Assessing orthotic normalization of pharyngeal dynamics

Airway orthotic therapy, considered mainstream in the treatment of sleep-disordered breathing, has been demonstrated to normalize both structure and function of the pathological airway through manipulation of mandibular posture. Although effective, the literature reports a variable rate of success and no validated candidacy selection protocol. Acoustic reflection has been used to evaluate and document the upper airway and its dynamics with and without an orthotic in place. This paper will discuss the use of acoustic reflection to assess the level of airway normalization resulting from protrusive and vertical repositioning of the mandible and its utility to establish orthotic candidacy, construction, titration, and maintenance parameters. This protocol has potential for use in both medical and dental facilities that treat patients with sleep-disordered breathing.