Oral Appliance for the Treatment of Severe Obstructive Sleep Apnea in Edentulous Patient

Abstract

Oral appliances have attracted interest for the treatment of mild and moderate obstructive sleep apnea (OSA) and the mandibular repositioning device (MRD) or a tongue-retainer device (TRD) is usually indicated to increase the upper air space. Describes a combination of MRD (with 60 % maximum mandibular protrusion) and TRD to treat severe OSA. Polysomnography (PSG) and two questionnaires: the Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI) evaluated the sleep pattern in two times (after and before the use of oral appliance). The initial PSG exam was compatible with diagnoses severe OSA and the Apnea–Hypopnea Index was 40.4, and 54 % oxygen saturation −spO 2. The ESS and PSQI scores were 11 and 6, respectively. After she began wearing the device she stopped snoring, her Apnea–Hypopnea Index decreased to 17.6, presented a sleep efficiency of 81.6 % and had a 77 % spO 2. The ESS and PSQI scores dropped to three. MRD in association with the tongue-retainer was effective in reducing the severity of the apnea for this edentulous patient.