• Contact us
  • E-Submission
ABOUT
BROWSE ARTICLES
JOURNAL POLICIES
FOR CONTRIBUTORS

Articles

Page Path

Review Article

Treatment of Obstructive Sleep Apnea with Oral Appliance

The Ewha Medical Journal 2013;36(2):97-101. Published online: September 26, 2013

Deptartment of Oral and Maxillofacial Surgery, Ewha Womans University Mokdong Hospital, Seoul, Korea.

1Division of Oral and Maxillofacial Surgery, Department of Dentistry, Ewha Womans University School of Medicine, Seoul, Korea.

Corresponding author: Sun-Jong Kim. Division of Oral and Maxillofacial Surgery, Department of Dentistry, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 158-710, Korea. Tel: 82-2-2650-5631, Fax: 82-2-2650-5764, sjsj7777@ewha.ac.kr
• Received: July 22, 2013   • Accepted: August 7, 2013

Copyright © 2013. Ewha Womans University School of Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

  • 41 Views
  • 0 Download
prev next
  • Oral appliances have been considered as effective treatment modality for obstructive sleep apnea (OSA). Especially mandibular advanced device (MAD) showed more effective treatment results compared to other oral appliances. With the accurate diagnosis through polysomnography, clinical examination and radiographic examination, the appropriate application of oral appliances would show promising results for OSA and snoring. However oral appliances can raise the complications such as untoward movement of teeth and development of temporomandibular joint disorders, thus it is highly recommended that the treatment Should be undertaken by skilled dental specialists. Moreover, periodic check-up and adjustment of appliances, if needed, should be performed. Although the assertion that continuous positive airway pressure is superior to MAD physiologically, consensus is not available until now. For optimum treatment for OSA, further researches are necessary for investigation of long-term efficiency, performance, cardiovascular status and objective adaptation.
  • 1. Guilleminault C, Tilkian A, Dement WC. The sleep apnea syndromes. Annu Rev Med 1976;27:465-484.
  • 2. Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 2002;165:1217-1239.
  • 3. Olson LG, King MT, Hensley MJ, Saunders NA. A community study of snoring and sleep-disordered breathing. Health outcomes. Am J Respir Crit Care Med 1995;152:717-720.
  • 4. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research: the Report of an American Academy of Sleep Medicine Task Force. Sleep 1999;22:667-689.
  • 5. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993;328:1230-1235.
  • 6. Young T, Evans L, Finn L, Palta M. Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep 1997;20:705-706.
  • 7. Sher AE, Schechtman KB, Piccirillo JF. The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. Sleep 1996;19:156-177.
  • 8. Janson C, Gislason T, Bengtsson H, Eriksson G, Lindberg E, Lindholm CE, et al. Long-term follow-up of patients with obstructive sleep apnea treated with uvulopalatopharyngoplasty. Arch Otolaryngol Head Neck Surg 1997;123:257-262.
  • 9. Brown DJ, Kerr P, Kryger M. Radiofrequency tissue reduction of the palate in patients with moderate sleep-disordered breathing. J Otolaryngol 2001;30:193-198.
  • 10. Practice parameters for the use of laser-assisted uvulopalatoplasty: Standards of Practice Committee of the American Sleep Disorders Association. Sleep 1994;17:744-748.
  • 11. Hoekema A, Stegenga B, De Bont LG. Efficacy and co-morbidity of oral appliances in the treatment of obstructive sleep apnea-hypopnea: a systematic review. Crit Rev Oral Biol Med 2004;15:137-155.
  • 12. Lojander J, Maasilta P, Partinen M, Brander PE, Salmi T, Lehtonen H. Nasal-CPAP, surgery, and conservative management for treatment of obstructive sleep apnea syndrome: a randomized study. Chest 1996;110:114-119.
  • 13. Jenkinson C, Davies RJ, Mullins R, Stradling JR. Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised prospective parallel trial. Lancet 1999;353:2100-2105.
  • 14. Song Y. Treatment of snoring and obstructive sleep apnea: oral appliance therapy of snoring and OSA. J Korean Dent Assoc 2010;48:190-195.
  • 15. Lowe AA, Sjoholm TT, Ryan CF, Fleetham JA, Ferguson KA, Remmers JE. Treatment, airway and compliance effects of a titratable oral appliance. Sleep 2000;23:Suppl 4. S172-S178.
  • 16. Menn SJ, Loube DI, Morgan TD, Mitler MM, Berger JS, Erman MK. The mandibular repositioning device: role in the treatment of obstructive sleep apnea. Sleep 1996;19:794-800.
  • 17. Lindman R, Bondemark L. A review of oral devices in the treatment of habitual snoring and obstructive sleep apnoea. Swed Dent J 2001;25:39-51.
  • 18. Schmidt-Nowara W, Lowe A, Wiegand L, Cartwright R, Perez-Guerra F, Menn S. Oral appliances for the treatment of snoring and obstructive sleep apnea: a review. Sleep 1995;18:501-510.
  • 19. Cameron DA, Lyons MF, Fox DL, Banham SW. Pilot study of a semi-flexible intra-oral appliance for the control of snoring. Br Dent J 1998;185:304-307.
  • 20. Arai H, Furuta H, Kosaka K, Kaneda R, Koshino Y, Sano J, et al. Changes in work performances in obstructive sleep apnea patients after dental appliance therapy. Psychiatry Clin Neurosci 1998;52:224-225.
  • 21. Bloch KE, Iseli A, Zhang JN, Xie X, Kaplan V, Stoeckli PW, et al. A randomized, controlled crossover trial of two oral appliances for sleep apnea treatment. Am J Respir Crit Care Med 2000;162:246-251.
  • 22. Marklund M, Franklin KA, Sahlin C, Lundgren R. The effect of a mandibular advancement device on apneas and sleep in patients with obstructive sleep apnea. Chest 1998;113:707-713.
  • 23. Marklund M, Persson M, Franklin KA. Treatment success with a mandibular advancement device is related to supine-dependent sleep apnea. Chest 1998;114:1630-1635.
  • 24. Tan YK, L'Estrange PR, Luo YM, Smith C, Grant HR, Simonds AK, et al. Mandibular advancement splints and continuous positive airway pressure in patients with obstructive sleep apnoea: a randomized cross-over trial. Eur J Orthod 2002;24:239-249.
  • 25. Chan AS, Cistulli PA. Oral appliance treatment of obstructive sleep apnea: an update. Curr Opin Pulm Med 2009;15:591-596.
  • 26. Mohsenin N, Mostofi MT, Mohsenin V. The role of oral appliances in treating obstructive sleep apnea. J Am Dent Assoc 2003;134:442-449.
Table 1
Representative studies presenting the treatment outcomes of MAD and CPAP*

