If you want to improve the materials used and the effectiveness of oral appliances for treating obstructive sleep apnea, remember that their significant evolution is related to project (design), material selection and calibration systems. Additionally, reduced vertical height, minimum advancement, and enhanced stability (retention) contribute to therapeutic success.
Multiple studies have confirmed the effectiveness of oral appliances in treating OSA. According to the latest guidelines from the American Academy of Sleep Medicine (AASM), these devices can be used for all degrees of severity. Therefore, patients should have the option to choose between CPAP therapy and oral appliances. A certified dentist must recommend the best solution for each case, considering the individual benefits of each treatment. In many instances, patients may benefit from a combination of therapies.
This article evaluated 102 participants who used a digitally designed oral appliance. The results, verified through Type III and IV polysomnography, showed a 69% success rate, with severe cases achieving an almost 75% success rate.
The study also highlighted that oral appliances with a minimal vertical dimension (up to 2mm) required less mandibular protrusive than taller devices. A previous study showed that there is a corresponding 3mm loss in mandibular protrusion for every millimetre increase. Higher oral appliances require greater advancement, which does not necessarily improve sleep apnea. Furthermore, excessive advancement can increase side effects such as muscle or joint pain, leading to higher treatment dropout rates.
It is crucial to personalize treatment plans to achieve better results, considering factors such as manufacturing method (conventional or digital), material selection, calibration type, and allowance for lateral or vertical movement, among others.
By Dr. Walter Silva Júnior
Sleep dentist certified by the American Board of Dental Sleep Medicine (ABDSM).
Ph.D. in Sleep Medicine at the Hospital for Rehabilitation of Craniofacial Anomalies/University of São Paulo – Bauru, São Paulo.
Website: http://www.institutowaltersilva.com.br/
Instagram: @walter_silva_odontologiadosono
REFERENCE: A Multicenter Prospective Study on the Use of a Mandibular Advancement Device in the Treatment of Obstructive Sleep Apnea.
Anitua, E. et al.
Dent. J. 2023, 11, 247
The Biologix Sleep Test®
Diagnosing obstructive sleep apnea is both simple and essential.
The Biologix Sleep Test® is a remote polysomnography that monitors oxygen saturation, heart rate, actigraphy, and snoring using a smartphone microphone.
Designed for at-home use, this test offers a simple yet effective method for healthcare practitioners to diagnose and monitor sleep apnea.
At bedtime, the patient only needs to place the sensor on their finger and start the test in the Biologix app. Upon waking up the next morning, after finishing the test, the result will be available at the exam portal in a matter of seconds.
