"please keep me updated about oximeters "
Sleep Apnea Forum Bringing Power to the Patient
New? Free Sign Up
Then check our Welcome Center to a Community Caring about Sleep Apnea diagnosis and Sleep Apnea treatment:
CPAP machines, Sleep Apnea surgery and dental appliances.
CPAP Supplies
Latest Activity
Oral Appliances Effectiveness - Who Benefits From Them
who benefits from Oral Appliances was the question addressed by the following study. Conclusion: depends on the anatomy of your mouth -- would an ENT or dentist be the right person to evaluate the anatomy, or both?
Arch Otolaryngol Head Neck Surg. 2010 Jul;136(7):677-81.
Determinants of treatment outcome after use of the mandibular advancement device in patients with obstructive sleep apnea.
Lee CH, Kim JW, Lee HJ, Seo BS, Yun PY, Kim DY, Yoon IY, Rhee CS, Park JW, Mo JH.
Department of Otorhinolaryngology, Dankook University College of Medicine, San 16-5 Anseo-dong, Cheonan, Chungcheongnam-do 330-715, South Korea. jihunmo@gmail.com.
Abstract
OBJECTIVE: To determine the predictors affecting treatment outcome after application of the mandibular advancement device (MAD). DESIGN: Retrospective analysis. SETTING: Tertiary care university hospital. PATIENTS: A total of 76 patients (68 men and 8 women) who were treated with the MAD for obstructive sleep apnea (OSA) were included from September 2005 through August 2008. All the subjects underwent cephalometry, nocturnal polysomnography, and sleep videofluoroscopy (SVF) before and at least 3 months after receipt of a custom-made MAD. Sleep videofluoroscopy was performed before and after sleep induction and was analyzed during 3 states of awakeness, normoxygenation sleep, and desaturation sleep. Subjects were divided into success and nonsuccess groups depending on treatment outcome. MAIN OUTCOME MEASURES: Multiple variables from cephalometry and SVF including the length of the soft palate, retropalatal space, retrolingual space, and mouth opening angle were evaluated during sleep events with or without the MAD between success and nonsuccess group. RESULTS: The soft palate was significantly longer in the nonsuccess group than in the success group. The retropalatal and retrolingual airway spaces and mouth opening angle were not different between 2 groups. Application of the MAD increased the retrolingual space and decreased the length of the soft palate and the mouth opening angle significantly in both success and nonsuccess groups. However, retropalatal space was widened only in the success group, which showed that retropalatal space may be important in determining treatment response of the MAD. CONCLUSION: The length of the soft palate showed a difference between success and nonsuccess groups, and widening of retropalatal space might be an important factor for successful outcome with MAD application.
Views: 24
Replies to This Discussion
-
Permalink Reply by Steven Y. Park, MD on
-
No surprises here. For many people, the tongue is the main culprit, but the soft palate and the nose are usually involved as well. So the more redundant and elongated your soft palate, the less likely the oral appliance will work. Dentists do say that the oral appliance can pull open the oropharynx, but from what I've seen, the effect is minimal. All this points to the fact that sleep apnea is a multilevel anatomic condition.
-
Permalink Reply by Banyon on
-
Take a case where the tongue is the main problem and MADs are effective because of pulling the tongue forward and MADs have minimal effect at best on pulling open the oropharynx. Would not the Full Breath Solution oral device, http://www.sleepguide.com/forum/topics/full-breath-solution-dental , be a better treatment? Jaw problems would be avoided and the device is much smaller and should be less uncomfortable.
-
Permalink Reply by Henning on
-
One problem with Sleep Apnea as I see it, there will always exist people who are cured with something that is not documented. (This is fine, but is not universally accepted).
If a person only has problems with the back of the tongue, I think maybe on this appliance.
What I suspect is that there will be a huge pressure on the posterior teeth, which can lead to TMJ problems.
So in this case I would prefer a little more documentation
Henning
© 2024 Created by The SleepGuide Crew.
Powered by
