Journal of dental sleep medicine最新文献

{"title":"Oral Appliance and Pharmacologic Agents in the Treatment of Sleep Apnea: A Pilot Clinical Study","authors":"R. Stache","doi":"10.15331/jdsm.7224","DOIUrl":"https://doi.org/10.15331/jdsm.7224","url":null,"abstract":"Hypothesis: Augmentation of a mandibular advancement oral appliance (OA) by pharmacotherapy (ondansetron+fluoxetine) will increase\u0000therapeutic efficacy in moderate to severe obstructive sleep apnea\u0000(OSA) patients.\u0000\u0000Methods: Fifteen subjects met inclusion criteria and were enrolled.\u0000Subjects with moderate-severe OSA were treated with a TAP3 Elite® OA\u0000plus placebo medication for two weeks, followed by a combination\u0000regimen of ondansetron (24 mg/day) and fluoxetine (10 mg/day) with\u0000continued use of the OA for four weeks.\u0000\u0000Results: Seven subjects (5 male and 2 female, BMI 39.1±6.6) completed\u0000the study. AHI OA + Medications (22.1±16.3) was lower than the AHI\u0000baseline (31.7±11.2). Sleep efficiency and oxygen desaturation indices\u0000improved. Subjective (ESS) and objective (PVT) daytime sleepiness\u0000showed improvement. Mean total airway volume at end inspiration\u0000increased by 35% with OA compared to without OA. Minimum cross\u0000sectional area (CSA) increased by 48.8% with OA compared to without\u0000OA\u0000\u0000Conclusions: Combination of pharmacotherapy and oral appliance maybe a viable option in treating patients with moderate to severe OSA.","PeriodicalId":91534,"journal":{"name":"Journal of dental sleep medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44365927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Obstructive Sleep Apnea Managed with Mandibular Advancement Device in Pediatrics: An Interdisciplinary Case Report","authors":"Devon M. Ptak, Ruba Alkadhi, Ilho Tae, L. Correa","doi":"10.15331/JDSM.7074","DOIUrl":"https://doi.org/10.15331/JDSM.7074","url":null,"abstract":"Mandibular advancement devices (MADs) may enhance upper airway patency during sleep by enlarging the upper airway and/or by decreasing upper airway collapsibility, thereby helping to prevent obstruction of the upper airway. Although MADs are commonly used for the management of obstructive sleep apnea (OSA) in adults, their use in pediatric patients is less common, with limited information available regarding their efficacy. However, for pediatric patients in whom continuous positive airway pressure (CPAP) has failed, who are interested in nonsurgical interventions, or who are awaiting future surgical interventions, an MAD may be an option. This report details one such case, and the successful treatment of OSA with an MAD after failure to tolerate CPAP in a pediatric patient awaiting orthognathic surgery.","PeriodicalId":91534,"journal":{"name":"Journal of dental sleep medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47099546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Will the orthodontic profession disappear?","authors":"J. Masse","doi":"10.15331/JDSM.7066","DOIUrl":"https://doi.org/10.15331/JDSM.7066","url":null,"abstract":"I am not the one saying this! Rather, the person who forecast the disappearance of orthodontists is Dr. Laurent Alexandre, a French physician, in his book about artificial intelligence entitled in French “La guerre des intelligences” (which can be loosely translated as “The War of the Intelligences”). Dr. Alexandre writes that an American company from Silicon Valley called Invisalign will use artificial intelligence to provide patients with better adapted orthodontic treatment protocols. In turn, this will very soon make the orthodontic profession irrelevant, just as the job of lamplighter became obsolete when electrical lighting was introduced. One does not have to agree with his view, but if you consider that Dr. Alexandre is a medical specialist with an MBA from HEC Paris (the Harvard Business School of France) who sold his website, Doctissimo (the French equivalent of WebMD), 12 years ago for 156 million US dollars, he certainly is more a visionary than a lunatic... After reading the book, I somewhat agree with Dr. Alexandre: if the orthodontic profession does not evolve, it could disappear. I know orthodontists who are aware of this. But, they are only moderately worried as orthodontics is now changing at an accelerated rate: we now see treatments involving the use of miniscrews, Carriere Motion Appliance, MARPE, PAOO, sometimes combined with Invisalign and the list goes on. The field of straightening teeth is certainly very different today from what it was only ten years ago. Why should this concern us? Just like orthodontists, we need to change too. Our model needs to evolve, and it should start in our universities. If you think that dental sleep medicine is the frontier of our field, it certainly does not appear to be so, as most universities are teaching only traditional dentistry. Now is the time to be moving into the expanded concept of dental medicine. With a little