Obstructive sleep apnea (OSA): A prosthodontic perspective

Aim:Aim of the current study was to evaluate the effect of occlusal jig with increased vertical dimension and mandibular advancement device on the oropharangeal volume in completely edentulous patients using spirometry and cephalometry.Materials and Methods:The current study included includes 30 completely edentulous patient according to inclusion criteria. They were each subjected to cephalometric and spirometric analysis wearing CCD, OJ & MAD. Results obtained were subjected to following statistical analysis, one-way ANOVA test, unpaired t-test, and Dunnett's test.Result:Both OJ & MAD brings about significant change in oropharangeal volume hence both the devices are effective treatment of choice for OSA, while greater increase was observed in oropharangealvolume of OJ as compared to MAD. Spirometric analysis shows insignificant changes in the oropharangeal volume caused by MAD while OJ causes small but significant change in oropharangeal volume (PIFR].Conclusion:Within the limitation of the study, it can be concluded that, on cephalometric & spirometric evaluation, OJ shows greater increase in oropharangeal volume when compared to MAD in completely edentulous patient.

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“…It causes impaired musculature of the oropharynx such as tone in soft palate and pharynx and macroglossia. [4]…”

Section: Introductionmentioning

confidence: 99%

“…Oral appliance alters the tongue position and also helps in regaining oral pharyngeal volume that is lost after a long span of complete edentulous. [4] The oropharyngeal space can be regained using an occlusal jig (OJ) with increased VDO and MAD. Both these devices have been suggested to be an effective treatment for patients with OSA.…”

Section: Introductionmentioning

confidence: 99%

A spirometric and cephalometric comparative evaluation of mandibular advancement devices and occlusal jig

Ujjwal

Kaurani

Padiyar

et al. 2019

J Indian Prosthodont Soc

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“…The role of prosthodontist in managing sleep disorders with oral appliances is attaining more significance. [ 1 ] The prosthodontist has the opportunity to recognize, evaluate sleep-related disorders, and manage the situations ranging from snoring to moderate obstructive sleep apnea (OSA). It is vital to be aware sleep disorders and the possible impact that can aid in providing effective care to the patients reporting to prosthodontic clinics.…”

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confidence: 99%

“…Home sleep apnea testing was used as a substitute tool, but it displayed lower accuracy and sensitivity in diagnosing nonrespiratory sleep disorders. [ 1 2 3 4 ] Epworth Sleepiness Scale, Malampatthy Scale, and questionnaires of BERLIN, STOP, STOP-BANG support in the evaluation of OSA. [ 3 ] These are adjunctive tools that can be used during examination.…”

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confidence: 99%

“…Behavioral therapies include weight loss, positional therapy for improving the airway patency, avoidance of alcohol, or sedative agents. [ 1 2 ] Continuous positive airway pressure (CPAP) and surgical options are chosen for patients with moderate to severe OSA. Positive air way pressure is an effective choice it reduces AHI and improves sleep and quality of life.…”

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confidence: 99%

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Sleep apnea and prosthodontic implications

Chander¹

2020

J Indian Prosthodont Soc

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Comparative evaluation of the efficacy of customized maxillary oral appliance with mandibular advancement appliance as a treatment modality for moderate obstructive sleep apnea patients—protocol for a randomized controlled trial

Belkhode

Godbole

Nimonkar

et al. 2022

Trials

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Background Obstructive sleep apnea (OSA) is due to the obstruction of the upper airway during sleep. This condition is often associated with multiple symptoms and co-morbidities. There are many treatment options mentioned in the literature to manage OSA, among which interventional option of continuous positive airflow (CPAP) and non-interventional option, i.e., mandibular advancement device (MAD), which is an oral appliance (OA), are the most preferred ones. This study aims to evaluate the efficacy of customized maxillary oral appliances with mandibular advancement devices in moderate OSA patients. Methods A prospective interventional study with a randomized controlled trial will be carried out involving 40 participants (sample size), with an apnea-hypopnea index (AHI) > 15–30, recorded on polysomnography (PSG). Study participants will be randomly divided into the following treatment groups: control group or group subjected to mandibular advancement device (MAD, n=20) and second group subjected to customized maxillary oral appliance (CMOA, n=20). Baseline assessment of apnea/hypopnea index (AHI), oxygen saturation in blood, percentage of rapid eye movement, electroencephalogram, electrocardiogram, oro-nasal airflow via a pressure transducer, and Epworth Sleepiness Scale will be done. Then both study group participants will receive their respective appliances. And after one month and three months of delivery of the appliance, all the parameters, i.e., AHI, oxygen saturation in blood, percentage of rapid eye movement, electroencephalogram, electrocardiogram, oro-nasal airflow via a pressure transducer, and Epworth Sleepiness Scale will be re-evaluated and compared with the baseline measurements. Descriptive and analytical statistics will be done. SPSS (Statistical Package for Social Sciences) Version 20.1 will be used as statistical software. The statistical significance between the two groups after one month and three months will be evaluated at p< 0.05. Discussion We expect, customized maxillary oral appliance to be more efficient in managing moderate OSA, in comparison with MAD. If the hypothesis of the present study is confirmed, then this customized maxillary appliance will be quoted as a “gold standard” for managing moderate OSA. Trial registration CTRI/2020/07/026936 Registered 31 July 2020.

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Obstructive sleep apnea (OSA): A prosthodontic perspective

Cited by 5 publications

References 18 publications

A spirometric and cephalometric comparative evaluation of mandibular advancement devices and occlusal jig

A spirometric and cephalometric comparative evaluation of mandibular advancement devices and occlusal jig

Sleep apnea and prosthodontic implications

Comparative evaluation of the efficacy of customized maxillary oral appliance with mandibular advancement appliance as a treatment modality for moderate obstructive sleep apnea patients—protocol for a randomized controlled trial

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