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DNA Appliance to Restructure Jaw/ Change Airway
DNA Appliance sounds like its goal is to restructure the jaw without surgery -- http://www.dnaappliance.com/index.html -- anyone have insight into how this compares to, say, MMA surgery?
Views: 9605
Replies to This Discussion
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Permalink Reply by Mary Z on
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I'd be interested in this, too. I read their FAQ. It's hard to believe they could achieve the same results as with the MMA surgery, but it sure would be simpler.
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Permalink Reply by Dr Eng on
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I'm a current provider of this appliance. It is very new and this appliance design was just developed over the last couple of years by Dr Dave Singh. I have worked with earlier prototypes and have seen the jaws grow and develop. So I know that it works. As far as the effect on OSA improvement, I have to say that it will vary according to the initial severity of the patient's condition. The less severe it is the higher the likelihood of the improvement and possible cure. I have a colleague whose patient did not tolerate CPAP and whose oral appliance therapy wasn't effective. He decided to try this and after about 18 months of treatment his airway improved to the point that his AHI is now below 5. His original AHI was in the moderate range. My experience has been in the use of this appliance for orthodontic purposes which works great. I just started using this for my severe OSA patients and for those who cannot tolerate CPAP or conventional mandibular advancement oral appliances. I do have one patient who has finished his treatment and is still using the appliance as a retainer until he gets his follow-up sleep study. For financial reasons, he hasn't done it yet but I can't wait until get his results. However, he does report that his sleep quality is so much improved, which is probably another reason why he's not urgent about getting the sleep study.
About how the DNA appliance works for OSA - The assumption of the location of the obstruction is at the tongue base level where oral appliances can address and help. The DNA appliance serves two functions. There is a wire loop extension which is about 7mm long and curved at 45 degrees from the end of the palate towards the throat that will cradle the back of the tongue during sleep preventing it from closing up the pharynx. The second function of the DNA appliance is the activation of growth and development of the bone of the palate and the lower jaw, essentially the maxilla and mandible. As they grow the soft tissues of the pharynx will stretch out across the larger bony framework creating a higher and wider opening of the pharynx. Theoretically, we are genetically programmed to have large enough craniofacial bony structures that will support our breathing functions but when there is a stunting of the growth and development then the airway is compromised. It's safe to day that we are stunted if teeth were taken out during our youth for braces and or our third molars (wisdom teeth) didn't have room to come in straight if at all. The DNA appliance is innovative in that it has the design mechanism to wake up this growing process in adults. However, we cannot predict how wide or long the jaws will develop for an individual as compared to surgery where the surgeon can decide to use a specific length of titanium plate to lengthen and change the dimension of the jaws. However, on the plus side is that the DNA appliance method is noninvasive with no health risks. It would be good to allow the individual jaws to develop to their maximum potential. We can then assess the improvement and if further improvement to the OSA is needed then less aggressive treatments can be an option later.
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Permalink Reply by Rooster on
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Excellent. I am so happy to see this approach to sleep-disordered breathing being tried. It gives me hope that my two children can eventually avoid the problems I had and live CPAP-free.
Sometime ago I wrote this, "I have a vision that soon our society will figure out an easy way to ensure that children develop wide, deep, healthy and attractive jaws and then obstructive sleep apnea will become an obscure bit of history."
Dr. Eng, Do you think that vision is within reach?
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Permalink Reply by Mike on
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have are Dr. Eng's responses to the questions of (1) whether peer-reviewed studies have been conducted to determine the effectiveness of the device; and (2) how does it differ from traditional orthodontics?
"Yes, there are studies published concerning the orthodontic function
and effects on the website, www.dnaappliance.com under the tab for
publications. The major difference between this method for
orthodontics and conventional is that this one addressed correction of
the body's maximum development and development of it's natural form
and symmetry. What does that mean? Basically, wearing the appliance
will help the jaw grow to it's maximum size and the teeth will drift
to the most stable position which tends to be in the straight
alignment. So, if the teeth is crowded, that means that the jaw size
was stunted. Teeth size is determined by DNA. Jaw size is partly
dictated by DNA and environment (function and nutrition). If the jaws
are not used as they are expected in nature such as breast feeding and
chewing unprocessed foods, then the jaws do not grow to their maximum
potential. Then teeth crowd and some teeth such as the third molars
do not have room to come in. As far as the OSA function, there are
small case reports that show it's effectiveness but the longitudinal
study with a large number of patients is currently being done and the
results and publication won't be submitted until next year. However,
it is know that as the bony structures expand in the jaws and face
then the soft tissues that comprise the airway will also stretch out
creating more space for breathing. The actual numbers in improvement
using AHI and RDI is to be determined with the study that is underway.
So basically, I'm giving this treatment to several patients that have
run out of options where CPAP was intolerable and conventional OAT
does not give satisfactory results and those who had surgery with
unsatisfactory results. I will be waiting for the results and I do
expect to hear positive results in a few months from these patients
after the fitting."
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Permalink Reply by sleepycarol on
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Interesting concept that I hope provides another valuable resource for those affected by osa.
I have always questioned the method of pulling good teeth to align teeth using the traditional metal braces. It seems to me that there has to be a better way of doing it. This technique seems like it does just that.
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i keep hearing positive buzz about this from the sleep professionals who are testing it. could this be . . . The Answer?
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I only wish it were more widely avaiable in the US.
Mike said:i keep hearing positive buzz about this from the sleep professionals who are testing it. could this be . . . The Answer?
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here's a map showing all the locations that have "certified providers" of the device: http://www.dnaappliance.com/certified_providers.php is there anything near you?
Mary Z said:I only wish it were more widely avaiable in the US.
Mike said:i keep hearing positive buzz about this from the sleep professionals who are testing it. could this be . . . The Answer?
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a woman at the NYC AWAKE Sleep Apnea Support Group Meeting Wednesday night had just been fitted with a DNA appliance and was going to try it that night for the very first time. she has a very complicated and serious case of Sleep Apnea. i asked to take a look, and i snapped this picture:
the dentist who fitted her with it said that she should experience some benefits within as little as a couple of weeks. i'm going to keep in touch with her and report back on her experiences as i learn about them.
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Permalink Reply by Dave on
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I would like to hear some hard AHI/RDI numbers for pre and post treatment. The fact no one is sharing such knowledge is hindering the device's growth in the OSA community.
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