Saturday, June 5, 2010

Tongue Measurements May Help Dentists Determine Oral Appliance Therapy Success in Sleep Apnea Patients

According to new research that received the Graduate Student Research Award on Friday, June 4, the ratio between tongue volume and bony enclosure size in patients with obstructive sleep apnea (OSA) may help dentists calculate oral appliance therapy success. The award was presented at the 19th Annual Meeting of the American Academy of Dental Sleep Medicine.

OAT has been shown to be a safe and effective treatment for OSA. But patient outcome is hard to predict.

The researchers assessed whether anatomical factors were associated with treatment outcome. These factors included craniofacial size and upper-airway soft tissue volume. They also examined the anatomical balance between these features.

The study included 49 OSA patients. Patients were at least 18 years of age. They had mild to severe sleep apnea. The patients had no other sleep disorders or serious comorbid medical or psychiatric disorders.

Each patient was fitted for a custom two-piece oral appliance, which was worn during sleep. Treatment outcome was assessed by polysomnography after approximately six weeks of OAT.

Of the 49 patients, 24 responded to the treatment. They demonstrated an apnea-hypopnea index (AHI) reduction of 50 percent or more.

Body mass index and age did not differ between responders and non-responders. Responders did have a lower baseline AHI, indicating that their sleep apnea was less severe before treatment.

Tongue cross-sectional area (CSA) was measured in a subset of 28 patients, including 12 responders and 16 non-responders. The measurements were taken using cephalometric soft-tissue imaging.

Responders had a larger tongue CSA than non-responders, but there was no difference in the bony oral enclosure CSA. The ratio of tongue to bony enclosure CSA significantly differed between responders and non-responders, indicating the ratio as a significant predictor of response to treatment.

Because patients who responded to oral appliance treatment had a larger tongue volume for a given oral cavity size, the researchers suggest that determining this ratio may help predict treatment success.

“While this study re-affirms the difficulties in predicting OSA treatment response to mandibular advancement splints, responders seem to have a larger tongue volume for a given oral cavity site, suggesting that oral appliances may help correct anatomical imbalances,” said lead author Whitney Mostafiz

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The Official Blog of the American Academy of Dental Sleep Medicine (AADSM) is intended as an information source only. Content of this blog should not be used for self-diagnosis or treatment, and it is not a substitute for medical care, which should be provided by the appropriate health care professional. If you suspect you have a sleep-related breathing disorder, such as obstructive sleep apnea (OSA), you should consult your personal physician or visit an AASM-accredited sleep disorders center. The AADSM, and the American Academy of Sleep Medicine, as the managing agent of the AADSM, assume no liability for the information contained on the Official Blog of the AADSM or for its use.