The effect of a modified functional appliance on obstructive sleep apnea

Area of Science:

• Dental Sleep Medicine
• Respiratory Medicine
• Orthodontics

Background:

• Obstructive sleep apnea (OSA) is a common sleep disorder characterized by repeated upper airway collapse.
• Current treatments for OSA include positive airway pressure devices and surgery, but alternatives are sought.
• Functional appliances offer a potential non-invasive approach to managing OSA by altering craniofacial structures.

Purpose of the Study:

• To evaluate the efficacy of a modified functional appliance in improving airway, sleep, and respiratory parameters in patients with OSA.
• To assess cephalometric changes in mandibular position induced by the appliance.
• To determine the impact of the appliance on obstructive events and apnea indices.

Main Methods:

• A prospective study involving 12 patients diagnosed with OSA via polysomnography.
• Patients were fitted with a modified functional appliance designed to reposition the mandible anteriorly and inferiorly.
• Overnight polysomnography and lateral cephalometric radiographs (with and without appliance) were performed.

Main Results:

• The appliance resulted in mean mandibular advancements of 8.49 mm vertically and 2.28 mm horizontally.
• Ten out of 12 patients experienced significant reductions in complete airway obstructions (mean decrease from 28.86 to 18.69 events/hour).
• The total apnea index decreased from a mean of 53.81 to 35.99 events/hour.

Conclusions:

• The modified functional appliance effectively reduced obstructive events in OSA patients.
• Cephalometric analysis demonstrated significant changes in mandibular and oropharyngeal structures.
• This appliance represents a conservative and successful treatment option for selected patients with obstructive sleep apnea syndrome.