Dr Cuny Constance

TITLE

Mandibular advancement device in the treatment of obstructive sleep apnea: towards a personalized management

ABSTRACT

Obstructive sleep apnea (OSA) is characterized by a reduction or interruption of ventilation during sleep. This chronic disorder can manifest itself by drowsiness and cause cardiovascular, neurological, chronic diabetic and cancer pathologies. Continuous positive airway pressure (CPAP) is the gold standard to treat obstructive sleep apnea. Treatments of choice for the majority of mild to moderate OSA patients are oral devices (OA) among which mandibular advancement device (MAD) is the most common one. It is also recommended as a viable alternative for intolerant patients to CPAP therapy. It allows a lower jaw propulsion during sleep in order to free the upper airway, the main obstructive site of OSA. In this situation, taking the oral health status of our patients into account seems essential. Moreover, the main side effect of OAM management is dental displacement, which is often responsible for treatment discontinuation. The author, therefore wishes to explore OSA through a dental prism by focusing first on partially edentulous patients and then on the dental movements caused by the treatment. Adapting the management of these patients and better predicting dental movements by establishing a phenotype of the patient could allow a personalized management for a better compliance and a better long-term effectiveness of the orthoses.

REFERENCES

American Academy of Sleep Medicine . International Classifi cation of Sleep Disorders . 3rd ed. Darien, IL : American Academy of Sleep Medicine; 2014. Pavwoski P, Shelgikar AV. Treatment options for obstructive sleep apnea. Neurology: Clinical Practice. 1 févr 2017;7(1):77‑85. Chen A, Burger MS, Rietdijk-Smulders MAWJ, Smeenk FWJM. Mandibular advancement device: Effectiveness and dental side effects. A real-life study. Cranio. mars 2022;40(2):97‑106