FROM DIAGNOSIS TO TREATMENT DENTISTRY PRACTICES AND THE ROLE OF DENTIST IN OBSTRUCTIVE SLEEP APNEA AND SNORING

Yıl 2018, Cilt: 4 Sayı: 2, 47 - 55, 08.10.2018

Hüseyin Kurtulmuş

Öz

Obstructive Sleep Apnea (OSA) is a chronic and widespread disease that generally requires a lifelong treatment. Therefore, a continuous oral appliance (OA) along with behavioral modifi cations as an alternative symptomatic treatment is required for this chronic disease. Patients of this chronic disease should have a regular and continuous follow-up to monitor adherence to therapy, side effects, development of medical systemic complications and constant resolution of symptoms. When considered from this point of view, OA is widely used. In other words, nowadays, patients can tolerate OAs and prefer using them thanks to improvements in OAs. OAs are designed to prevent any kind of obstruction in upper airway by advancing mandibular and thus holding open respiratory tract during sleep. There are increasing evidence that an active OA helps improve daytime sleepiness and apnea/hypopnea severity (sleep disordered breathing data) when compared to an inactive OA (control group). It approaches through mechanical ventilation method (non-invasive, conservative). There are many researches that prove OA to be even more effective. It is declared many times that symptomatic response difference is in favor of OA.

