Luca Levrini1, Franco Sacchi2, Francesca Milano3, Antonella Polimeni4, Paolo Cozza5, Edoardo Bernkopf6, Marzia Segù7, Marco Zucconi1, Claudio Vicini1, Enrico Brunello1. 1. Dipartimento di Scienze Chirurgiche e Morfologiche, Università degli Studi dell'Insubria, Varese, Italy. 2. Società Italiana Medicina del Sonno Odontoiatrica, Milano, Italy. 3. Società Italiana Medicina del Sonno Odontoiatrica, Bologna, Italy. 4. Dipartimento di Scienze Odontostomatologiche e Maxillo Facciali, Università di Roma "Sapienza", Roma, Italy. 5. Università degli Studi di Roma "Tor Vergata", Roma, Italy. 6. Associazione Nazionale Dentisti Italiani, Vicenza, Italy. 7. Unità per lo Studio del dolore orofacciale e dei disordini temporomandibolari, University of Pavia, Italy.
Abstract
BACKGROUND: The aim of the present article is to present a set of proposed clinical recommendations aimed at Italian dentists involved in the management of patients with obstructive sleep apnea syndrome or snoring. METHODS: With the purpose of creating a study group, some of the most important Italian scientific societies operating in fields relevant to the issue of sleep medicine in dentistry were asked to appoint a representative. Each member of the study group was required to answer questions regarding the clinical management of OSAS and snoring. RESULTS: Oral appliances can be used to treat: - simple snoring, in patients who do not respond to, or do not appear to be suitable candidates for behavioral measures such as weight loss or positional therapy; - mild or moderate OSAS, in patients who prefer OAs to continuous positive airway pressure (CPAP) or who are not suitable candidates for CPAP, because of its failure or failure of behavioral approaches like weight loss or positional therapy; - severe OSAS, in patients who do not respond to or do not tolerate CPAP and in whom no indication for either maxillofacial or ENT surgery appears applicable. CONCLUSIONS: The application of oral appliances is highly desirable in cases of simple snoring or mild to moderate OSAS, whereas considerable caution is warranted when treating severe OSAS. It is fundamental to ensure that the patient understands his problem and, at the same time, to present all the various treatment options.
BACKGROUND: The aim of the present article is to present a set of proposed clinical recommendations aimed at Italian dentists involved in the management of patients with obstructive sleep apnea syndrome or snoring. METHODS: With the purpose of creating a study group, some of the most important Italian scientific societies operating in fields relevant to the issue of sleep medicine in dentistry were asked to appoint a representative. Each member of the study group was required to answer questions regarding the clinical management of OSAS and snoring. RESULTS: Oral appliances can be used to treat: - simple snoring, in patients who do not respond to, or do not appear to be suitable candidates for behavioral measures such as weight loss or positional therapy; - mild or moderate OSAS, in patients who prefer OAs to continuous positive airway pressure (CPAP) or who are not suitable candidates for CPAP, because of its failure or failure of behavioral approaches like weight loss or positional therapy; - severe OSAS, in patients who do not respond to or do not tolerate CPAP and in whom no indication for either maxillofacial or ENT surgery appears applicable. CONCLUSIONS: The application of oral appliances is highly desirable in cases of simple snoring or mild to moderate OSAS, whereas considerable caution is warranted when treating severe OSAS. It is fundamental to ensure that the patient understands his problem and, at the same time, to present all the various treatment options.
Authors: F Gagnadoux; B Fleury; B Vielle; B Pételle; N Meslier; X L N'Guyen; W Trzepizur; J L Racineux Journal: Eur Respir J Date: 2009-03-26 Impact factor: 16.671
Authors: Letizia Lonia; Marco Scalese; Gianluca Rossato; Giovanni Bruno; Francesca Zalunardo; Alberto De Stefani; Antonio Gracco Journal: Medicina (Kaunas) Date: 2020-06-30 Impact factor: 2.430
Authors: G Magliulo; M De Vincentiis; G Iannella; A Ciofalo; B Pasquariello; A Manno; D Angeletti; A Polimeni Journal: Acta Otorhinolaryngol Ital Date: 2018-08 Impact factor: 2.124