Mandibular-Lingual Repositioning Device - MLRD

preliminary results of 8 patients with Obstructive Sleep Apnea Syndrome - OSAS

Autores

  • Ricardo Castro Barbosa
  • Flávio Aloe
  • Stella Tavares
  • Ademir Baptista Silva

Palavras-chave:

Obstructive Sleep Apnea, Snoring, Dental device

Resumo

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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Biografia do Autor

Ricardo Castro Barbosa

Universidade de São Paulo, College of Dentistry. USP, Medical School , Hospital das Clínicas. Hospital, Israelita Albert Einstein, Center for Sleep Disorders. Baptista Silva Clinica, São Paulo, Brazil.

Flávio Aloe

Universidade de São Paulo, College of Dentistry. USP, Medical School , Hospital das Clínicas. Hospital, Israelita Albert Einstein, Center for Sleep Disorders. Baptista Silva Clinica, São Paulo, Brazil.

Stella Tavares

Universidade de São Paulo, College of Dentistry. USP, Medical School , Hospital das Clínicas. Hospital, Israelita Albert Einstein, Center for Sleep Disorders. Baptista Silva Clinica, São Paulo, Brazil.

Ademir Baptista Silva

Universidade de São Paulo, College of Dentistry. USP, Medical School , Hospital das Clínicas. Hospital, Israelita Albert Einstein, Center for Sleep Disorders. Baptista Silva Clinica, São Paulo, Brazil.

Referências

BERNSTEIN, A. & REIDY, R. - The effects of mandibular repositioning on obstructive sleep apnea. J. Craniomandibular Practice 6: 179-181, 1988.

BONHAM, E.; CURRIER, G.; ORR, W.; OTHMAN, J. & NANDA, R. - The effects of a modified functional appliance on OSA. Am. J. Orth Dentofac Orthop 94: 384-392, 1988.

BRADLEY, T.; BROWN, I.G.; GROSSMAN, R.F.; ZAMEL, N.; MARTINEZ, D.; PHILLIPSON, E.A. & HOFFSTEIN, V.- Pharyngeal size in snorers, nonsnoreres, and patients with Obstructive Sleep Apnea. New Engl. J. Med. 315: 1327-1327, 1986.

CARTWRIGHT, R.D. & SAMELSON, C.F. - The effects of a nonsurgical treatment for obstructive sleep apnea. Jama 248: 705-709,1982

CARTWRIGHT, R.D. - Predicting Response to the Tongue Retaining Device for Sleep Apnea Syndrome. Arch Otolaryngol 111: 385-388,1985.

CARTWRIGHT, R.D.; STEFOSKI, D.& CALDARELLI, D. - Toward a treatment logic for sleep apnea: the place for the tongue retaining device. Behav Res Ther 26:121-126.,1988

CARTWRIGHT, R.D.; RISTANOVIC, R.; DIAZ, F.; CALDARELLI, D. & ALDER, G. - A Comparative Study of Treatments for Positional Sleep Apnea. Sleep 14: 546-552, 1991.

CLARK, G.T. & NAKAMO, M. - Dental appliances for the treatment of obstructive sleep apnea. J. Am. Dent Ass 118: 611-619,1989.

CRAMPETTE, L.; CARLANDER, B.; MONDAIN, M.; BILLIARD, M.; GUERRIER, B. & DEJEAM, Y. - Surgical Alternatives to Uvulopalatopharynplasty in Sleep Apnea Syndrome. Sleep 5: S63-S68, 1992

DJUPESLAND, G.; LYBERG, T. & KROSGTAD, O. - Cephalometrics analysis and surgical treatment of patients with obstructive sleep apnea. Acta Otoryngol 103: 551-557, 1987.

FUJITA, S.; CONWAY, W.; ZORICK, F. - Surgical correction of antomical abnormalities in Obstructive Sleep Apnea: Uvulopalatopharingoplasty. Otorynol Head Neck Surg 89: 923 -934, 1981 .

GEORGE, P. - A modified functional appliance for treatment of obstructive sleep apnea. J Clin Ortho 21: 171-175, 1987.

GUILLEMINAULT, C. - Obstructive sleep apnea syndrome. Psych Clin North Am 10: 607-6261, 1987.

HE, J.; KRYEGER, M.H.; ZORICK,.F.J.; CONWAY, W. & ROTH, T. - Mortality and apnea index in obstructive sleep apnea. Chest 94: 9-14, 1988.

HORNER, R.L.; MOHIADDIN, R.H.; LOWELL, D.G.; SHEA, S.A.; BURMAN, E.D.; LONGMORE, D.B & GUZ, A. - Sites and Sizes of fat deposits around the pharynx in obese patients with obstuctive sleep apnea and weight matched controls. Eur Respir J 2: 613-622. 1989.

ISSA, F.G & SULLIVAN, C.E. - Upper airway closure pressures in obstructive sleep apnea. J Appl Physiol 57: 140-146. 1984.

JOHNS, M.W. - A New Method for Measuring Daytime Sleepiness: The Epworth Sleepiness Scale. Sleep 14:540-545, 1991.

KRIEGER, J. - Long - Term Compliance with Nasal Continuos Positive Airway Pressure (CPAP) in Obstrucive Sleep Apnea Patients and Nonapneic Snorers. Sleep 15: 542-S46, 1992.

KRYGER, M.H. - Management of Obstructive Sleep Apnea. In: Principles and Practice of Sleep Medicine, KRYGER, M.; ROTH, T. & DEMENT, W. (eds). Saunders, Toronto, 584-590, 1986.

