Abstract
This paper reports on the case of an oral appliance used in the treatment of obstructive sleep apnea syndrome (OSAS) fitted to a superior total prosthesis. In this case, the chosen device was the adjustable PMPositioner, a mandibular repositioning appliance. A polysomnogram (PSG) both prior and with the oral appliance “in situ” was applied to evaluate the effect of the adaptation of the adjustable PMPositioner fixed onto a maxillary full denture in decreasing the apnea–hypopnea index from 18.0 to 2.2 as well as increasing the minimum oxygen saturation (SaO2 nadir) from 83 to 92%, proving that the device remained in position during sleep.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Dement WC (1990) A personal history of sleep disorders medicine. J Clin Neurophysiol 7(1):17–47
Shahar E, Whitney CW, Redline S, Lee ET, Newman AB, Javier Nieto F, O’Connor GT, Boland LL, Schwartz JE, Samet JM (2001) Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med 163(1):19–25
Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328(17):1230–1235
Ayappa I, Rapoport DM (2003) The upper airway in sleep: physiology of the pharynx. Sleep Med Rev 7(1):9–33
Johal A, Gill G, Ferman A, McLaughlin K (2007) The effect of mandibular advancement appliances on awake upper airway and masticatory muscle activity in patients with obstructive sleep apnoea. Clin Physiol Funct Imaging 27(1):47–53
Vgontzas AN, Bixler EO, Chrousos GP (2005) Sleep apnea is a manifestation of the metabolic syndrome. Sleep Med Rev 9(3):211–224
Chiu KL, Ryan CM, Shiota S, Ruttanaumpawan P, Arzt M, Haight JS, Chan CT, Floras JS, Bradley TD (2006) Fluid shift by lower body positive pressure increases pharyngeal resistance in healthy subjects. Am J Respir Crit Care Med 174(12):1378–1383
Saunamäki T, Jehkonen M (2007) A review of executive functions in obstructive sleep apnea syndrome. Acta Neurol Scand 115(1):1–11
Tan YK, L’Estrange PR, Luo YM, Smith C, Grant HR, Simonds AK, Spiro SG, Battagel JM (2002) Mandibular advancement splints and continuous positive airway pressure in patients with obstructive sleep apnoea: a randomized cross-over trial. Eur J Orthod 24(3):239–249
Li KK, Guilleminault C, Riley RW, Powell NB (2002) Obstructive Sleep Apnea and Maxillomandibular Advancement: an Assessment of Airway Changes Using Radiographic and Nasopharyngoscopic Examinations. J Oral Maxillofac Surg 60(5):526–530
Ferguson KA (2003) The role of oral appliance therapy in the treatment of obstructive sleep apnea. Clin Chest Med 24(2):355–364
Tsuiki S, Lowe AA, Almeida FR, Fleetham JA (2004) Effects of an anteriorly titrated mandibular position on awake airway and obstructive sleep apnea severity. Am J Orthod Dentofac Orthop 125(5):548–555
Lowe AA (1999) Titratable oral appliances for the treatment of snoring and obstructive sleep apnea. J Can Dent Assoc 65(10):571–574
Barthlen GM, Brown LK, Wiland MR, Sadeh JS, Patwari J, Zimmerman M (2000) Comparison of three oral appliances for treatment of severe obstructive sleep apnea syndrome. Sleep Med 1(4):299–305
Kushida CA, Morgenthaler TI, Littner MR, Alessi CA, Bailey D, Coleman J, Friedman L, Hirshkowitz M, Kapen S, Kramer M, Lee-Chiong T, Owens J, Pancer JP, American Academy of Sleep Medicine (2006) Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances: An update for 2005. Sleep 29(2):240–243
Nayar S, Knox J (2005) Management of obstructive sleep apnea in an edentulous patient with a mandibular advancement splint: a clinical report. J Prosthet Dent 94(2):108–111
Meyer JB, Knudson RC (1990) Fabrication of a prosthesis to prevent sleep apnea in edentulous patients. J Prosthet Dent 63(4):448–451
McNamara JA (1984) A method of cephalometric evaluation. Am J Orthod 86(6):449–469
Tsuiki S, Hiyama S, Ono T, Imamura N, Ishiwata Y, Kuroda T, Lowe AA (2001) Effects of a titratable oral appliance on supine airway size in awake non-apneic individuals. Sleep 24(5):554–560
Riley R, Guilleminault, Herran J, Powell N (1983) Cephalometric analyses and flow-volume loops in obstructive sleep apnea patients. Sleep 6(4):303–311
Otsuka R, Ribeiro de Almeida F, Lowe AA, Linden W, Ryan F (2006) The effect of oral appliance therapy on blood pressure in patients with obstructive sleep apnea. Sleep Breath 10(1):29–36
Coruzzi P, Gualerzi M, Bernkopf E, Brambilla L, Brambilla V, Broia V, Lombardi C, Parati G (2006) Autonomic cardiac modulation in obstructive sleep apnea: effect of an oral jaw-positioning appliance. Chest 130(5):1362–1368
Clark GT (1998) Mandibular advancement devices and sleep disordered breathing. Sleep Med Rev 2(3):163–174
Bucca C, Cicolin A, Brussino L, Arienti A, Graziano A, Erovigni F, Pera P, Gai V, Mutani R, Preti G, Rolla G, Carossa S (2006) Toothloss and obstructive sleep apnoea. Respir Res 17;7,8
Acknowledgement
We would like to thank State of Sao Paulo Research Support Foundation (local acronym FAPESP) for supporting this study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Giannasi, L.C., Magini, M., de Oliveira, C.S. et al. Treatment of obstructive sleep apnea using an adjustable mandibular repositioning appliance fitted to a total prosthesis in a maxillary edentulous patient. Sleep Breath 12, 91–95 (2008). https://doi.org/10.1007/s11325-007-0134-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11325-007-0134-x