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Journal of American Science, 2010;6(11)
Management of obstructive sleep apnea using oral appliance with magnetic versus increase vertical dimension
Mohamed. A. Saad-Eldeen1, Shawky M. Elmorsy2, Shaza. M. Hammad3
1
Ass. Prof., Prosthodontic Department, Faculty of Dentistry, Mansoura University 2 Ass. Prof, ENT Department, Faculty of Medicine, Mansoura University 3 Lecturer, Orthodontic Department, Faculty of Dentistry, Mansoura University. mohamed.elkhodary@hotmail.com
Abstract Statement of Problem: Oral devices may be helpful in the management of obstructive sleep apnea by improving upper airway potency. Purpose: Management of obstructive sleep apnea using oral appliance with magnetic versus oral appliance with increased vertical dimension. Material and Methods: 12 patients with mild to moderate obstructive sleep apnea were evaluated in this study before and after wearing devices for six months. The patients randomly divided into two equal groups(A and B ). Group A used oral appliances with magnetic for six month Patients in group B wear oral appliances with increased vertical dimension, Evaluation was done by Polysomnograph, clinical findings and cephalometric x-rays. Results: The results of this study revealed that improvement of clinical finding, symptoms and apnea index for patients wearing two types of oral appliance. Conclusions: It can be concluded that oral appliance, with magnetic and increase vertical dimension, make improvement for OSA patients oral appliances with magnets are more effective in management of mild and moderate obstructive sleep apnea in comparison to appliances with increased vertical dimension. [Mohamed. A. Saad-Eldeen, Shawky M. Elmorsy, Shaza. M. Hammad. Management of obstructive sleep apnea using oral appliance with magnetic versus increase vertical dimension. Journal of American Science 2010;6(11):734-741]. (ISSN: 1545-1003). Keywords: Management; obstructive; sleep; apnea; oral appliance; magnetic; dimension Introduction Obstructive sleep apnea (OSA) is repetitive episodes of upper air way obstruction during sleep, arterial oxygen desaturation, daytime hypersomnolence and snoring. (1) In addition, these patients are at increased risk for hypertension, heart failure myocardial infarction and stroke and road and traffic accidents when compared with general population.(2,3) The site of sleep dependent obstruction in OSA is usually in the retro palatal or the retroglossal region or both, the upper air way lumen. Several studies demonstrate that oral appliances can be a useful alternative to positive air way pressure with mild to moderate sleep apnea . (4,5) There is also robust evidence of the efficacy of oral appliances for improving polysomnographic indices and modifying the health risk associated with OSA. (6) Oral device may be helpful in the management of OSA by; improving upper air way potency, increasing the cross sectional area or decreasing the upper air way collapsibility by increasing the muscle tone . (7) Orthodontists who get involved in this form of therapy are often surprised at how grateful their patients are after only a few nights of sleep without interruption and the subsequent restoration of adequate rapid eye movement (REM) sleep. (8) The main advantages of oral devices are their relative simplicity of the treatment, reversibility , cost effectiveness and providing a genuine non surgical alternative to patients who can't tolerate continuous positive airway pressure devices ( CPAP) or who represent a poor surgical risk . Also, they enhance craniofacial growth. (9) The US FDA approved 16 devices for use in sleep apnea oral appliances as an alternative to CPAP therapy. They are designed to keep upper air way open. (10) Although Mandibular Advancement Device (MAD) has positive effect in treatment of OSAS, it has multiple complications. These may include craniofacial change in maxillomandibular relationship and bony dimensions, overbite alteration, tooth pain and TMJ problems. (11) In 2003, Iranhoe(12) suggested other devices claimed to increase vertical jaw separation. Frantz, 2001(13) mentioned that the effectiveness of such appliance improved when increasing vertical opening exceeding the rest position up to 5mm opening and

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