KUNA, S.T. & SANT'AMBROSIO, G. - Pathophysiology of Upper Airway Closure during Sleep. JAMA 22: 1384-1389, 1991.

LOWE, A.; GURZA, S. & SESSELE, B. - Excitatory and inhibitory influences on tongue muscle activity in cat and monkey. Brain Res 21: 417-422, 1976.

LOWE, A.; SANTAMARIA, J.; FLEETHAM, J.& PRICE, C. - Facial morphology and obstructive sleep apnea. Am J Orthod Dentofac Orthop 90: 364-374, 1986.

LOWE, A. - Effects of a mandibular repositioning appliance used in the treatment of obstructive sleep apnea on tongue muscle activity. In: ISSA, F., SURATT, P. & REMMERS, J. (eds) Sleep and Respiration, New York: Wiley-Liss, Inc. 395-405, 1990.

LOWE, A. - Dental appliances for the treatment of snoring and! or obstructive sleep apnea. In KRYEGER, M.; ROTH, T. & DEMENTW. (eds) Principles and practice of sleep medicine 2 nd edition. W.B. Saunders Co: 722-735, 1993.

MONTPLAISIR, J..; BÊDARD, M.A.; RICHER, F. & ROULEAU, I. - Neurobehavioral Manifestations in Obstructive Sleep Apnea Syndrome Before and After Treatment with Continuous Positive Airway Pressure. Sleep 15: S17-S19, 1992.

NICO-MURCIA, G.; MCCANN, C.C.; BLIWISE, D.L..; GUILLEMINAULTIC, C. & DEMENT, W.C. - Compliance and side effects in sleep apnea patientes treated with nasal continuous positive airway pressure. West J. Med. 150: 165-169, 1989.

PARTINEN, M.; GUILLEMINAULT, C.; QUERA-SALVA, M.A. & JAMIESON, A. - Obstructive Sleep Apnea and cephalometric roentgenograms. The role of anatomic upper airway abnormalities in the definition of abnormal breathing during sleep. Chest 93: 1199-1205, 1988a.

PARTINEN, M.; JAMIESON, A. & GUILLEMINAULT, C. - Long term outcome for obstructive sleep apnea syndrome patients: mortality. Chest 94: 1200-1204, 1988b.

PARTINEN, M. & GUILLEMINAULT, C. - Daytime sleepiness and vascular morbidity at seven-year follow-up in obstructive sleep apnea patients. Chest 97: 27-32, 1990.

PARTINEN, M. & TELAKIVI, T. - Epidemiology of Obstructive Sleep Apnea. Sleep 15: S1-S4, 1992.

POWEL, N.B. & RILEY, R.W. Obstructive sleep apnea, continuous positive airway pressure, and surgery. Otolaryngol Head Neck Surg. 99: 362-369, 1988.

REMMERS, J.E. - Anatomy and physiology of upper airway obstruction. In: Principles and Practice of Sleep Medicine, KRYGER, M.; ROTH, T. & DEMENT, W. (eds). Saunders, Toronto, 525-536, 1989.

RICHARDSON, G.S.; CARSKADON, M.A.; FLAGG, W.; VAN DEN HOED, J.; DEMENT, W.C. & MITTLER M.M. - Excessive daytime sleepiness in man: multiple sleep latency measurements in narcoleptic and control subjects. Electroencephalogr Clin Neurophysiol 45: 621-627, 1978.

ROBIN, P. - Glossoptosis due to atresia and hyportrophy of the mandible. Amer J. Dis. Child. 48: 541-7, 1934.

SANDERS, M.H.; GRUENDL, C. & ROGERS, R.M. - Patient compliance with nasal CPAP therapy for sleep apnea. Chest 90: 330-333, 1986.

SCHIMIDT-NOWARA, W.; MEADDE, T. & HAYS, M. - Treatment of snoring and obstructive sleep apnea with a dental orthosis. Chest 99: 1378-1385, 1991.

SHEPARD, J.W.; GEFTER, W.B.; GUILLEMINAULT, C.; HOFFMAN, E.A.; HOFFSTEIN, V.; HYDGEL, D.W.; SURATT, P.M. & WHITE, D.P. - Evaluation of the Upper Airway in Patients with Obstructive Sleep Apnea. Sleep 14: 361-371, 1992.

SOLL, B. & GEORGE, P. - Treatment of obstructive sleep apnea with a nocturnal airway-patency appliance. N. Engl. J. Med. 313: 386, 1985.

THURROW, R.C. - Functional anatomy of the dental mechanisms. In: Atlas of Orthodontic Principles C. V. Mosby Co., St. Louis, 135, 1970.

WALDHORN, R.E.; HERRICK, T. W.; NGUYEN, M.C.; O'DONNEL, A.E.; SODERO, J. & POTOLICCHIO, S.J. - Long term compliance with nasal continuous positive airway pressure therapy for sleep apnea. Chest 97: 33-38, 1990.

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Publicado

1995-05-05

Como Citar

1.
Barbosa RC, Aloe F, Tavares S, Silva AB. Mandibular-Lingual Repositioning Device - MLRD: preliminary results of 8 patients with Obstructive Sleep Apnea Syndrome - OSAS. Sao Paulo Med J [Internet]. 5º de maio de 1995 [citado 16º de outubro de 2025];113(3):888-94. Disponível em: https://periodicosapm.emnuvens.com.br/spmj/article/view/1679

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