected patients.ObjectiveThe aim of this study is to assess the efficacy of MAD in patients with OSAHS, using split night polysomnography (SNP)MethodWe performed an auto controlled clinical trial to assess the efficacy of MAD in 30 patients with snoring and OSAHS. Clinical evaluation was made every 2 weeks to adjust treatment and observe changes in clinical symptoms. Three-months after placement of the MAD, a SNP was performed, using the MAD in the second half of the night, in order to compare the respiratory results.ResultsSNP show significant changes with use of MAD (p<0.05) such as: Decrease in Snore index (from 159.95 to 32.46/h) and in Apnea-hypopnea index (AHI, from 22.45 to 4.63/h), increase in oxygen saturation (SaO2, from 89.98% to 91.39%) and somnolence improvement, using the Epworth Sleepiness Scale (from 14.4 to 4.6 points).ConclusionOur data supports that the use of MAD is an alternative in the management of OSAHS, in well selected patients, used in a multidisciplinary fashion, and evaluated using a SNP.

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Section: Discussionsupporting

confidence: 91%

Decrease of respiratory events in patients with obstructive sleep apnea-hypopnea syndrome using a mandibular advancement device assessed with split night polysomnography

et al. 2016

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“…The treatment decreased AHI from 12.0/h to 4.0/h. Another case report presented a denture-supported MAD for a patient wearing complete upper and partial lower dentures with mild OSA; the AHI decreased from 12.5/h to 0.0/h [88]. Some case reports have described MAD directly affecting the alveolar ridge.…”

Section: Madmentioning

confidence: 99%

Focus of dental sleep medicine on obstructive sleep apnea in older adults: A narrative review

Okuno,

Wang,

Almeida

2023

J Prosthodont Res

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and Spain, and Japan has the highest aging rate of 28% [1].Older adults have many oral and dental health issues, such as tooth loss, periodontitis, decreased motor dysfunction, malnutrition, and dysphagia, as well as sleep disorders. Due to complications and age-related changes, sleep quality decreases in older adults. Obstructive sleep apnea (OSA), which substantially reduces sleep quality, is a common disorder that occurs in 3% of women and 10% of men aged 30-49 years, and in 9% of women and 17% of men aged 50-70 years [2]. Older adults are at a markedly higher risk of developing OSA owing to age-related increases in its incidence. Although mandibular advancement devices (MAD) are recommended for OSA, many factors, including the presence of other sleep disorders in conjunction with OSA, the use of medications that affect sleep apnea, and a lack of teeth (which are needed to support MAD), make this treatment difficult in older adults.This narrative review discusses important information for dentists practicing dental sleep medicine in older adults. As limited information is currently available on older adults with frailty, we did not discuss this population in the review. Sleep physiology in older adultsAge-related changes in brain function affect sleep and wakefulness. Sleep physiology differs between older and younger adults, with sleep disturbances occurring frequently in older adults. Decreased sleep quality in older adults considerably impacts their quality of life. Older adults have lower sleep efficiency as they spend more time lying in bed and less time sleeping than younger adults[3], thereby reducing the amount of deep sleep [4].The total amount of sleep gradually decreases with age. Sleep duration is approximately 8 h in late adolescence and slowly decreases to approximately 6 h in older adults aged ≥75 years. In older adults, the time to fall asleep and wake up is slightly earlier because of the advanced phase of the circadian rhythm and core body temperature [5]. It is important to note that these age-related physiological changes in older adults may affect the quality and quantity of sleep. Thus, questionnaires to understand their sleep cycles are important.

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“…Obstructive sleep apnea syndrome (OSAS) is a critical disorder with repetitive cessation of respiration owing to narrowing or collapse of the upper airway during sleep [ 1 , 2 ]. Repetitive episodes of apnea (complete cessation of airflow), hypopnea (partial reduction in airflow), oxygen desaturation, and sleep fragmentation are the common symptoms experienced by these patients [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Current guidelines put forward non-surgical treatment options involving continuous positive airway pressure (CPAP), lifestyle changes, and position therapy as first-line treatments. Second in line are oral appliances and surgical approaches (uvulopalatopharyngoplasty and tracheostomy) based upon the etiology and degree of severity [1]. Over the past two decades, CPAP therapy has been considered the most beneficial treatment for OSA [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Mandibular Advancement Device (MAD) for Obstructive Sleep Apnea in an Edentulous Patient

Burugpalli¹,

Chikhale²,

Galav³

et al. 2022

Cureus

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Mandibular advancement devices have been efficiently used for the treatment of mild to moderate obstructive sleep apnea (OSA) by forward positioning of the tongue-mandible complex with a resultant increase in oropharyngeal volume. However, the literature on the treatment of edentulous patients is limited. This clinical report describes a clinical and laboratory method for the fabrication of a mandibular advancement device in a 75-year-old completely edentulous patient with mild OSA.

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

Cited by 6 publications

References 15 publications

Decrease of respiratory events in patients with obstructive sleep apnea-hypopnea syndrome using a mandibular advancement device assessed with split night polysomnography

Decrease of respiratory events in patients with obstructive sleep apnea-hypopnea syndrome using a mandibular advancement device assessed with split night polysomnography

Focus of dental sleep medicine on obstructive sleep apnea in older adults: A narrative review

Mandibular Advancement Device (MAD) for Obstructive Sleep Apnea in an Edentulous Patient

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