Anahtar Kelimeler

Obstructive Sleep Apnea, Snore, Oral Appliance, Dentistry

Kaynakça

• [1] Bailey DR. Dental management of sleep disorders. Dentistry Today 2002; November: 88-93. [2] Gelb ML, Bailey DR. Managing snoring and sleep apnea with the NORAD oral appliance. Dental Products Report 2002; December: 100-101. [3] Gotsopoulos H, Chen C, Qlan J, Clstull PA. Oral appliance therapy improves symptoms in obstructive sleep apnea. A randomized, controlled trial. Am J Respir Crit Care Med 2002; 166: 743-748. [4] Ivanhoe JR, Cibirka RM, Lefebvre CA, Parr GR. Dental considerations in upper airway sleep disorders: a review of the literature. J Prosthet Dent 1999; 82: 685-698. [5] Yoshida, K. Oral device therapy for the upper airway resistance syndrome patient. J Prosthet Dent 2002; 87: 427-429. [6] Meyer JB, Knudson RC. The sleep apnea syndrome. Part I: diagnosis. J Prosthet Dent 1989; 62: 675-679. [7] Yoshida K. Effect of a prosthetic appliance for treatment of sleep apnea syndrome on masticatory and tongue muscle activity. J Prosthet Dent 1998; 79: 537-544. [8] Nieto FJ, Young TB, Lind BK et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. JAMA 2000; 283: 1829-1836. [9] Eveloff SS, Rosenberg CL, Carlisle CC, Millman RP. Efficacy of a herbst mandibular advancement device in obstructive sleep apnea. Am J Respir Crit Care Med 1994; 149: 905-909. [10] Johal A, Battagel JM. Current principles in the management of obstructive sleep apnoea with mandibular advancement appliances. Br Dent 2001; 190: 532-536. [11] Lowe AA, Santamaria JD, Fleetham JA, Price C. Facial morphology and obstructive sleep apnoea. Am J Orthod Dentofacial Orthop 1986; 90: 484-491. [12] Schmidt-Nowara WW, Mead TT, Hays MB. Treatment of snoring and obstructive sleep apnea with a dental orthosis. Chest 1991; 99: 1378-1385. [13] Garcia-Rio F, Racionero A, Pino J et al. Sleep apnea and hypertension. Chest 2000; 117: 1417-1425. [14] Lyons MF, Cameron DA, Banham SW. Snoring, sleep apnoea and the role of dental appliances. Dent Update 2001; 28: 254-256. [15] Ameerican Sleep Disorders Association. The international classifications of sleep disorders. 1990; Rochester, MN. [16] Clark GT, Arand D, Chung E, Tong D. Effect of anterior mandibular positioning on obstructive sleep apnea. Am Rev Respir Dis 1993; 147: 624-629. [17] Grisius R, Moore DJ. Miscellaneous prostheses, Obstructive sleep apnea. In: Beumer J, Curtis TM, Marunick MT. Maxillofacial rehabilitation: Prosthodontic and surgical considerations. 2th Ed., St. Louis, Tokyo, 1996, 515. [18] Eskofi M, Cline C, Nilner M, Israelsson B. Treatment of sleep apnea in congestive heart failure with a dental device. The effect on brain natriuretic peptide and quality of life. Sleep Breath 2006; 10: 90-97. [19] Naismith SL, Winter VR, Hickie IB, Cistulli PA. Effect of oral appliance therapy on neurobehavioral functioning in obstructive sleep apnea: a randomized, controlled trial. JCSM 2005; 1: 374-380. [20] Mehta A, Qian J, Petocz P, Darendeliler MA, Cistulli PA. A randomized, controlled study of a mandibular advancement splint for obstructive sleep apnea. Am J Respir Crit Care Med 2001; 163: 1457-1461. [21] Yamaoka M, Furusawa K, Uematsu T, Okafiju N, Kayamoto D, Kurihara S. Relationship of the hyoid bone and posterior surface of the tongue in prognathism and micrognathia. J Oral Rehabil 2003; 30: 914- 920. [22] Ryan CF, Lowe AA, Li D, Fleetham JA. (1991). Three-dimensional upper airway tomography in obstructive sleep apnea. A prospective study in patients treated by uvulopalatopharyngoplasty. Am Rev Respir Dis 1991; 144: 428-432. [23] Neill A, Whyman R, Bannan S, Jeffrey O, Campbell A. Mandibular advancement splint improves indices of obstructive sleep apnoea and snoring but side effects are common. NZMJ 2002; 115: 1-8. [24] Pae EK, Lowe AA, Fleetham JA. (1997) A role of pharyngeal length in obstructive sleep apnea patients. Am J Orthod Dentofac Orthop 1997; 111: 12-17. [25] Nayar S, Knox J. Management of obstructive sleep apnea in an edentulous patient with a mandibular advancement splint: a clinical report. J Prosthet Dent 2005; 94: 108-111. [26] Johal A, Battagel JM. An investigation into the changes in airway dimension and the efficacy of mandibular advancement appliances in subjects with obstructive sleep apnoea. Br J Orthodont 1999; 26: 205-210. [27] Lamont J, Baldwin DR, Hay KD, Veale GA. Effect of two types of mandibular advancement splints on snoring and obstructive sleep apnoea. Eur J Orthod 1998; 20: 293-297. [28] Millman RP, Rosenberg CL, Kramer NR. Oral appliances in the treatment of snoring and sleep apnea. Clin Chest Med 1998; 19: 69-75. [29] Prinsell JR. Cover story maxillomandibular advancement surgery for obstructive sleep apnea syndrome. J Am Dent Assoc 2002; 133: 1489-1497. [30] L’estrange FR, Battagel JM, Harkness B, Spratley MH, Nolan PJ, Jorgensen GI. A method of studying adaptive changes of the oropharynx to variation in mandibular position in patients with obstructive sleep apnoea. J Oral Rehabil 1996; 23: 699-711. [31] Battagel JM, Johal A, Kotecha B. A cephalometric comparison of subjects with snoring and obstructive sleep apnoea, Cephalometry in sleep disordered breathing. Eur J Orthod 2000; 22: 353-365. [32] Pringle MB, Croft CB. A grading system for patients with obstructive sleep apnoea based on sleep nasendoscopy. Clin Otolaryngol 1993; 18: 480-484. [33] Meyer JB, Knudson RC. (1990). The sleep apnea syndrome. Part II: treatment. J Prosthet Dent 1990; 63: 320-324. [34] Riley RW, Powell NB, Guilleminault C. Maxillary, mandibular, and hyoid advancement for treatment of obstructive sleep apnea: a review of 40 patients, J Oral Maxillofac Surg 1990; 48: 20-26. [35] Knudson RC, Meyer JB, Montalvo R. Sleep apnea prosthesis for dentate patients. J Prosthet Dent 1992; 68: 109-111. [36] Hans MG, Nelson S, Luks VG, Lorkovich P, Baek SJ. Comparison of two dental devices for treatment of obstructive sleep apnea syndrome (OSAS). Am J Orthod Dentofacial Orthop 1997; 111: 562-570. [37] Clark GT, Nakano M. Dental appliances for the treatment of obstructive sleep apnea. J Am Dent Assoc 1989; 118: 611-619. [38] Schmidt-Nowara W, Lowe A, Wiegand L, Cartwright R, Perez-Guerra F, Menn S. Oral appliances for the treatment of snoring and obstructive sleep apnea: a review. Sleep 1995; 18: 501-510. [39] Mohsenin N, Mostofi MT, Mohsenin V. The role of oral appliances in treating obstructive sleep apnea. J Am Dent Assoc 2003; 134: 442-449. [40] Mulligan KM. Obstructive sleep apnoea: a dental perspective. Malta Medical Journal 2003; 15: 32-36. [41] Endo S, Mataki S, Kurosaki N. Cepholometric evaluation craniofacial and upper airway structures in Japanese patients with obstructive sleep apnea. J Med Dent Sci 2003; 50: 109-120. [42] Nayar S, Knox J. Management obstructive sleep apnea in an edentulous patient with a mandibular advancement splint: a clinical report. J Prosthet Dent 2005; 94: 108-111. [43] George P. A modified functional appliance for treatment of obstructive sleep apnea. J Clin Orthod 1987; 21: 171-175. [44] American Sleep Disorders Association Board of Directors. Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances. Sleep 1995; 6: 511-513. [45] Kurtulmuş H. Obstrüktif Uyku Apnesinin tedavisinde prostodontik uygulamalar. Ege Üniversitesi Sağlık Bilimleri Enstitüsü, İzmir, 2004, Doktora Tezi.