Predictors of Success in the Treatment of Obstructive Sleep Apnea Syndrome with Mandibular Repositioning Appliance: A Systematic Review

Saffer, Fernanda; Neto, José Lubianca; Rösing, Cassiano K; Closs, Luciane Quadrado; Dias, Caroline Pietá

doi:10.1055/s-0035-1562934

Cited by 4 publications

(3 citation statements)

References 1 publication

(1 reference statement)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Any obstructive disease in the nasal cavity will significantly increase airway resistance and local pharyngeal pressure. This will finally lead to soft tissue collapse in the pharyngeal cavity and apnea 15 . Besides, nasal obstruction will impair the action of airflow in the nasal cavity on pharyngeal nerves.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy Analysis of Extended Uvulopalatopharyngoplasty Combined With the Simultaneous Multiplane Operation to Treat Obstructive Sleep Apnea

Yuan

Tang

et al. 2023

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

Purpose: The purpose of this study was to discuss the safety and long-term efficacy of extended uvulopalatopharyngoplasty combined with the simultaneous multiplane operation to treat obstructive sleep apnea (OSA). Materials and Methods: Sixty-two patients confirmed with OSA by polysomnography received physical examinations, determination of nasal resistance, Muller’s maneuver under electronic laryngoscope, and upper airway computed tomography scan to locate the obstruction planes. Then the patients received extended uvulopalatopharyngoplasty combined with the simultaneous multiplane operation of the nasal cavity and/or tongue root under general anesthesia. Body mass index, Epworth Sleepiness Scale (ESS) score, apnea-hypopnea index (AHI), and lowest arterial oxygen saturation (LSaO2) were compared before and after surgery. Postoperative complications were recorded. All patients were followed up for 12 to 24 months after surgery. The above-mentioned indicators were determined. Results: Fourteen patients (22.58%) achieved a cure, 20 patients (32.26%) marked effectiveness, 20 patients (32.26%) moderate effectiveness, and 8 patients (12.90%) ineffectiveness. The overall response rate was 87.10%. AHI and ESS score decreased, and LSaO2 increased after surgery than before, all in a significant manner (P<0.05). There was no significant difference in body mass index before and after surgery. No severe complications occurred in any patients. Conclusions: Extended uvulopalatopharyngoplasty combined with the simultaneous multiplane operation had a good safety for OSA, improving ESS, AHI, and LSaO2 significantly. The patients enjoyed an improved life quality after surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

“…This will finally lead to soft tissue collapse in the pharyngeal cavity and apnea. 15 Besides, nasal obstruction will impair the action of airflow in the nasal cavity on pharyngeal nerves. As a result, the nervous reflex causing the excitation of the pharyngeal dilator muscle is weakened, reducing its regulatory effect on respiration.…”

Section: Complicationsmentioning

confidence: 99%

Efficacy Analysis of Extended Uvulopalatopharyngoplasty Combined With the Simultaneous Multiplane Operation to Treat Obstructive Sleep Apnea

Yuan

Tang

et al. 2023

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

show abstract

“…Although the AHI values recorded at 10 years were within the clinically acceptable range of treatment success (>50% AHI reduction), this finding would encourage the necessity to monitor treatment progress, changes in lifestyle, and health status in the long term to evaluate the integration or the substitution with CPAP device. Furthermore, compliance with MAD treatment seems to decrease with time, particularly from the 6th decade, when the patient's ability or willingness to adapt to an intraoral appliance was associated with an increased number of dropouts [35,36]. As a consequence, the efficacy of MAD could be influenced by patients' age and dentists should dedicate time (clinical appointments) and appropriate tools (including questionnaires) for motivating older subjects to the treatment at the baseline.…”

Section: Factors Not Assessable By the Dental Specialist Predictingmentioning

confidence: 99%

Indications for Dental Specialists for Treating Obstructive Sleep Apnea with Mandibular Advancement Devices: A Narrative Review

