Keywords
PMPositioner, oral appliance, sleep apnea, sleep disorders.
How to Cite
Uso del aparato bucal PMpositioner" en el tratamiento del ronquido y la apnea obstructiva del sueño. (2010). Odontoestomatología, 12(15), 39-45. https://odon.edu.uy/ojs/index.php/ode/article/view/220
Abstract
The choice of an adequate oral appliance is very important in the treatment of obstructive sleep apnea. The present study evaluated the effect of PMPositioner for the treatment of snoring and mild obstructive sleep apnea through polysomnography and Epworth Sleep Scale prior to treatment and after six months. Seventeen patients, divided into 2 groups, snoring (n=7) and 10 with mild obstructive sleep apnea were enrolled. The results were significant for obstructive sleep apnea group reveling a decrease in the apnea/hypopnea index from 7.4±5.0 to 3.0±2.5 (p<0.05), an increase in oxigen saturation from 88.0±6.0 to 90.0±2.8 (p<0.05), an increase in REM sleep from 16.0±6.0 to 19±4.0 and a sleepiness improved in from 12.5±5.4 to 7.4±2.4. Furthermore, it was noticed an improvement in snoring and subjective symptoms according to reports from the patients and their partners. We conclude that the PM Positioner is efficient in the treatment of snoring and mild obstructive sleep apnea and in reduction of sleepiness and others symptoms.
References
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27. Tsuik S, Lowe AA, Almeida FR, Fleethan JA. Effects of an anteriorly titrated mandibular position on awake airway and obstructive sleep apnea severity. Am J Orthod Dentofacial Orthop. 2004;125:548-55.
28. Marklund M, Sahlin C, Stenlund H, Person M, Franklin KA. Mandibular advancement device in patient with obstructive sleep apnea: long-term effects on apnea and sleep. Chest. 2000;120:162-69.
29. Rose E, Mering L, Frucht S, Virchow C, Jonas IE. Oral Appliances in Patients with Obstructive Sleep Apnoea-Polysomnographic outcome. Eur J Orthod. 2000;22:456-57.
30. Wolk R, Ahamsuzzaman A, Somers VK. Obesity, sleep apnea, and hypertension. Hypertension. 2003; 42:1067-74.
31. Isono S. Contribution of obesity and craniofacial abnormalities to pharyngeal collapsibility in patients with obstructive sleep apnea. Sleep and Biological Rythms. 2003;2:17-21.
32. Ward FW, McNicholas WT. Clinical prediction of the sleep apnea syndrome. Sleep Med Rev. 1997; 1: 19-32.
33. Walker-Engström ML, Ringqvist I, Vestling O, Wilhelmsson B, Tegelberg AA. Prospective Randomized Study Comparing Two Different Degrees of Mandibular Advancement with a Dental Appliance in treatment of Severe Obstructive Sleep Apnea. Sleep and Breath. 2003; 10:119-30.
34. Almeida FR, Bittencourt LR, de Almeida CIR, Tsuik S, Lowe AA, Tufik S. Effects on Mandibular Posture on Obstructive Sleep Apnea Severity and the Temporomandibular Joint in Patients Fitted with an Oral Appliance. Sleep. 2002; 25(5):505-11.
35. Johal A, Gill G, Ferman A, McLaughlin K. The effect of mandibular advancement appliances on awake upper airway and masticatory muscle activity in patients with obstructive sleep apnoea. Clin Physiol Funct Imaging. 2007; 27:47–53.
2. Ayappa I, Rapoport DM. The upper airway in sleep: physiology of the Pharynx. Sleep Medicine Reviews. 2003;7(1):9-33.
3. Mahfoud Y, Talih F, Streem D, Budur K. Sleep disorders in substance abusers: how common are they? Psychiatry (Edgmont). 2009; 6(9):38-42.
4. Shepard JW Jr, Gefter WB, Guilleminault C, Hoffman EA, Hoffstein V, Hudgel DW, Suratt PM, White DP. Evaluation of the upper airway in patients with obstructive sleep apnea. Sleep. 1991; 14(4):361-71. Review .
5. Chiu KL, Ryan CM, Shiota S, Ruttanaumpawan P, Arzt M, Haight JS, Chan CT, Floras JS, Bradley TD. Fluid shift by lower body positive pressure increases pharyngeal resistance in healthy subjects. Am J Respir Crit Care Med. 2006; 174(12):1378-1383.
6. Tsuda H, Fastlicht S, Almeida FR, Lowe AA. The correlation between craniofacial morphology and sleep-disordered breathing in children in an undergraduate orthodontic clinic. Sleep Breath. 2010; DOI 10.1007/s11325-010-0345-4.
7. Sleep–Related Breathing Disorders in Adults: Recommendations for Syndrome Definition and Measurement Techniques in Clinical Research- The Report of an American Academy of Sleep Medicine Task Force. Sleep. 1999; 22(5): 667-89.
8. Zias N, Bezwada V, Gilman S, Chroneou A Obstructive sleep apnea and erectile dysfunction: still a neglected risk factor? Sleep Breath. 2009; 13: 3-10.
9. Provini F, Vetrugno R, Lugaresi E, Montagna P. Sleep-related breathing disorders and headache. Neurol Sci. 2006; 27 Suppl 2:S149-52.
10. Zamarron C, García Paz V, Riveiro A. Obstructive sleep apnea syndrome is a systemic disease. Current evidence. Eur J Intern Med. 2008;19(6):390-8.
