Modified mandibular advancement appliance for an edentulous obstructive sleep apnea patient: a clinical report

Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder with periodic reduction or cessation of airflow during sleep. It is associated with loud snoring, disrupted sleep and observed apneas with prevalence up to 54% in elderly people. Treatment of OSA varies from simple measures such as dental appliances and nasal continuous positive airway pressure (CPAP) to surgical procedures like uvulopalatopharyngoplasty and tracheostomy. Dental appliances are a viable nonsurgical treatment alternative in patients with OSA, of which mandibular advancement appliances are most common. Edentulism which contributes to the worsening of OSA reduces the number of available therapeutic strategies and is considered a contraindication to oral appliance therapy. This clinical report describes the treatment of a 61-year old edentulous OSA patient for whom a modified mandibular advancement appliance was designed. The patient reported an improvement in AHI index and he was satisfied with the modified appliance. This clinical report describes the newer technique of fabricating oral appliance for edentulous OSA patient.