Respiratory Treatment and Prevention (Advances in Experimental Medicine and Biology)

Advs Exp. Medicine, Biology - Neuroscience and Respiration (2016) 27: 63–71
DOI 10.1007/5584_2016_61
#Springer International Publishing Switzerland 2017
Published online: 29 July 2016

Mandibular Advancement Appliance

for Obstructive Sleep Apnea Treatment

J. Kostrzewa-Janicka, P. S ́liwin ́ski, M. Wojda, D. Rolski,

and E. Mierzwin ́ska-Nastalska

Abstract

A combination of abnormal anatomy and physiology of the upper airway

can produce its repetitive narrowing during sleep, resulting in obstructive

sleep apnea (OSA). Treatment of sleep-breathing disorder ranges from

lifestyle modifications, upper airway surgery, continuous positive airway

pressure (CPAP) to the use of oral appliances. A proper treatment selec-

tion should be preceded by thorough clinical and instrumental

examinations. The type and number of specific oral appliances are still

growing. The mandibular advancement appliance (MAA) is the most

common type of a dental device in use today. The device makes the

mandible protrude forward, preventing or minimizing the upper airway

collapse during sleep. A significant variability in the patients’ response to

treatment has been observed, which can be explained by the severity of

sleep apnea at baseline and duration of treatment. In some trials, patients

with mild OSA show a similar treatment effect after the use of CPAP or

MAA. It is worthwhile to give it a try with an oral appliance of MAA type

in snoring, mild-to-moderate sleep apnea, and in individuals who are

intolerant to CPAP treatment.

Keywords

Airway collapse • Life style • Mandibular advancement device • Sleep

apnea • Sleep disordered breathing • Treatment effectiveness • Upper

airways

1 Etiology and Epidemiology

Obstructive Sleep Apnea (OSA)

OSA represents a group of sleep-breathing

disorders and makes up 90 % of all forms

of apnea syndromes (Hudgel 1992 ). It is

J. Kostrzewa-Janicka (*), M. Wojda, D. Rolski,
and E. Mierzwin ́ska-Nastalska
Department of Prosthodontics, Medical University
of Warsaw, Warsaw, Poland
e-mail:[email protected]

P. S ́liwin ́ski
IV Fourth Clinic of Lung Diseases, Institute of
Tuberculosis and Lung Diseases, Warsaw, Poland

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