11. Hoffstein V. Review of oral appliances for treatment of sleep-disordered breathing. Sleep Breath. 2007; 11:1-22.
12. Lowe AA. Titratable Oral Appliances for the Treatment of Snoring and Obstructive Sleep Apnea. J Can Dent Assoc. 1999; 65:571-4.
13. Vanderveken OM, Devolder A, MArklund M et al. Comparison of a Custom-made and a Thermoplastic Oral Appliance for the Treatment of Mild Sleep Apnea. Am J Respir Crit Care Med. 2008; 178:197–202.
14. Rose E, Staats R, Virchow C et al. A comparative study of two mandibular advancement appliances for the treatment of obstructive sleep apnoea. Eur J Orthod. 2002; 24:191-98
15. Coruzzi P, Gualerzi M, Bernkopf E, Brambilla V, Broia V, Lombardi C, Parati G. Autonomic Cardiac Modulation in Obstructive Sleep Apnea: Effect of an Oral Jaw-Positioning Appliance. Chest. 2006;130:1362-68.
16. Otsuka R, Almeida F R, Lowe A A, Linden W, Ryan F. A comparison of responders and nonresponders to oral appliance therapy for the treatment of obstructive sleep apnea. Am J Orthod Dentofacial Orthop. 2006;129:222-9.
17. Tan Y K, L’estrange P R, Luo Y M, Smith C, Grant H R, Simonds A K. Mandibular Advancement Splints and Continuous Positive Airway Pression in Pacients with Obstructive Sleep Apnea: a mandibular randomized cross-over trial. Eur J Orthod. 2002; 24: 239-49.
18. Johnston C D, Gleadhill I C, Cinnamond M J, Gabbey J, Burden D J. Mandibular advancement appliance and OSA a randomized clinical trial. Eur J Orthod. 2002; 24:251-62.
19. Giannasi LC, Magini M, Oliveira CS, Oliveira LVF. Treatment of obstructive sleep apnea using an adjustable mandibular repositioning appliance fitted to a total prosthesis in a maxillary edentulous patient. Sleep Breath. 2008; 12(1):91-95.
20. Schimidt-Nowara W, Lowe A A, Wiegand L, Cartwright R, Perez-Guerra F, Menn S. Oral appliances for treatment of snoring and sleep apnea a review. Sleep. 1995;18(6):501-510.
21. Lowe AA, Sjoholm T, Ryan CF, Fleetham JA, Ferguson KA, Remmers JE. Treatment, airway, and compliance effects of titrattable oral appliance. Sleep. 2000; 23:172-78.
22. Giannasi LC, Magini M, Costa MS, Oliveira CS, Oliveira LVF. Oral appliance treatment for obstructive sleep apnea in partly edentulous patient. Am J Orthod Dentofacial Orthop. 2010; 137:548-51.
23. Kushida CA, Morgenthaler TI, Littner MR et al. Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances: An update for 2005. Sleep. 2006; 29:240-43.
24. Johns, MW. Daytime sleepiness, snoring, and obstructive sleep apnea. Chest. 1993; 103:30-36.
25. Rechtschaffen A, Kales A. A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. Los Angeles: UCLA. Brain Information Service/Brain Research Institute, 1968.
26. Tsuiki S, Lowe AA, Almeida FR, Kawahata N, Fleetham JA. Effects of mandibular advancement on airway curvature and obstructive sleep apnoea severity. Eur Respir. 2004; 23:263-68.
27. Tsuik S, Lowe AA, Almeida FR, Fleethan JA. Effects of an anteriorly titrated mandibular position on awake airway and obstructive sleep apnea severity. Am J Orthod Dentofacial Orthop. 2004;125:548-55.
28. Marklund M, Sahlin C, Stenlund H, Person M, Franklin KA. Mandibular advancement device in patient with obstructive sleep apnea: long-term effects on apnea and sleep. Chest. 2000;120:162-69.
29. Rose E, Mering L, Frucht S, Virchow C, Jonas IE. Oral Appliances in Patients with Obstructive Sleep Apnoea-Polysomnographic outcome. Eur J Orthod. 2000;22:456-57.
30. Wolk R, Ahamsuzzaman A, Somers VK. Obesity, sleep apnea, and hypertension. Hypertension. 2003; 42:1067-74.
31. Isono S. Contribution of obesity and craniofacial abnormalities to pharyngeal collapsibility in patients with obstructive sleep apnea. Sleep and Biological Rythms. 2003;2:17-21.
32. Ward FW, McNicholas WT. Clinical prediction of the sleep apnea syndrome. Sleep Med Rev. 1997; 1: 19-32.
33. Walker-Engström ML, Ringqvist I, Vestling O, Wilhelmsson B, Tegelberg AA. Prospective Randomized Study Comparing Two Different Degrees of Mandibular Advancement with a Dental Appliance in treatment of Severe Obstructive Sleep Apnea. Sleep and Breath. 2003; 10:119-30.
34. Almeida FR, Bittencourt LR, de Almeida CIR, Tsuik S, Lowe AA, Tufik S. Effects on Mandibular Posture on Obstructive Sleep Apnea Severity and the Temporomandibular Joint in Patients Fitted with an Oral Appliance. Sleep. 2002; 25(5):505-11.
35. Johal A, Gill G, Ferman A, McLaughlin K. The effect of mandibular advancement appliances on awake upper airway and masticatory muscle activity in patients with obstructive sleep apnoea. Clin Physiol Funct Imaging. 2007; 27:47–53.