Long-term sequellae of oral appliance therapy in obstructive sleep apnea patients: Part 1. Cephalometric analysis

Almeida, Fernanda R.; Lowe, Alan A.; Sung, Jung Ok; Tsuiki, Satoru; Otsuka, Ryo

doi:10.1016/j.ajodo.2005.10.001

Cited by 130 publications

(110 citation statements)

References 39 publications

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“…[8][9][10][11][12][13] For some patients, a decrease in occlusal contact area (OCA) around the molar and premolar regions has also been reported. 14 Almeida et al 8 estimated OCA by counting the number of contact points before and after 5 years of OA therapy using articulating paper on patients' models.…”

Section: Introductionmentioning

confidence: 99%

Changes in Occlusal Contact Area during Oral Appliance Therapy Assessed on Study Models

Ueda

Almeida

Lowe

et al. 2008

The Angle Orthodontist

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Objective: To test the hypothesis that long-term use of an oral appliance (OA) does not cause changes in the occlusal contact area (OCA). Materials and Methods: Baseline and follow-up treatment study models were obtained for 45 patients with obstructive sleep apnea who had been using an OA for 4 or more days/week for more than 5 years. Study models in centric occlusion, with an inserted pressure-sensitive sheet, were loaded in compression. An image scanner was used to evaluate OCA. Results: A significant change in total OCA was identified in 39 patients (86.7%): a decrease in 26 (66.7%) and an increase in 13 (33.3%) patients. Regional changes Ͼ5% were observed in Ͼ90% of patients in each of the three regions. In the molar and premolar regions, 24 (53.3%) and 27 (60.0%) of the patients showed an OCA decrease, while only 16 (35.6%) and 15 (33.3%) showed an increase. Conversely, for the anterior region, more increases (24 patients-53.3%) than decreases were identified. Conclusion: The hypothesis is rejected. Long-term OA therapy resulted in dramatic changes of occlusion, suggesting that monitoring of occlusal changes is required.

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Section: Introductionmentioning

confidence: 99%

Changes in Occlusal Contact Area during Oral Appliance Therapy Assessed on Study Models

Ueda

Almeida

Lowe

et al. 2008

The Angle Orthodontist

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“…Almeida et al 6 observed favorable dental changes in almost half of the patients who had been using IODs for an average of 7.4 years. According to the results of Almeida et al 30 , IODs induced teeth movement but no craniofacial skeletal changes. In 2005, because of existing concerns regarding adverse events, the Standards of Practice Committee of AASM published practical guidelines for treatment using IODs in patients with obstructive sleep apnea, in which they recommended follow-up every 6 months during the first year of treatment and annually thereafter 16 .…”

Section: Discussionmentioning

confidence: 99%

Obstructive sleep apnea syndrome: how should the dental surgeon proceed?

Ronsani

Meira

Godolfim³

et al. 2014

RGO, Rev. Gaúch. Odontol.

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RESUMOO presente trabalho tem por objetivo relatar um caso clínico diagnosticado como Síndrome da apnéia obstrutiva do sono, e expor uma sequência lógica para o tratamento de pacientes que sofrem desta doença. Através da interpretação do exame de polissonografia, da anamnese, exame clínico e, ainda, por meio da realização do traçado e análise cefalométrica para apnéia do sono, indicou-se de forma segura e efetiva a terapia com aparelho intra-oral. Desta maneira, foi confeccionado um aparelho de avanço mandibular, o PLG. Após quatro semanas de uso do aparelho, o paciente foi encaminhado à realização de uma nova polissonografia, a qual revelou ausência de apnéias obstrutivas durante o sono. As etapas seguidas no tratamento deste estudo de caso destacaram a importância e a necessidade de uma abordagem correta e criteriosa dos casos de pacientes com apnéia do sono encaminhados ao consultório odontológico. A abordagem e sequência apresentadas garantiram o sucesso no tratamento deste estudo de caso. Obstructive episodes are usually accompanied by loud snoring and a drop in blood oxygen saturation (hypoxemia), ending in short micro-awakenings, which result in sleep fragmentation 4 . Sleep basically consists of two moments that alternate between waking states: non-rapid eye movement (NREM) and rapid eye movement (REM). Sleep apnea events last longer and have higher hypoxemia during REM sleep than during NREM sleep in patients with OSAS 5 . Termos de indexação:According to Jauhar et al. 2 , the deterioration of sleep quality caused by OSAS significantly contributes to excessive daytime sleepiness, loss of cognitive capacity, and mood swings and personality changes. It has also been associated with a worsening in the quality of life and in relationships with spouses and partners, decreased alertness, and an increased risk of traffic accidents. In addition, there are indications of an increase in cardiovascular diseases among untreated OSAS patients, and it is a potentially life-threatening condition 1,3,[6][7] that requires an early diagnosis and effective treatment.

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“…Some authors [25][26][27] correlate the observed occlusal changes with the type of initial occlusion in patients using mandibular protruding devices for OSAH treatment. Almeida et al (2006) 25 and Almeida et al (2006) 26 carried out some long term assessment works, 4.7 years average.…”

Section: Discussionmentioning

confidence: 99%

Tratamento da síndrome da apnéia e hipopnéia obstrutiva do sono com aparelhos intrabucais

Almeida¹,

Teixeira

Vieira

et al. 2006

Rev. Bras. Otorrinolaringol.

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Obst ructive sleep apnea and hipoapnea syndrome (OSAHS) is a disorder that affects about 4% of the adult population, and besides the social problems associated to snoring and extreme day time sleepiness, it is preoccupying since it may cause pulmonary hypertension and cardiac failure. Review and discussion -Through a literature review, we discuss the use of oral appliances to treat this condition, in regards of therapy effectiveness and limitations, main clinical symptoms, major occlusal side effects, rate of improvement and patient satisfaction. Conclusions -We concluded that the use of oral appliances should be a first choice treatment for mild to moderate OSAHS, being dental, joint and muscular discomforts, hypersalivation and xerostomia, the most frequent clinical symptoms, with light occlusal side effects that normally do not bother the patients, with a good degree of improvement and high satisfaction index.

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Long-term sequellae of oral appliance therapy in obstructive sleep apnea patients: Part 1. Cephalometric analysis

Cited by 130 publications

References 39 publications

Changes in Occlusal Contact Area during Oral Appliance Therapy Assessed on Study Models

Changes in Occlusal Contact Area during Oral Appliance Therapy Assessed on Study Models

Obstructive sleep apnea syndrome: how should the dental surgeon proceed?

Tratamento da síndrome da apnéia e hipopnéia obstrutiva do sono com aparelhos intrabucais

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