1/4. Genioglossal advancement--a simple surgical procedure for sleep apnea. Case report and literature review.Although the use of a standard nasal continuous positive airway pressure device to combat obstructive sleep apnea is often effective, it is neither curative nor universally well tolerated. Thus, surgical intervention is often inevitable. We describe a simple, conservative surgical procedure performed on a patient with profound mandibular retrognathia (dolichofacial type), accompanied by sleep apnea. The procedure resulted in a significant pharyngeal airway enlargement of 53 and 87% at the mandible angle and hyoid bone levels, respectively, increased oxygen saturation, reduction in the respiratory disturbance index by 50%, and improved sleep quality. We present a procedure for patients whose sleep apnea is due to extensive mandibular retrognathism with concomitant retrolingual narrowing and collapse.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
2/4. Orofacial complications associated with forward repositioning of the mandible in snore guard users.snoring and obstructive sleep apnea (OSA) result from a collapse of the tongue, soft palate, and pharynx, causing temporary airway blockage. Acrylic mandibular advancement splints and Herbst appliances are used to relieve snoring and mild OSA. Repositioning the mandible forward may have an adverse effect on the orofacial and dentoalveolar structures of susceptible individuals. This article reports two cases in which orofacial complications developed following the utilization of snore guard appliances.- - - - - - - - - - ranking = 5keywords = mandible (Clic here for more details about this article) |
3/4. A three-dimensional airway assessment for the treatment of snoring and/or sleep apnea with jaw repositioning intraoral appliances: a case study.The purpose of this snoring/sleep apnea study was to assess the role of 3-D magnetic resonance imaging (MRI) of the airway correlated to jaw reposturing/intraoral appliance design. A clinical case is presented utilizing this technology, integrating a diagnostic baseline and follow-up sleep study/ polysomnograph. The baseline polysomnography, prior to jaw repositioning appliance design, indicated a respiratory disturbance index (RDI) of 21.5 hypopnea/apneas per hour. The follow-up sleep study, with use of an intraoral repositioning appliance, showed a 3.9 per hour RDI, an 82% RDI reduction/improvement. Magnetic resonance TMJ and airway images were done. The MRI enhanced airway assessment computer software program analyzed the 3-dimensional volume and cross sectional area changes from hard/soft palate junction to epiglottis. Imaged were the oropharynx nasopharynx and hypopharynx regional anatomy. The baseline, without mandibular positioning device, showed a total airway volume of 5,801.31 cubic mm, whereas with the mandibular positioning device in place, the total airway volume was increased to 8,657.22 cubic mm or a total increased volume of 32%. The largest improvement site in the airway was the mid-soft palatal uvula/nasopharynx region, with base of tongue moving forward. Along with traditional polysomnography, 3-dimensional MRI airway imaging should be considered as a diagnostic procedure in assessing sleep apnea patients. The necessity of a combined medical/dental team approach is emphasized.- - - - - - - - - - ranking = 1.7322632545674keywords = jaw (Clic here for more details about this article) |
4/4. Oral appliance therapy for obstructive sleep apnea syndrome: progressive mandibular advancement during polysomnography.Six patients diagnosed with obstructive sleep apnea completed titration of an adjustable oral appliance, called the Silencer, during a single night of polysomnography. This protocol allowed for rapid titration of the oral appliance and effective treatment of sleep apnea. Variables which showed improvement included frequency of obstructive events, oxyhemoglobin saturation and snoring. Dental appliance adjustments with the silencer device can be made within three minutes. We have demonstrated that incremental mandibular advancement and repositioning allow us to determine the most effective jaw position to treat sleep apnea and snoring, which is also most likely to be tolerated by the patient.- - - - - - - - - - ranking = 0.28871054242789keywords = jaw (Clic here for more details about this article) |