Dentists and exhibitors from around the country will gather tomorrow in Seattle for the 24th Annual Meeting of the American Academy of Dental Sleep Medicine (AADSM) to further advance oral appliance therapy (OAT) as a treatment for obstructive sleep apnea. The three-day event will feature several educational and professional development opportunities to help dentists stay up-to-date on the latest advancements in dental sleep medicine.
“With the growing volume of research supporting the benefits of oral appliance therapy, dental sleep medicine is gaining prominence in the medical community,” said Kathleen Bennett, DDS, president of the AADSM. “The AADSM Annual Meeting serves to increase the understanding of oral appliance therapy as an effective alternative for sleep apnea patients who don’t adhere to CPAP – the traditionally prescribed treatment.”
The Annual Meeting is an opportunity for dentists from across the globe to share new research on dental sleep medicine. This year’s highlighted research abstracts include findings showing direct correlations between OAT and decreased hypertension, evaluative procedures for predicting OAT success and prototype oral appliances that auto-adjust and auto-titrate to increase OAT effectiveness and efficiency.
Noteworthy research findings from the Annual Meeting include:
‧ Impact of Custom-made Mandibular Repositioning Device on Blood Pressure in Obstructive Sleep Apnea Patients Noncompliant with CPAP
Oral Appliance Therapy May Help Reduce Blood Pressure in Patients with Hypertension
Due to the prevalence of arterial hypertension in OSA patients, researchers evaluated the benefits of oral appliances on blood pressure in patients who do not adhere to CPAP. Of the 222 patients evaluated, 26 percent had hypertension (HTN). Compared to the non-HTN patients, oral appliances significantly lowered the systolic and diastolic blood pressure of HTN patients, normalizing blood pressure in 59 percent of patients. Specifically, there was a strong correlation between the baseline AHI and a decrease in diastolic blood pressure.
‧ Development of Auto-adjusting Mandibular Repositioning Device for In-home Use
Prototype Device May Allow Dentists to Auto-adjust an Oral Appliance
To help provide objective information on OAT adherence and decrease time at which efficacy is achieved, an auto-adjusting, in-home oral appliance was tested. The prototype features a pneumatic actuator capable of changing the position of the jaw via a small syringe pump connected to a wireless controller. Changes to the jaw position are specified through the controller based on respiratory sounds, a digital pulse oximeter and a body position sensor. In the pilot tests, the device reached the patient’s maximum jaw protrusion limit, demonstrating that a low-cost, minimally intrusive pneumatic actuator can auto-adjust an oral appliance.
‧ Auto-titrating Mandibular Positioner: Accuracy in Predicting OAT Outcome and Efficacious Mandibular Protrusion
Prototype Device May Help Predict OAT Effectiveness
One hundred and twenty-four patients received a two night, at-home mandibular titration study, which involved temporary dental trays attached to a computer-controlled actuator. The first study determined the predicted effective target protrusive position (ETPP) that was used in the second study. Of the 75 patients who experienced therapeutic success, 71 responded positively at the predicted ETPP, indicating that an auto-titrating mandibular positioner can accurately predict OAT outcome and ETPP.
‧ Quantitative Evaluation of Upper Airway Using Nasoendoscopy for Prediction of OAT Outcome in Moderate and Severe Obstructive Sleep Apnea
Nasoendoscopy May Help Predict the Success of Oral Appliance Therapy
Using nasoendoscopy, the velopharynx and oropharynx of sixty-one patients with moderate to severe OSA were assessed to calculate the airway expansion ratio. With treatment success defined as an AHI <10/h and a >50 percent reduction in baseline AHI, the expansion ratio of the velopharynx and oropharynx were significantly greater in responders than non-responders. The results indicate that nasoendoscopy may help clinically predict patients’ success using OAT.
The entire program for the 24th AADSM Annual Meeting, which details continuing education courses, invited lectures and discussion groups that will be hosted during the meeting, can be found at: https://www.aadsm.org/AnnualMeeting.aspx.
Dentists interested in applying for AADSM membership should visit the AADSM website at www.aadsm.org.
For the full research abstracts or interviews, please contact Lindsey Lucenta at llucenta@lcwa.com.
