Respiratory outcomes with the use of a lower custom fit genioglossal‐effecting oral appliance

Abstract

Objective Sleep apnea research cites that an oral appliance, which places the mandible in a more forward position and the genioglossus (tongue muscle) on the floor of the mouth, improves aspects of the pharyngeal opening. Exercise science research has cited improvements in airway dynamics and physiological variables with oral appliance use during exercise. Thus, the purpose of this study was to design an oral appliance that would act on the genioglossus and determine if there were effects on respiratory parameters while exercising. Materials and methods Seventeen healthy subjects ages 18–43 participated in this study. Prior to the exercise protocol, the order of the oral applicance (OA) or no oral appliance (no OA) condition was randomly assigned to subjects, with subjects completing both conditions. Respiratory parameters (respiratory rate, ventilation, oxygen, and carbon dioxide) were measured between conditions while subjects ran for 10 min at steady state. Results The results demonstrated that both respiratory rate (25.97 BPM, OA and 28.35 BPM, no OA) and ventilation (47.66 l/min, OA and 50.34 l/min, No OA) were significantly lowered (p < .01) in the OA condition. There were no differences in carbon dioxide (1.89 l/min, no OA and 1.88 l/min, OA) or oxygen outcomes (2.17 l/min, no OA and 2.17 l/min OA). Discussion The outcomes from this study suggest that the design of the oral appliance elicits an effect on the genioglossus, thereby resulting in lowered respiratory rate and ventilation with no negative effects on oxygen uptake during exercise.

Systematic changes of the static upper body posture with a symmetric occlusion condition

“…It is speculated that the change of the mandibular results in a sensory information that is processed in the central nervous system and effects the muscles of the upper body [ 76 ]. Another speculation is that due to the change of the opening of the airflow, the head position has to be readjusted, in order to increase or decrease the air tunnel [ 1 ]. As the head is controlled via muscles attached to the upper body this would result in a reaction in order to balance the head again.…”

“…While the temporal bone is rigidly attached to the other bones of the skull, the mandible is only attached through several muscles to the clavicle and the upper edge of the trunk. In addition, the position of the mandible to the temporal bone does influence the respiratory outcomes [1]. Subject will optimize head position to maximize air flux [1,2].…”

“…In addition, the position of the mandible to the temporal bone does influence the respiratory outcomes [1]. Subject will optimize head position to maximize air flux [1,2]. The changes of mandible and head positions might be transferred through muscle chains to the upper body [3].…”

Symmetrical Dental Occlusion Blocking - What are the Required Changes of Pressure Distribution to be Clinical Relevant?

“…Several explanations are discussed in the scienti c literature to give a theoretical explanation of the observed phenomena. The most common explanations can be categorized in two categories, sensory dependent theory (7,20) and mechanical dependent theory (21,22). The sensory dependent theory states, that missing sensory information in the occlusion condition alters brain circuits, that lead subsequently to a change of the motor pathways (7,20,23,24).…”

“…The sensory dependent theory states, that missing sensory information in the occlusion condition alters brain circuits, that lead subsequently to a change of the motor pathways (7,20,23,24). The mechanic dependent theory states that either a relaxation of muscles of the anterior triangle or a change of the air tunnel lead to a repositioning of the head and therefore leads to a change of body positioning and subsequently to a change of the pressure distribution (21,22,25,26). Unfortunately, to date none of the theories has been investigated more deeply.…”