32^nd Asia Pacific Dental and Oral Health Congress

Biography

Biography: Prof. Dr. G. Dave Singh

Abstract

We investigated changes in upper airway morphology to test the hypothesis that the upper airway can be non-surgically remodeled in adult patients with obstructive sleep apnea (OSA).  After obtaining informed consent, we undertook a 3D cone-beam (CBCT) scan of a 56-year-old male patient, who was diagnosed with mild OSA by a sleep specialist prior to treatment.  The patient was treated using a biomimetic oral device (DNA appliance®).  The active treatment time was 18 months approx.  Volumetric 3D reconstruction of the upper airway from the CBCT scan was undertaken prior to treatment, and the patient was monitored with a follow up CBCT scan 5.5yrs later.  All measurements were taken with no device in the patient’s mouth during wakefulness.  The results showed that the upper airway volume increased from 13.9cm³ to 29.2cm³.  The minimal antero-posterior retropalatal distance increased from 1.5mm to 11mm in the mid-sagittal plane; the minimum medio-lateral retropalatal width increased from 4.5mm to 29mm in the coronal plane; the minimum retropalatal area in the axial plane at the same level as above increased from 67mm² to 477.5mm².  In addition, the minimum antero-posterior retroglossal distance increased from 6mm to 17mm in the mid-sagittal plane; the minimum medio-lateral retroglossal width increased from 14.5mm to 26.5mm in the coronal plane, and the minimum retroglossal area in the axial plane at the same level as above increased from 83.5mm² to 423.5mm².  We conclude that biomimetic oral appliance therapy may be able to non-surgically remodel the upper airway in adult patients diagnosed with mild OSA.  This biomimetic protocol requires further investigation to elucidate the novel mechanism of pneumopedics or physiologic upper airway remodeling.