Obstructive sleep apnea: a mandibular positioning device for treatment and diagnosis of an obstruction site

Obstructive sleep apnea (OSA) is a common condition with serious health and social consequences for millions of people. If untreated, it has significant effects on mortality, particularly by contributing to the rate of hypertension, stroke, and cardiac pathology. Standard therapy involves the use of a nasal continuous positive airway pressure device during sleep. This keeps the upper airway from collapsing, avoiding the cause of apneas and hypopneas. The inconvenience and side effects of the device make compliance with its use less than ideal. There are several surgical techniques that have been developed to correct OSA. These techniques have had variable success rates and are accompanied by some morbidity and mortality. Intraoral devices that position the mandible forward show promise for increasing the hypopharyngeal airway. A technique for physiologically determining an effective jaw relationship is described, as is a design for a device that maximizes nighttime retention. Radiographic analyses in the upright and supine positions are used to determine adequate airway improvement. The intraoral device can be used as a diagnostic tool to select patients who will most likely benefit from surgery.