HORLAMA VE OBSTRUKTİF UYKU APNESİ TEDAVİSİNDE ORAL APAREY KULLANIMI

Amaç: Bu derleme üst solunum yollarının anatomisini kavrayarak bu alandaki bozukluğa bağlı gelişen horlama ve obstruktif uyku apnesi sendromunun (OUAS) teşhis yöntemleri, tedavi seçenekleri, tedavide kullanılan oral aparey çeşitleri ve yapım yöntemleri hakkında diş hekimlerine bilgi verme amacını taşımaktadır. OUAS hastalarında tanı ve tedavi seçeneklerini gözden geçirerek bu hastalara karşı diş hekiminin yaklaşımının ne olması gerektiği de incelenmiştir. OUAS toplumda daha sıklıkla özellikle orta yaş üstü erişkinlerde görülen bir bozukluktur. OUAS ve horlama tedavisinde cerrahi ve diğer tedavi yöntemlerine alternatif olarak oral apareylerin kullanımı, non-invaziv ve uygulaması daha kolay bir tedavi seçeneği olması sebebiyle günümüzde oldukça popüler hale gelmiştir.

THE USE OF ORAL APPLIANCES IN TREATMENT OF SNORING AND OBTRUCTIVE SLEEP APNEA

This article aimed to help dentists to understand the anatomy of upper airway, the diagnosis and treatment options of snoring and obstructive sleep apnea and the oral appliance types used in treatment. This article invastigates the treatment options and diagnosis of OUAS patients and reviews the clinical approach of dentists. OUAS is a sleeping disorder commonly seen in middle aged and older adult population. Dental devices became more popular in the treatment of obstructive sleep apnea and snoring. These devices are non-invasive and easy to apply comparing to other surgical treatment options

