Indian Journal of Sleep Medicine

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VOLUME 5 , ISSUE 4 ( October-December, 2010 ) > List of Articles

REVIEW ARTICLE

Obstructive sleep apnea and edentulism – role of complete dentures/oral appliance from prosthodontics perspective : a review

Prachi Gupta, Ram Thombare, Sameer Singhal, A J Pakhan

Keywords : OSA, Oral appliances, Edentulism, Retropharyngeal space

Citation Information : Gupta P, Thombare R, Singhal S, Pakhan AJ. Obstructive sleep apnea and edentulism – role of complete dentures/oral appliance from prosthodontics perspective : a review. Indian Sleep Med 2010; 5 (4):116-119.

DOI: 10.5005/ijsm-5-4-116

License: CC BY-SA 4.0

Published Online: 01-12-2010

Copyright Statement:  Copyright © 2010; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: Edentulism results in decrease in size and tone of the pharyngeal musculature and may be an important risk factor for development of Obstructive Sleep Apnea (OSA). Epidemiological studies estimated that edentulism has been found to be present in about 18% of patients older than 60 years of age and that such prevalence would remain constant over the next 30 years. Considering the high prevalence of obstructive sleep apnea in the advanced age, it is conceivable that a consistent number of elderly people are at risk of edentulism induced worsening of obstructive sleep apnea and, consequently of morbidity and mortality due to this condition. Although cranio-mandibular abnormalities are well recognised risk factors for this manifestation, the role played by edentulism has never been investigated at length. The literature available on this issue was critically reviewed for the occurrence, etiology and prosthodontist\'s involvement in treating this condition Objective: The authors reviewed medical and dental literature dealing with edentulism and development of OSA and effect of complete denture/ oral appliances on the retropharyngeal space (smallest linear distance between anterior and posterior pharyngeal wall) and reduction in theincidence of OSA among apnea hypoapnea index (AHI). Results: Edentulous patients tends to be higher than that of the general population. Loss or absence of teeth produces prominent anatomical changes that may influence upper airway size and function, such as loss of the vertical dimension of occlusion resulting into reduction of height of the lower face and mandibular rotation. Rehabilitation of edentulous patients with complete dentures is an integral part of prosthodontic treatment. A denture not only provides aesthetics and improves the phonetics but also restores the desired function of mastication and also provides adequate support to oro-facial structures by restoring altered vertical dimension of face. Besides, it also improves OSA/hypopnea.


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  1. Bucca C, Cicolin A, Brussino L, Arienti A, Graciano A, Erovigni F et al. Tooth loss and obstructive sleep apnoea. Respiratory Research 2006; 7:8.
  2. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 1999; 22:667-89.
  3. Meyer JB, Knudson RC. Fabrication of prosthesis to prevent sleep apnea in edentulous patients. J Prosthet Dent. 1990; 63:448-51.
  4. Robertson CJ. Treatment of obstructive sleep apnea in edentulous patients- design of a combination appliance: a case study. N Z Dent J. 1998; 94(417):123-4.
  5. Bucca C, Carossa S, Pivetti S, Gai V, Rolla G, Preti G. Edentulism and worsening of obstructive sleep apnoea. Lancet. 1999; 353:121-2.
  6. Bucca C, Carossa S, Colagrande P, Brussino L, Chiavassa G, Pera P et al. Effect of edentulism on spirometric tests. Am J Respir Crit Care Med. 2001; 162:1018-20.
  7. Erovigni F, Graziano A, Ceruti P, Gassino G, Lillo A De, Carossa S. Cephalometric evaluation of the upper airway in patients with complete dentures. Minerva Stomatol. 2005; 54:293-301.
  8. Nayar S, Knox J. Management of obstructive sleep apnea in an edentulous patient with a mandibular advancement splint: A clinical report. J prosthet Dent. 2005; 94:108-11.
  9. Taner T, Aydinatay BS, Turkyilmaz I, Demir AU. The use of modified mandibular advancement device in the treatment of a partially edentulous patient with obstructive sleep apnea. Turkey Dental Journal 2007; 31(3):82-7.
  10. Hoekema A, Vries FD, Heydenrijk K, Stegenga B. Implant-retained oral appliances: a novel treatment for edentulous patients with obstructive sleep apneahypopnea syndrome. Clinical Oral Implants Research 2007; 18 (3):383-7.
  11. Kurtulmus H, Cotert HS. Management of obstructive sleep apnea in an edentulous patient with a combination of mandibular advancement splint and tongue retaining device: a clinical report. Sleep Breath 2009; 13:97-102.
  12. Arisaka H, Sakuraba S, Tamaki K, Watanabe T, Takeda J, Yoshida K. Effect of wearing complete dentures during sleep on the apnea-hypoapnea index. Int J Prosthodont 2009; 22:173-7.
  13. Marcus PA, Joshi A, Jones JA, Morgano SM. Complete edentulism and denture use for elders in New England. J Prosthet Dent 1996; 76:260-6.
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