Mandibular-Lingual Repositioning Device - MLRD
preliminary results of 8 patients with Obstructive Sleep Apnea Syndrome - OSAS
Palavras-chave:
Obstructive Sleep Apnea, Snoring, Dental deviceResumo
INTRODUÇÃO: Os aparelhos bucais têm sido usados principalmente para o tratamento de roncos primários e síndrome da apnéia obstrutiva do sono (SÃOS) leve-moderada. Os autores relatam resultados clínicos preliminares em 8 pacientes com síndrome da apnéia obstrutiva do sono diagnosticada clínica e polissonograficamente. Foram tratados com o Aparelho Reposicionador Mandíbulo-Lingual (ARML), desenvolvido por um dos autores (RCB). MATERIAL E MÉTODOS: Foram realizados: cefalometria pré-ARML; escala de sonolência de Epworth (ESE) pré e pós-ARML e questionário que quantifica uma melhora global subjetiva (MGS) do paciente. Controles foram obtidos 4 semanas pós-ARML. RESULTADOS: A melhora global subjetiva foi de 73,75% em média e a escala de sonolência de Epwoeth variou de 13,88 (pré-ARML) para 6,63 (pósARML) apresentando significância estatística (p=0,05). Os autores discutem os prováveis fatores envolvidos na melhora da medida subjetiva de sonolência excessiva diurna.
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