less than 6000 new dentists joining the US work force in 2016 alone and the prevalence of tooth decay steadily going down, educators need to wake up quickly. The only good news I find is that the AADSM took upon itself to gather as many university professors in DSM as possible and allowed them to meet at their last annual meeting in Baltimore. I understand that this gathering will occur again at this year’s annual AADSM meeting. While many universities are slowly awakening to the need for crucial change, we as clinicians also need to improve our clinical expertise. If one looks back at the major review done by Ferguson et al. 13 years ago and compares what was found then to the more recent studies on oral appliance therapy, the reduction of the apneahypopnia index (AHI) as a result of OAT has surprisingly not changed that much. Granted, we make better, sturdier, more hygienic and comfortable appliances now but in order to expand our field we also need to look elsewhere. One of the areas where we need to do better is case selection. At a time when the field of sleep medicin","PeriodicalId":91534,"journal":{"name":"Journal of dental sleep medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45215161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of potential tooth movement and bite changes with a hard-acrylic sleep appliance: A 2-year clinical study.","authors":"Allen Lee Khai, N. Vranješ, K. Schulze, G. Santucci, D. Kuhns","doi":"10.15331/JDSM.7070","DOIUrl":"https://doi.org/10.15331/JDSM.7070","url":null,"abstract":"Study Objectives: The objective of this study was to test a proprietary hard-acrylic computer-aided design/computer-aided manufacturing (CAD/CAM) oral appliance with “retainer-like fit” and determine whether it resulted in tooth movement upon regular wear over a minimum 2-year period. Additionally, this study focused on determining patient acceptance of said device considering any reported side effects. Methods: The 2-year clinical study reports on selected patients in whom sleep apnea has been diagnosed (n=18) recruited from The Snore Center in Calgary. Patients were fitted with a ProSomnus® Sleep Appliance. Impressions were taken at baseline, after approximately 1 year, and after 2 years of use with the oral appliance. Models were marked, scanned, and scored; upper and lower anterior teeth crowding was assessed; and overjet and overbite were measured independently at the University of Pacific. Patients were surveyed on compliance, satisfaction with the appliance, and quality of life using the Sleep Apnea Quality of Life Index (SAQLI-10). Results: This study shows a rigid OA made with proprietary CAD/CAM technology demonstrated no significant change in tooth position during the 2.3-year test period, or in bite changes per maximum intercuspation (MIP), as measured by overjet and overbite. At 2 years, the mean change in Little Irregularity Index for the lower anterior teeth was 0.007 mm (95% confidence interval = [-0.03, 0.05]), which was not statistically different from zero (P>0.05). Patients were highly satisfied with the device and considered it beneficial. Conclusions: A key component to any treatment is patient's acceptance of the appliance and the willingness to wear the OA long term. When patient compliance is observed, hard-acrylic sleep appliances have little effect on tooth movement and MIP bite changes as shown by overjet/overbite. Clinical Trial Registration: Health Research Ethics Board of Alberta: CTC-16-0108","PeriodicalId":91534,"journal":{"name":"Journal of dental sleep medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45190057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep Apnea Phenotyping: Implications for Dental Sleep Medicine","authors":"Victor Lai, J. Carberry, D. Eckert","doi":"10.15331/JDSM.7072","DOIUrl":"https://doi.org/10.15331/JDSM.7072","url":null,"abstract":"New knowledge of obstructive sleep apnea (OSA) pathophysiology has highlighted the heterogeneity of this common chronic health condition. Recent advances in OSA ‘phenotyping’ concepts have provided a novel framework in which to understand OSA pathophysiology on an individual patient basis. This has also provided new potential precision medicine strategies to optimize efficacy and success rates with current OSA treatments including mandibular advancement therapy.","PeriodicalId":91534,"journal":{"name":"Journal of dental sleep medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47311374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Study: Is Snoring During Pediatric Dental Procedures Indicative of Obstructive Sleep Apnea?","authors":"Harmeet K. Chiang, R. Robinson, A. Best, T. Brickhouse, D. Leszczyszyn","doi":"10.15331/JDSM.7068","DOIUrl":"https://doi.org/10.15331/JDSM.7068","url":null,"abstract":"Study Objectives: To determine whether pediatric snoring during sedation could be used to screen for obstructive sleep apnea (OSA) by pediatric dentists. Methods: Pediatric dental patients requiring moderate