CLINICALfocus
A Successful Case of Combination Therapy Using Myofunctional Therapy, an Aligner Sleep Appliance, and Clear Aligners by Maria Sokolina, DDS, D.ABDSM
A
lot of obstructive sleep apnea (OSA) patients have misaligned, crowded teeth that impinge on the tongue space, forcing the tongue into the airway. An Aligner Sleep Appliance in combination with Clear Aligners can address the misalignment of the teeth and achieve restorative goals after orthodontic therapy. Patients can use the ASA with modified clear aligners during restorative treatment as well. An Aligner Sleep Appliance in combination with Clear Aligners can be a useful solution for practitioners who are preparing their patients for orthognathic surgery to correct OSA. Most patients who seek orthognathic surgery have misaligned teeth and are also seeking surgery because they could not tolerate CPAP therapy.
Abstract
Patients that present with obstructive sleep apnea (OSA) often have co-existing dental conditions including bruxism and dental
malocclusions1-3 (Figures 1-5). Comprehensive treatment for these patients requires customized plans that take into account individual anatomy, medical history, lifestyle, and preferences. This report details one such case in which we were able to significantly improve a patient’s sleep and breathing quality with a combination of oral appliance, clear aligners therapy, myofunctional therapy, and home remedies to relieve nasal congestion.
Introduction
An estimated 2-4% of middle-aged Americans meet the diagnostic criteria for obstructive sleep apnea (OSA), with up to a quarter of men between 30 and 49 years of age potentially experiencing sleep-disordered breathing.4 The gold standard treatment for OSA is continuous positive airway pressure (CPAP) therapy, but adherence to CPAP therapy is low.5 Mandibular advancement devices (MAD) are a common alternative for patients who do not want to use or do not tolerate
Figures 1-5: A 60-year-old male was referred to our practice due to CPAP intolerance. Oral examination revealed upper and lower dental crowding and bruxism.
52 DSP | Fall 2023