Review of systematic reviews on mandibular advancement oral appliance for obstructive sleep apnea: The importance of long-term follow-up

Publication date: December 2020Source: Japanese Dental Science Review, Volume 56, Issue 1Author(s): Kazumichi Sato, Tsuneya NakajimaSummaryThe purpose of this review was to present the currently available information on oral appliance (OA) therapy for dentists, especially clinic-based dentists, to aid them in performing this treatment for the management of symptoms of obstructive sleep apnea (OSA). The clinical research evidence comprised of systematic reviews concerned with the mandibular advancement oral appliance (OAm). Continuous positive airway pressure (CPAP) is superior to OA therapy in improving OSA symptoms. It is necessary to survey the adherence of patients who stopped CPAP therapy to OAm therapy. There is little evidence supporting the theory that OAm therapy prevents cardiovascular disease or improves prognosis. There is still room to investigate the types of OAm. OAm therapy has clear dental and skeletal side effects with long-term use, and these are important for dentists. However, a certain percentage of patients discontinue consultations. Regarding consultation rate for follow-up and repair/adjustments of OAm, there are advantages for the clinic-based dentists treating OSA with OAm. We believe that enhancing under-graduate and post-graduate education on sleep medicine, and establishing a specialist system could be the strategies for enabling the dentists to handle OAm therapy in dental clinics.
Source: Japanese Dental Science Review - Category: Dentistry Source Type: research

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Conclusions:OSA did not develop or worsen following primary palatoplasty. However, the oAHI increased by 5 or more events/h in approximately 20% of study participants. The presence of a syndrome was the only factor predictive of worsening OSA after palatoplasty. These findings suggest that palatoplasty does not worsen or cause OSA in most patients, and that nonsyndromic children are at low risk for the development or worsening of OSA.Citation:Bergeron M, Cohen AP, Maby A, Babiker HE, Pan BS, Ishman SL. The effect of cleft palate repair on polysomnography results.J Clin Sleep Med. 2019;15(11):1581–1586.
Source: Journal of Clinical Sleep Medicine : JCSM - Category: Sleep Medicine Source Type: research
Authors: Cancienne JM, Brockmeier SF, Deasey MJ, Werner BC Abstract BACKGROUND: A few investigations exist which evaluate the influence of obstructive sleep apnea (OSA) on complications after arthroscopic rotator cuff repair. METHODS: A database was queried for patients undergoing rotator cuff repair with and without OSA and further subdivided into those with and without a billing code for a continuous positive airway pressure (CPAP) device. Thirty-day and 6-month adverse events were assessed. RESULTS: After regression analysis, patients with OSA had markedly increased emergency department visits and hospital admission (P
Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research
Conclusions Resuming PPV use after transsphenoidal surgery did not result in intracranial complications. However, delay in resuming PPV resulted in four patients requiring oxygen at home. We propose a preliminary PPV device management algorithm based on the size of the intraoperative CSF leak to facilitate future studies. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: Journal of Neurological Surgery Part B: Skull Base - Category: Neurosurgery Authors: Tags: Original Article Source Type: research
Abstract Background: Obstructive sleep apnea (OSA) is a common disease. It can cause many serious complications. OSA may increase the risk of hypertension. However, the exact mechanism of OSA causing hypertension is not fully understood. YKL-40/chitinase-3-like protein-1 plays an important role in vascular injury, repair, and generation. We sought to explore the role of YKL-40 in endothelial dysfunction and hypertension in OSA patients. Methods: All subjects were examined by polysomnography (PSG) and the expression of YKL-40 in the plasm of the subjects was measured by luminex. Carotid intima-media thickness ...
Source: Biomed Res - Category: Research Authors: Tags: Biomed Res Int Source Type: research
Conclusion Analysis of the pleiotropic effects of IL-33 on multiple immunological cells (macrophages, mastocytes), as well as neurological cells of medulla oblongata, dorsal root ganglion, antigen-induced arthritis system, carrageen, and formalin, shows that this alarmin plays curtail, yet not fully known role in mediating inflammation, especially in chronic inflammatory pulmonary diseases such as asthma, COPD, and OSA. Taken into consideration the engagement in this process, in particular of mastocytes and their secretion of CXCL2, 4, 8, and other cytokines, there is no doubt regarding the etiopathogenic role of IL-33 in...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Conclusions Aging leads to a progressive decrease in androgen production that, in turn, leads to the development of LOH, defined by significant low T serum levels (in the lowest quartile) in the presence of signs and symptoms of hypogonadism (51). LOH could be due to both testicular and hypothalamic-pituitary dysfunction (32), and ED is one of its main symptoms. ED in LOH is linked to increased oxidative stress, subclinical inflammation, and subsequent endothelial dysfunction (101). In elderly men, it has been shown that LOH is also linked to lower cAMP pool and to an alteration of the cGMP signaling pathway. PDE5 gene l...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
This study provides a possible reason why genes carrying health risks have persisted in human populations. The second found evidence for multiple variants in genes related to ageing that exhibited antagonistic pleiotropic effects. They found higher risk allele frequencies with large effect sizes for late-onset diseases (relative to early-onset diseases) and an excess of variants with antagonistic effects expressed through early and late life diseases. There also exists other recent tangible evidence of antagonistic pleiotropy in specific human genes. The SPATA31 gene has been found under strong positive genomic sele...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
ConclusionDifferent skull base repair techniques have varying ability to withstand CPAP. Both second and third repair techniques performed in a nearly similar fashion with regard to their ability to withstand positive pressure ventilation.
Source: International Forum of Allergy and Rhinology - Category: Allergy & Immunology Authors: Tags: ORIGINAL ARTICLE Source Type: research
By Sandee LaMotte, CNN (CNN) — Here’s another reason why getting a good night’s sleep should be on your must-do list: Sleeping fewer than six hours a night or waking frequently raises your risk of developing damaging plaque in arteries throughout your body, not just your heart. Previous research has shown poor sleep to be strongly associated with coronary heart disease, but “This is the first study to show that objectively measured sleep is independently associated with atherosclerosis throughout the body,” José Ordovás, director of nutrition and genomics at the Jean Mayer USDA H...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - Category: Consumer Health News Authors: Tags: Boston News Health CNN Heart Disease Sleep Tufts University Source Type: news
Conclusions: Respiratory failure is an uncommon but devastating complication of abdominal wall reconstruction. The authors report clinical risk factors that may facilitate perioperative risk-reduction strategies to improve outcomes of elective abdominal wall reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.
Source: Plastic and Reconstructive Surgery - Category: Cosmetic Surgery Tags: Reconstructive: Trunk: Original Articles Source Type: research
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