back to contentsTreatment of obstructivesleep apnea syndrome with oral appliance : report of 2 cases
Masahiro Yonezawa,Masaki Kohno, Ken Nakatani ,Tamio Nakajima
Hirosi Kobayashi*, Yukihiro Tsuchida* and Shoji Kohno*
First Department of Oral and Maxillo-facialSurgery, School of Dentistry, Niigata University
(Chief: Prof. Tamio Nakajima)
*First Department of Prosthodontics, School of Dentistry,Niigata University
(Chief: Prof. Shoji Kohno)
Abstract :
Two cases of obstructive sleep apnea syndrome treatedconservatively by a oral appliance are reported.
Case 1 was a 60-year-old man with elongated soft palate andnarrow posterior air way space. On polysomnography,apnea andhypopnea were observed 94 times and 13 times, respectively and STdepression was noted during apnea on ECG. The minimum SpO2 was68% and SpO2 decreased below 90% 52 times and for 1470 secondsduring sleep. Because of myocardial infarction, surgicaltreatment was abandoned and a oral appliance was set to put themandible anteriorly by 7 mm and posteriorly by 6 mm. It resultedin an increase of the posterior air way space. The minimum SpO2became 86%. The number and time of SpO2 below 90% also decreasedto 23 times and 390 seconds,respectively. Respiration disturbanceduring sleep was markedly improved. No complications associatedwith the appliance were encountered.
Case 2 was a 49-year-old man who had sleep apnea due to excessiveelongation of the soft palate and narrowing of the posterior airway space. Apnea and hypopnea were encountered 75 times and 32times during sleep, respectively. The minimum SpO2 was 56% andSpO2 decreased below 90% 92 times and for 1985 seconds. All thesevalues were aggravated just before hemodialysis due to thickningof the soft palate. The mandible was set anteiorly andposteriorly by 6 mm. Then,there was a 1.9 mm increase of theposterior air way space which was accompanied by an improvementof SpO2 and disappearance of nocturnal respiration difficulties.
The dental appliance was found to be effective in the treatmentof obstructive sleep apnea syndrome.