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Immunologic and Physiologic Effects of Dental Sleep Appliance Therapy

  • G. Gary DemerjianEmail author
  • Pooja Goel
Chapter

Abstract

Obstructive sleep apnea (OSA) is characterized by episodes of oropharyngeal obstruction due to repetitive collapse of the oropharyngeal tissues during sleep. OSA is associated with sleep fragmentation, hypoxemia, hypercapnia, marked swings in intrathoracic pressure, increased sympathetic activity, and cardiovascular complications.There are multiple medicalrisk factors for patients diagnosed with OSA and evidence showing improvement of health factors with the treatment of positive airway pressure (PAP) therapy.

 Multiple forces contribute to oropharyngeal collapse, including the elongation of the soft palate and uvula, loss of vertical dimension resulting in a shortening of the lower 1/3rd of the face, increase in tongue size due to fat deposition in the tongue, constriction of dental arches, negative transmural pressure gradient and tissue weight. The goal of this chapter is to show the correlation and improvements on immunologic and physiologic effects of dental sleep appliance therapy based on the improvements seen with PAP therapy.

Abbreviations

AASM

American Academy of Dental Sleep Medicine

AHI

Apnea-hypopnea index

BMI

Body mass index

CGRP

Calcitonin gene-related peptide

CKD

Chronic kidney disease

CPAP

Continuous positive airway pressure

CPH

Craniofacial Pain Handbook

CT

Computerized tomography scan

GERD

Gastroesophageal reflux disorder

GPT-9

Glossary of Prosthodontic Terms Ninth Edition

HTR

Hormone replacement therapy

IBS

Irritable bowel syndrome

ICSD-3

International Classification of Sleep Disorders Third Edition

LES

Lower esophageal sphincter

MA

Microarousals

MRI

Magnetic resonance imaging

OAT

Oral appliance therapy

ODI

Oxygen desaturation index

ODS

Obsessive daytime sleepiness

OFPG-4

Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management, Fourth Edition

OSA

Obstructive sleep apnea

PAP

Positive airway pressure

PAS

Posterior airway space

PGP 9.5

Protein gene product 9.5

PM

Portable monitors

PSG

Polysomnogram

RAAS

Renin angiotensin-aldosterone system

RDI

Respiratory distress index

REM

Rapid eye movement

RME

Rapid maxillary expansion

RMMA

Rhythmic masticatory muscle activity

RPS

Retropharyngeal space

SB

Sleep-related bruxism

SP

Substance P

TAD

Temporary anchorage device

TCR

Trigemino-cardiac reflex

TMD

Temporomandibular joint disorder

TST

Total sleep time

TTH

Tension-type headache

VDO

Vertical dimension of occlusion

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Center for TMJ & Sleep TherapyGlendoraUSA
  2. 2.Smiles for Life Dental GroupSanta ClaritaUSA

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