Lo Giudice,

La Rosa,

Ronsivalle

et al. 2024

International Journal of Dentistry

View full text Add to dashboard Cite

Obstructive sleep apnea (OSA) syndrome is characterized by repeated airway collapse during sleep. It determines cardiovascular, pulmonary, and neurocognitive consequences and is associated with several daytime and nighttime symptoms that influence the patient’s quality of life. The contribution of the dental specialist in the clinical management of OSA patients entails participating in the screening process as diagnostic sentinels and providing adequate treatment using mandibular advancement devices (MADs). Since the treatment of OSA requires a multidisciplinary approach, including different medical specialists, dentists should have a comprehensive understanding of medical and dental factors that influence the strategy and effectiveness of OSA treatment with MAD. Such expertise is crucial in determining the appropriate treatment indications and helps clinicians establish a consolidated position within the multidisciplinary OSA team. In this regard, this review summarizes the evidence of the clinical indications for MAD treatment and provides the dental specialist with helpful information about medical, functional, and other relevant factors that should be considered during diagnosis, treatment plan, and follow-up stages. Information retrieved was organized and discussed, generating specific domains/queries oriented to the clinical management of OSA patients from the clinical perspective of dental specialists.

show abstract

Friedman Score in Relation to Compliance and Treatment Response in Nonsevere Obstructive Sleep Apnea

Berg

Ankjell

Sun

et al. 2020

International Journal of Otolaryngology

View full text Add to dashboard Cite

Nonsevere obstructive sleep apnea (OSA) is most often treated with a continuous positive airway pressure (CPAP) device or a mandibular advancement splint (MAS). However, patient compliance with these treatments is difficult to predict. Improvement in apnea-hypopnea index (AHI) is also somewhat unpredictable in MAS treatment. In this study, we investigated the association between Friedman tongue position score (Friedman score) and both treatment compliance and AHI improvement in patients with nonsevere OSA receiving CPAP or MAS treatment. 104 patients with nonsevere OSA were randomly allocated to CPAP or MAS treatment and followed for 12 months. Data were collected through a medical examination, questionnaires, sleep recordings from ambulatory type 3 polygraphic sleep recording devices, and CPAP recordings. Associations between Friedman score, treatment compliance, and AHI improvement were analysed with logistic regression analyses. Friedman score was not associated with treatment compliance (odds ratio [OR]: 0.85, 95% confidence interval [CI]: 0.59-1.23), or AHI improvement (OR: 1.05, 95% CI: 0.62-1.76) in the overall study sample, the CPAP treatment group, or the MAS treatment group. Adjustment for socioeconomic factors, body mass index, and tonsil size did not significantly impact the results. Although Friedman score may predict OSA severity and contribute to the prediction of success in uvulopalatopharyngoplasty, we found no association between Friedman score and treatment compliance in patients with nonsevere OSA receiving CPAP or MAS treatment, nor did we find any association between Friedman score and AHI improvement. Factors other than Friedman score should be considered when deciding whether a patient with nonsevere OSA should be treated with CPAP or MAS.

show abstract

Predictors of Success in the Treatment of Obstructive Sleep Apnea Syndrome with Mandibular Repositioning Appliance: A Systematic Review

Cited by 4 publications

References 1 publication

Efficacy Analysis of Extended Uvulopalatopharyngoplasty Combined With the Simultaneous Multiplane Operation to Treat Obstructive Sleep Apnea

Efficacy Analysis of Extended Uvulopalatopharyngoplasty Combined With the Simultaneous Multiplane Operation to Treat Obstructive Sleep Apnea

Indications for Dental Specialists for Treating Obstructive Sleep Apnea with Mandibular Advancement Devices: A Narrative Review

Friedman Score in Relation to Compliance and Treatment Response in Nonsevere Obstructive Sleep Apnea

Contact Info

Product

Resources

About