| Abstract [eng] |
The primary aim of this systematic review is to provide a comprehensive overview of diagnostic measurements for obstructive sleep apnea (OSA) and its management options with a particular focus on dentistry and the use of mandibular advancement devices (MAD). This review also covers other Management options, such as continuous positive airway pressure (CPAP) therapy and surgical interventions. In total, 1567 articles were initially screened based on their titles and abstracts, with 24 articles ultimately selected for inclusion in this thesis. Obstructive Sleep apnea is a condition caused by the collapse and narrowing of the throat during sleep, leading to breathing cessation. It is characterized by its severity, which is mild, moderate or severe. Clinical symptoms of OSA can vary in severity and may include snoring, daytime sleepiness, choking or gasping at night, heartburn, morning headaches, obesity, hypertension and more. A proper diagnosis is important, as untreated OSA can lead to complications such as heart disease, stroke and cognitive impairment. Diagnosis is done using tests including respiratory polygraphy, polysomnography, mallampati score, cephalometric evaluation, and CBCT volumetric airway measurements. Treatment modalities include lifestyle changes, mandibular advancement devices, continuous positive airway pressure or surgical interventions. It has been shown that MAD and CPAP have similar clinical effects due to greater MAD compliance achieving net similar AHI reduction. The American academy of sleep medicine suggested that the treatment with custom made MAD is preferred over non titrable MAD. It has been demonstrated that, wearing custom made appliances show a success rate of 80%, as well as a greater reduction in AHI and polysomnographic readings. |
