A Tanner type stabilization splint, fabricated in the musculoskeletally stable CR position, appears to be an effective and efficient means for the treatment of patients with disc displacement without reduction. The efficacy of this specific splint, fabricated in the musculoskeletally stable CR position, makes it a promising tool to treat TMD patients with disc displacement without reduction.
The objectives for this study is to collect non-controlled, therapy-related observations; in other words, to demonstrate the efficacy of this appliance for the treatment of patients with disc displacement without reduction.
Overall, the study enrolled 55 patients, 5 men, and 50 women, with the clinical diagnosis disc displacement without reduction, 42 with and 13 without limited mouth opening. All patients received a splint in the musculoskeletally stable centric relation (CR) position. Mouth opening, clinical performance, and the timeframe of splint treatment were assessed.
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Mandibular repositioning devices (MRD) have been deployed for the management of mild, moderate and even severe cases of OSA, but there are some concerns regarding unwanted tooth movements, temporo-mandibular joint issues and facial profile changes using that approach. Biomimetic oral appliance therapy (BOAT) differs from conventional MRD therapy as it aims to correct the nasal airway through midfacial redevelopment followed by mandibular correction, which aims to improve the oropharyngeal airway in adults. In this investigation, Dr. Griffin and Singh test the hypothesis that severe OSA can be addressed without primary mandibular advancement using BOAT.
BOAT may be a useful method of managing severe cases of OSA in adults, and may represent an alternative to CPAP and MRD therapy. However, long-term follow up using a larger sample size is needed to reach more definitive conclusions on these initial findings.
To find more information about this study regarding Osturrtucitve Sleep Apnea please click on the link below:
Mouth breathing: Adverse effects on facial growth, health, academics, and behavior- Yosh Jefferson, DMD, MAGD
The vast majority of health care professionals are unaware of the negative impact of upper airway obstruction (mouth breathing) on normal facial growth and physiologic health. Children whose mouth breathing is untreated may develop long, narrow faces, narrow mouths, high palatal vaults, dental malocclusion, gummy smiles, and many other unattractive facial features, such as skeletal Class II or Class III facial profiles.
These children do not sleep well at night due to obstructed airways; this lack of sleep can adversely affect their growth and academic performance. Many of these children are misdiagnosed with attention deficit disorder (ADD) and hyperactivity. It is important for the entire health care community (including general and pediatric dentists) to screen and diagnose for mouth breathing in adults and in children as young as 5 years of age. If mouth breathing is treated early, its negative effect on facial and dental development and the medical and social problems associated with it can be reduced or averted.
Practice Parameters for the Treatment of Snoring and Obstructive Sleep Apnea with Oral Appliances: An Update for 2005
These practice parameters are an update of the previously published recommendations regarding use of oral appliances in the treat- ment of snoring and Obstructive Sleep Apnea (OSA). Oral appliances (OAs) are indicated for use in patients with mild to moderate OSA who prefer them to continuous positive airway pressure (CPAP) therapy, or who do not respond to, are not appropriate candidates for, or who fail treatment attempts with CPAP. Until there is higher quality evidence to suggest efficacy, CPAP is indicated whenever possible for patients with severe OSA before considering OAs. Oral appliances should be fitted by qualified dental personnel who are trained and experienced in the over- all care of oral health, the temporomandibular joint, dental occlusion and associated oral structures. Follow-up polysomnography or an attended cardiorespiratory (Type 3) sleep study is needed to verify efficacy, and may be needed when symptoms of OSA worsen or recur.
Patients with OSA who are treated with oral appliances should return for follow-up of- fice visits with the dental specialist at regular intervals to monitor patient adherence, evaluate device deterioration or maladjustment, and to evalu- ate the health of the oral structures and integrity of the occlusion. Regular follow up is also needed to assess the patient for signs and symptoms of worsening OSA. Research to define patient characteristics more clearly for OA acceptance, success, and adherence is needed.
Oral appliances (OAs) are indicated for use in patients with mild to moderate OSA who prefer them to continuous positive airway pressure (CPAP) therapy, or who do not respond to, are not appropriate candidates for, or who fail treatment attempts with CPAP. Patients with OSA who are treated with oral appliances should return for follow-up office visits with the dental specialist at regular intervals to monitor patient adherence, evaluate device deterioration or maladjustment, and to evaluate
the health of the oral structures and integrity of the occlusion.
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