Abstract Archives

IADR Abstract Archives

INTRAORAL DEVICES FOR OSA TREATMENT IN EDENTULOUS PATIENTS. LITERATURE AND PATENTS DATEBASE REVIEW.

Objectives: The Obstructive Sleep Apnea (OSA) is considered a problem of World Public Health that affects a big part of men and women between 50 and 70 years old, which is difficult to treat in many occasions because they can be edentulous patients. The objective of this study was to identify the existing devices for mild and moderate OSA treatment in edentulous patients.
Methods: To achieve the objective of this work a review of the literature and patent was conducted in the databases Science Direct, Pubmed and Thomson Innovation.
Results: A comprehensive review was conducted in the literature and patent databases, obtaining only 5 articles and 2 patents about intraoral devices to treat OSA in edentulous patients. The main therapy objective in all devices is to increase the upper airway space between the tongue base and the posterior pharyngeal wall trough mandibular advancement. Although the 7 devices can increase the upper airway through mandibular advancement placed directly on the patient's edentulous ridge, one of them is supported on the prosthesis. Several problems with use of these devices include lack retention, difficult for maintain the vertical dimension, allergies, muscular discomfort and Temporomandibular Disorders.
Conclusions: There are limited effective intraoral devices in literature for OSA treatment in edentulous patients. Therefore it is necessary to design future investigations in this area.
Division: Latin American Region Meeting
Meeting: 2015 Latin American Region Meeting (Bogota, Colombia)
Location: Bogota, Colombia
Year: 2015
Final Presentation ID:
Abstract Category|Abstract Category(s): Clinical studies
Authors
  • Galdon Torres, Roneith  ( Pontificia Universidad Javeriana , Bogota , Bogota , Colombia )
  • Peña Petit, Vanessa  ( Pontificia Universidad Javeriana , Bogota , Bogota , Colombia )
  • Suarez, Angela  ( Pontificia Universidad Javeriana , Bogota , Bogota , Colombia )
  • Lara, Laura  ( Pontificia Universidad Javeriana , Bogota , Bogota , Colombia )
  • Otero, Liliana  ( Pontificia Universidad Javeriana , Bogota , Bogota , Colombia )
    • Financial Interest Disclosure: The authors report no relevant conflicts of interest
    SESSION INFORMATION
    Oral Session
    CLINICAL STUDIES IV -FRIDAY OCTOBER 9th
    Friday, 10/09/2015 , 10:00AM - 11:30AM
    TABLES
    Annex
    Name and autorPatent NumberAdvantageDisadvantage
    Keyf F, Ciftci B, Firat S. Management of obstructive sleep apnea in edentulous lower jaw patient with a mandibular advancement device. Case Reports in Dentistry. Case Reports in Dentistry Vol 2014, Article ID 436904, 4 pages-
    1. Increase the anteroposterior dimension of the oropharynx.
    2. Easy fabrication.    		1. Preferably it requires some teeth to greater retention
    2. It requires greater retention implants in edentulous patients.
    Nayar S, Knox J. Management of obstructive sleep apnea in an edentulous patient with a mandibular advancement splint: a clinical report. The Journal of Prosthetic dentistry. Volume 94 Number 2.-1. Simplicity in design
    2. It does not increase the vertical dimension    		1. In patients with limited opening it is difficult to insert.
    2. It does not allow lateral movements.
    Kurtulmus H, Cotert S. Management of Obstructive Sleep apnea with a mandibular and tongue advancement splint (MTAS) in edentulous Patient. A clinical report. Journal of Prosthodontics 18 (2009) 348–352.-1. Easy fabrication
    2. Economic, fully realized in acrylic.    		1. It does not allow the mobility of the tongue.
    2. Increases the patient's normal vertical dimension.
    Piskin B, et al. Efficacy of a modified mandibular advancement device for a totally edentulous patient with severe obstructive sleep apnea. Sleep Breath (2010) 14:81–85.-1. Does not increase the vertical dimension.
    2. It creates more space for the tongue.    		1. Monoblock.
    2. Poor retention.
    3. In the long term can generate ATM and myofascial pain.
    Nelogi S, Porwal A, Naveen H. Modified mandibular advancement appliance for an edentulous obstructive sleep apnea patient: A clinical Report. Journal of Prosthodontic Reserch. 55 (2011) 179–183.-1. It can be used on the patient's dentures.
    2. Greater retention because their manufacture is directly on the dentures.    		1. It requires further study to assess long-term adverse effects.
    Awake airway: non stimulating (Non-Gagging) feature.US patent US2008/0153057 A11. It can be used in patients with teeth and edentulous.
    2. It allows adjusting the opening angle.
    3. It can be used while you are awake.    		1. It does not allow lateral movements.
    2. Depending on the angle generates a very wide mouth opening.
    Apparatus for the reduction of apnaa in the edentulous.US patent 5,018,5331. Search and maintains the neuromuscular balance.
    2. Generate more space in the oral cavity, giving more freedom of movement and spatial location of the tongue.    		1. Holds the tongue forward, which over time can cause damage to the muscles.
    2. Excessively increases the vertical dimension.