4) 睡眠時無呼吸症候群の歯科治療(〈シンポジウム〉睡眠時無呼吸症候群

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The sleep-disordered breathing (SDB) such as primary snoring (PS), upper airway resistance syndrome (UARS) and obstructive sleep apnea (OSA), are characterized by repeated upper airway narrowing or collapse during sleep. The obstruction is caused by the soft palate and/or base of tongue collapsing against the pharyngeal walls. The signs and symptoms of SDB may be recognizable in the dental practice. Common findings in the medical history include daytime sleepiness, snoring, hypertension, and type 2 diabetes mellitus. Common clinical findings include male gender, obesity, a long soft palate, a large and/or low-positioned tongue, a small recessive mandible and maxilla, long face syndrome and calcified carotid artery atheromas. Dentists who recognize these signs and symptoms have an opportunity to diagnose patients with SDB. After confirmation of the diagnosis with a polysomnography (PSG), dentists can participate in the management of the disorder by fabricating oral appliances (OA) that enlarge the retroglossal space by anterior displacement of the mandible and tongue and performing corrective upper airway surgeries such as Laser-Assisted Uvulopalatoplasty (LAUP), Maxillomandibular osteotomy (MMO) and Total replacement of TMJs (TMJ implants) those prevent recurrent airway obstruction. The current strategy of our clinic for the management patients with SDB is a multidisciplinary approach. A combination of LAUP and OA for the patients with PS, UARS and mild OSA is more effective than either treatment alone. And a combination of nasal continuous positive airway pressure (NCPAP) and OA is more acceptable for patients using NCPAP than NCPAP alone because of decreased airway pressure.

4) 睡眠時無呼吸症候群の歯科治療(〈シンポジウム〉睡眠時無呼吸症候群

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