sedation with American Society of Anesthesiologists (I or II) or Brodsky classification (grade 1 and 2) were identified, recruited, separated in groups of snorers and nonsnorers, and then matched based on body mass index to within ±5%. Parents completed a Pediatric Symptom Checklist (PSC), and Pediatric Sleep Questionnaire (PSQ). OSA was diagnosed using a home sleep monitoring device. Groups were compared using a t-test. Results: Overall, 19 children were screened for eligibility and 17 enrolled: 10 who snored (59%) and 7 control participants. Although children who snored during sedation had a nominally higher respiratory disturbance index (RDI) (mean = 5.3 vs. 4.3), this difference was not statistically significant (p > 0.7). Using a cutoff RDI > 5 to indicate significant OSA, 5 of 8 in the snorer group and 2 of 4 in the nonsnorer group met this criterion. Conversely, one nonsnoring participant had a maximum relative loudness of 27dB, which resulted in a nominally higher group mean than the snoring group. The questionnaire results of both the PSC and PSQ average was 5 points higher in the snoring group but the difference was not statistically significant (PSQ p = 0.056, PSC p > 0.4). Conclusions: Snoring alone during pediatric dental procedures does not appear to be indicative of obstructive sleep apnea. Recognition of pediatric sleep apnea may be enhanced through questionnaires and adding snore analysis to home-based sleep apnea screening.","PeriodicalId":91534,"journal":{"name":"Journal of dental sleep medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42998884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Buteyko technique: News","authors":"P. McKeown","doi":"10.15331/JDSM.7078","DOIUrl":"https://doi.org/10.15331/JDSM.7078","url":null,"abstract":"","PeriodicalId":91534,"journal":{"name":"Journal of dental sleep medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43786552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel device for passive restraint of the tongue as an adjunct to mandibular advancement therapy in incomplete responders","authors":"Gregory Turek","doi":"10.15331/JDSM.7076","DOIUrl":"https://doi.org/10.15331/JDSM.7076","url":null,"abstract":"Tongue restraint may provide additional benefit in mandibular advancement splint (MAS) therapy. However, previous methods of tongue restraint are based on applying active force, resulting in a substantial degree of discomfort for most users. This report describes a novel method called Tongue Tamer (TT), which uses the natural passive ‘flow’ of the tongue to fill the space available to it when relaxed. The TT has been added to the lower plate of patients with an incomplete response to MAS therapy. In a series of 17 cases, the addition of TT has resulted in an additional reduction of -41.8 ± 67.3% (mean ± standard deviation) in apnea-hypopnea Index (AHI) compared to MAS therapy alone and 30% of patients were converted to complete responders (AHI<5 events/h). This novel method of passive restraint of the tongue may be a useful adjunct to MAS therapy.","PeriodicalId":91534,"journal":{"name":"Journal of dental sleep medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46761290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to \"The Buteyko technique: News\"","authors":"J. Masse","doi":"10.15331/JDSM.7080","DOIUrl":"https://doi.org/10.15331/JDSM.7080","url":null,"abstract":"","PeriodicalId":91534,"journal":{"name":"Journal of dental sleep medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47209098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Appliance Therapy Should be Reimbursed as a First-Line Therapy for OSA","authors":"Jennifer Q. Le, J. Rodgers, Kevin Postol","doi":"10.15331/JDSM.7058","DOIUrl":"https://doi.org/10.15331/JDSM.7058","url":null,"abstract":"It is the position of the American Academy of Dental Sleep Medicine (AADSM) that oral appliance therapy (OAT) should be reimbursed as a first-line therapy for the treatment of obstructive sleep apnea (OSA). OAT has been deemed an alternate therapy for OSA,, and numerous studies have indicated that OAT is an effective treatment for sleep-related breathing disorders. The American Academy of Sleep Medicine (AASM) has also acknowledged that OAT should be considered if a patient does not wish to use Continuous Positive Airway Pressure (CPAP) therapy. In their joint clinical practice guideline, the AADSM and the AASM stated that “[p]atient preference for OAs versus CPAP should be considered by the treating sleep physician before therapy is prescribed.” Patient treatment preference and choice can be critical in ensuring that patients experience positive health outcomes. This paper explores evidence regarding patient preference for OAT and how preference may lead to greater adherence and health improvement.","PeriodicalId":91534,"journal":{"name":"Journal of dental sleep medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49385767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}