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  • Vuorjoki-Ranta TR, Lobbezoo F, Tuomilehto H, Könönen M, Pihakari A, Ahlberg J. Health 2013;5:1-5.
  • Battagel JM, L‟Estrange PR. The cephalometric morphology of patients with obstructive sleep apnea. Eur J Orthod 1996;18:557-69.
  • Kyung HS, Park YC, Pae EK. Obstructive sleep apnea patients with the oral appliance experience pharyngeal size and shape changes in three dimensions. Angle Orthod 2004;75:15-22.
  • Kuhl W.History of clinical research on the sleep apnea syndrome. Respiration 1997;64:5-10.
  • Kryger MH. Fat, sleep and Charles Dickens: Literary understanding of sleep apnea. Clin Chestmed 1985;6:555-62. to the
  • Guilleminault C, Eldridge FL, Dement WC. Insomnia with sleep apnea: a new syndrome. Science 1973;181:856-8.
  • Ivanhoe JR, Cibirka RM, Lefebvre CA, Parr G. Dental considerations in upper airway sleep disorders: A review of the literature. J Prosthet Dent 1999;82:685-98.
  • Lawton HM, Battagel JM, Kotecha BA. Comparison of the Twin Block and Herbst Mandibular advancement splints in the treatment of patients with obstructive sleep apnea: a prospective study. Eur J Orthod 2005;27:82-90.
  • Johnston CD, Gleadhil IC,Cinnamond MJ,Gabbey J,Burdan D. Mandibular advancement appliances and obstructive sleep apnea: a randomized clinical trial. Eur J Orthod 2002;24:251-62.
  • Battagel JM, Johal A,Smith AM,Kotecha B. Postural variation in oropharyngeal dimensions in subjects with sleep disordered breathing: A cephalometric study.Eur J Orthod 2002;24:263-76.
  • Mossaz CF, Richter M,Oehlrich S. Case Report: Surgical orthodontic management of posttraumatic obstuctive sleep apne syndrome. Angle Orthod 1997;67:155-60.
  • Rose E, Staats R, Virchow C, Jonas IE. A comparative study of two mandibular advancement appliances for the treatment of obstructive sleep apnoea. Eur J Orthod 2002;24:191-8.
  • Robertson C. Cranial base considerations between apnoeics and non-apnoeic snorers, and associated effects of long term mandibular advancement on condylar and natural head position. Eur J Orthod 2002;24:353-61.
  • Şahin A. Obstrüktif uyku apne sendromunun fizyopatolojisi, Obstrüktif Sleep Apne Sendromu, Türkiye Akciğer Hastalıkları Vakfı Yayınları. 1993;1:19-29
  • Ivanhoe, JR, Cibirka RM, Lefebvre CA, Parr G. Dental Considerations in Upper Airway Sleep Disorders: A Review of the Literature. J Prosthet Dent 1999;82:685-98
  • Johal A, Battagel JM. Current Principles in the Management of Obstructive Sleep Apnoea with Mandibular Advancement Appliances. British Dental Journal 2001;190:532-6.
  • Clark GT, Arand D, Chung E, Tong D. Effect of Anterior Mandibular Positioning on Obstructive Sleep Apnea. Am Rev Respir Dis 1993;147:624-9.
  • Lyons, MF, Cameron DA, Banham SW. Snoring, Sleep Apnoea and the Role of Dental Appliances. Dent Update 2001;28:254-6.
  • Yoshida, K. Effect of a Prosthetic Appliance for Treatment of Sleep Apnea Syndrome on Masticatory and Tongue Muscle Activity. J Prosthet Dent 1998;79:537-44.
  • Türel H. Basit horlama ve hafif dereceli obstrüktif uyku apne sendromu olgularında MA tipi oral apareyin tedavi etkinliğinin incelenmesi. Gazi Üniversitesi Doktora Tezi 2007.
  • Grisius R, Moore DJ. Miscellaneous prostheses, Obstructive sleep apnea. In: Beumer J, Curtis TM, Marunick Prosthodontic and surgical considerations. 2nd ed. St. Louis; ABD: 1996.p: 515. rehabilitation:
  • Meyer JB, Knudson RC. The sleep apnea syndrome. Part II: treatment. J Prosthet Dent 1990;63:320-4.
  • Naismith SL, Winter VR, Hickie IB, Cistulli PA. Effect of oral appliance therapy on neurobehavioral functioning in obstructive sleep apnea: a randomized, controlled trial. J Clin Sleep Med 2005;1:374-80.
  • Cote EF. Obstructive sleep apnea: An orthodontic concern. Angle Orthod 1988;28:293-307.
  • Thornton WK. Combined CPAP. Oral appliance therapy. Sleep and Breathing 2002;3:16-21.
  • Denbar MA. A case study involving the combination of treatment of an oral appliance and auto-titrating CPAP unit. Sleep and Breathing 2002;6:125-7.
  • Ferguson KA, Ono T, Lowe AA, Keenan SP, Fleetham JA. A randomized crossover study of an oral appliance vs nasal-continuous positive airway pressure in the treatment of mild-moderate obstructive sleep apnea. Chest 1996;109:1269-75.
  • Chesson AL Jr, Ferber RA, Fry JM, Grigg- Damberger M, Hartse KM, Hurwitz TD, Johnson S, Kader GA, Littner M, Rosen G, Sangal RB, Schmidt Nowara W, Sher A. Practice parameters for the indications for polysomnography and related procedures. Sleep. 1997;20:406–22.
  • Kokturk O, Ulukavak Ciftci T. Obstruktif uyku apne sendromu CPAP/BPAP tedavisi. Tuberkuloz ve Toraks Dergisi. 2002;50:317-34.
  • Eskofi M, Cline C, Nilner M, Israelsson B. Treatment of sleep apnea in congestive heart failure with a dental device. The effect on brain natriuretic peptide and quality of life. Sleep Breath 2006;10:90-7.
  • Schmidt-Nowara W, Lowe A, Wigand L, Cartwright R, Perez-Guerra F, Mean S. Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances. SleepAnd Breathing 1995;18:511-3.
  • Kurtulmus H, Cotert HS, Basoglu OK, Bilgen C. Cephalographic and polysomnographic evaluation of excellent efficiacy of the mandibular advancement splint in a patient with moderate obstructive sleep apnea syndrome. Atatürk Üniv Dis Hek Fak Derg 2009;9:31-6.
  • Rose E, Germann M, Sorichter S, Jones IE. Case control study in the treatment of obstructive sleep- disordered breathing with a mandibular protrusive appliance. J Orofac Orthop 2004;65:489-500.
  • Rose E, Staats R. Der therapeutische efekt eines aktivators bei der therapie der obstruktiven schlafapnoe-eine longitidinal studie Deutsche Zahnarztliche Zeitschrift 2002;57:473-80.
  • Lowe AA. Orthodontists and oral sleep-disordered breathing. Am J Orthod Dentofac Orthop 2006;129:194-5.
  • Sarı E, Liebermann L, Karaçay Ş. Oral Horlama ve Obstrüktif Uyku Apnesinde Kullanılan Apareyler. Türk Ortodonti Dergisi 2006;19:181-96.
  • Samelson C. The role of tongue retaining device treatment of snoring and obstructive sleep apnea. CDS Rev 1988:9;44-7
  • Lowe AA, Schmidt-Nowara WW. Oral appliance therapy 1995;18;501-10 and apnea. Sleep
  • Lowe A. Treating obstructive sleep apnea: The case for oral appliances. American Journal of Orthodontics 2012;142:434-40. Orthopedics.
  • Kushida CA, Morgenthaler TI, Littner MR, Alessi CA, Bailey D, Coleman J Jr, Friedman L, Hirshkowitz M, Kapen S, Kramer M, Lee-Chiong T, Owens J, Pancer JP. American Academy of Sleep Medicine: Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances: an update for 2005. Sleep. 2006; 29:240–3.
  • Steven D. Bender. Oral appliance therapy for sleep-related breathing disorders. Operative Techniques in Otolaryngology 2012; 23, 72-8.
  • Lamant J, Baldwin DR, Mateljan R, Pantin C, Finucane KE. Mandibular advancement splints of obstructive sleep apnea. Europ J Orthod 1998;20:293-7.