Original article
The effect of a modified functional appliance on obstructive sleep apnea

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Abstract

This study combined the use of cephalometrics and overnight polysomnographic monitoring to analyze the effects of a modified functional appliance on airway, sleep, and respiratory variables in patients with obstructive sleep apnea (OSA). Twelve patients without overt anatomic or pathologic evidence of obstruction were selected on the basis of an initial single night of polysomnographic monitoring, which confirmed the diagnosis of obstructive sleep apnea syndrome. The patients subsequently were fitted with a modified functional appliance designed to securely hold the mandible in an anterior-inferior position. A subsequent overnight polysomnographic study was obtained with each patient wearing the appliance. Lateral cephalometric radiographs with and without the appliance in place were also obtained. The mean vertical and horizontal changes in mandibular position while wearing the appliance were 8.49 mm and 2.28 mm, respectively. The findings indicate that 10 of the 12 patients had decreases in the rate of complete airway obstructions from a mean of 28.86 to 18.69 events per hour, and in the total apnea index from a mean of 53.81 to 35.99 events per hour. A reduction in the rate of obstructive events is attributed to the effect of the appliance on the oropharyngeal structures. Six cephalometric measurements are presented to provide a means of assessing effects of the appliance on the oropharynx and associated structures. The modified functional appliance is a conservative, successful treatment alternative that could benefit patients with obstructive sleep apnea syndrome.

References (26)

  • J.E. Remmers et al.

    Pathogenesis of upper airway occlusion during sleep

    J Appl Physiol

    (1978)
  • H. Gastaut et al.

    Mechanism of the respiratory pauses accompanying slumber in the Pickwickian syndrome

    Activ Nerv Sup

    (1969)
  • K.P. Strohl et al.

    Sleep apnea syndromes

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    This article is based on a thesis submitted to the Faculty of Graduate Studies, University of Oklahoma, in partial fulfillment of the requirements for the degree of master of science. This research project was supported in part by a grant from the Foundation for Orthodontic Research, Pacific Palisades, Calif.

    a

    presently in private practice in Tempe, Arizona.

    b

    presently at the Ohio Institute for Medical Science, Canton, Ohio.

    c

    presently in private practice in Cumberland, Md.

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