MRA, mandibular repositioning appliance; CPAP, continuous positive airway pressure; RDI, respiratory disturbance index (event per hour); PCS, propective case series; RCT, randomized controlled trial; NG, not given; NA, not applicable. *Values are presented as mean±standard error of the mean, unless so marked, all other values are mean±standard deviation. P<0.05 compared with baseline. P<0.05 compared with MRA. Adapted from Mohsenin et al. [26] with permission from ADA Publishing Co.

emj-36-97-i001.jpg
Table 2
Protocol for treatment with oral appliance.
emj-36-97-i002.jpg

Figure & Data

References

    Citations

    Citations to this article as recorded by  

      Download Citation

      Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

      Format:

      Include:

      Treatment of Obstructive Sleep Apnea with Oral Appliance
      Ewha Med J. 2013;36(2):97-101.   Published online September 26, 2013
      Download Citation
      Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

      Format:
      • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
      • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
      Include:
      • Citation for the content below
      Treatment of Obstructive Sleep Apnea with Oral Appliance
      Ewha Med J. 2013;36(2):97-101.   Published online September 26, 2013
      Close
      Treatment of Obstructive Sleep Apnea with Oral Appliance
      Treatment of Obstructive Sleep Apnea with Oral Appliance

      Representative studies presenting the treatment outcomes of MAD and CPAP*

      MRA, mandibular repositioning appliance; CPAP, continuous positive airway pressure; RDI, respiratory disturbance index (event per hour); PCS, propective case series; RCT, randomized controlled trial; NG, not given; NA, not applicable. *Values are presented as mean±standard error of the mean, unless so marked, all other values are mean±standard deviation. P<0.05 compared with baseline. P<0.05 compared with MRA. Adapted from Mohsenin et al. [26] with permission from ADA Publishing Co.

      Protocol for treatment with oral appliance.

      Table 1 Representative studies presenting the treatment outcomes of MAD and CPAP*

      MRA, mandibular repositioning appliance; CPAP, continuous positive airway pressure; RDI, respiratory disturbance index (event per hour); PCS, propective case series; RCT, randomized controlled trial; NG, not given; NA, not applicable. *Values are presented as mean±standard error of the mean, unless so marked, all other values are mean±standard deviation. P<0.05 compared with baseline. P<0.05 compared with MRA. Adapted from Mohsenin et al. [26] with permission from ADA Publishing Co.

      Table 2 Protocol for treatment with oral appliance.

      TOP