- Mandibular advancement splints for the treatment of obstructive sleep apnea. [Journal Article]Expert Rev Respir Med 2019; :1-8ER
- Introduction: Obstructive sleep apnea (OSA) is a chronic condition which requires a comprehensive chronic disease management model, rather than a device-focused approach, so as to achieve the best possible health outcomes. Oral appliances are the main alternative to continuous positive airway pressure (CPAP) for the treatment of OSA. There has been an expansion of the research evidence to support…
Introduction: Obstructive sleep apnea (OSA) is a chronic condition which requires a comprehensive chronic disease management model, rather than a device-focused approach, so as to achieve the best possible health outcomes. Oral appliances are the main alternative to continuous positive airway pressure (CPAP) for the treatment of OSA. There has been an expansion of the research evidence to support the use of oral appliances in clinical practice and the clinical use of oral appliances for the treatment of OSA has become a mainstream practice.Areas covered: This review summarizes the evidence base for the use of oral appliances for the treatment of OSA. The types of oral appliances; their mechanism of action and clinical efficacy for the treatment of OSA; adverse effects, and the impact on patient acceptability and treatment adherence; and clinical effectiveness and health outcomes are discussed.Expert opinion: Personalization of treatment is vitally important in OSA and is a pre-requisite for optimizing adherence with treatment which, in turn, is a key determinant of clinical effectiveness. Treatment of OSA with mandibular advancement splints could provide an equivalent health benefit to CPAP despite not achieving a complete normalization of polysomnographic indices, mediated by differences in adherence profiles.
- Oral appliance therapy in obstructive sleep apnea and snoring - systematic review and new directions of development. [Journal Article]Cranio 2019; :1-12C
- CONCLUSIONS: The mandibular advancement device is an effective treatment, improving the Apnea Hypopnea Index and the symptoms of patients with OSA in 92% of the subjects from all the investigated studies. The future may include the integration of a biosensor for the diagnosis and follow-up. Abbreviations: OSA: Obstructive sleep apnea; MADs: Mandibular advancement devices; CPAP: Continuous positive airway pressure; OAT: Oral appliance therapy; MRD: Mandibular repositioning devices; MAS: Mandibular advancement splints; MAA: Mandibular advancement appliances; OA: Oral appliances; AASM: American Academy of Sleep Medicine; AHI: Apnea-hypopnea index; EEG: Sleep-related breathing disorder SRBD; Electroencephalogram; EOG: Electrooculogram; ECG: Electrocardiogram; QOL: Quality of life; TMJ: Temporomandibular joint.
- Dose-dependent effects of mandibular advancement on optimal positive airway pressure requirements in obstructive sleep apnoea. [Journal Article]Sleep Breath 2019SB
- CONCLUSIONS: Increasing mandibular advancement lowers optimal CPAP requirements in a dose-dependent manner. This supports prior work indicating a beneficial effect of MAS on upper airway collapsibility.
- Polysomnographic Endotyping to Select Patients with Obstructive Sleep Apnea for Oral Appliances. [Journal Article]Ann Am Thorac Soc 2019; 16(11):1422-1431AA
- CONCLUSIONS: Quantifying OSA traits using clinical polysomnography can identify an endotype-based subgroup of patients that is highly responsive to oral appliance therapy. Prospective validation is warranted.
- Mandibular advancement splints for obstructive sleep apnoea - a cautionary tale. [Journal Article]Aust Dent J 2019AD
- CONCLUSIONS: Based on this study, mandibular advancement splint therapy is a viable treatment for a subset of patients with obstructive sleep apnoea. Protocol driven, multi-disciplinary care with auditing of results is recommended.
- Cephalometric outcomes of a new orthopaedic appliance for Class III malocclusion treatment. [Journal Article]Eur J Orthod 2019EJ
- CONCLUSIONS: This study presents a short-term evaluation of the treatment and the use of a historical control group.The PS3 was effective for the treatment of Class III malocclusion in growing patients, with favourable maxillary advancement and control of the vertical skeletal relationships.
- An update on the current management of adult obstructive sleep apnoea. [Journal Article]Aust J Gen Pract 2019; 48(4):182-186AJ
- Obstructive sleep apnoea (OSA) is common in adults. Various contributing factors to this condition have resulted in the development of a number of potential treatment modalities, some of which are in evolution. A multidisciplinary team involving the general practitioner is an important aspect in providing personalised care.
Obstructive sleep apnoea (OSA) is common in adults. Various contributing factors to this condition have resulted in the development of a number of potential treatment modalities, some of which are in evolution. A multidisciplinary team involving the general practitioner is an important aspect in providing personalised care.
- Outcomes After Tooth-Bearing Maxillomandibular Facial Transplantation: Insights and Lessons Learned. [Journal Article]J Oral Maxillofac Surg 2019; 77(10):2085-2103JO
- CONCLUSIONS: Maxillomandibular transplantation is a viable reconstructive solution for composite midface defects not amenable to autologous reconstruction. Improvement of functional outcomes and prevention of major complications rely on close attention to occlusal relationships, temporomandibular joint dynamics, dental health, and the intraoral donor-recipient soft tissue interface.
- Combination therapy with mandibular advancement and expiratory positive airway pressure valves reduces obstructive sleep apnea severity. [Journal Article]Sleep 2019; 42(8)S
- CONCLUSIONS: Combination therapy with a novel MAS device and simple oral or oro-nasal EPAP valves reduces OSA severity to therapeutic levels for a substantial proportion of incomplete/nonresponders to MAS therapy alone.
New Search Next
- Subjective versus objective dental side effects from oral sleep apnea appliances. [Journal Article]Sleep Breath 2019SB
- CONCLUSIONS: Patients who choose to continue long-term treatment with oral appliances for sleep apnea are unaware of various types of bite changes. Such changes will, however, progressively increase in magnitude and be more difficult to take care of, if needed. It is therefore important continuously to follow up patients in regard to bite changes.