• Title/Summary/Keyword: Oral appliance

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Treatment Outcomes of Mandibular Advancement Devices between Rapid-Eye-Movement (REM)-Related and Not-REM-Related OSA Patients

  • Oh, Jae-Tak;Jang, Ji-Hee;Chung, Jin-Woo
    • Journal of Oral Medicine and Pain
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    • v.41 no.2
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    • pp.54-60
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    • 2016
  • Purpose: Mandibular advancement devices (MAD) are used effectively and widely for the treatment of obstructive sleep apnea (OSA) and rapid-eye-movement (REM) dependency of the patients can affect the treatment outcome of OSA. The aim of this study was to compare treatment outcomes of MAD between REM-related and not-REM-related OSA patients. Methods: Fifty-six consecutive patients with OSA who received MAD therapy were evaluated using full night polysomnography before and after insertion of the MADs. The patients were divided into REM-related (REM apnea-hypopnea index [AHI] at least two times higher than their non-REM AHI) and not-REM-related (REM AHI less than two times higher than their non-REM AHI) OSA groups. Results: MAD is used for the treatment of OSA effectively. In respect of AHI, MAD therapy were effective both in REM-related OSA and not-REM-related OSA, but MAD therapy was more effective in not-REM-related OSA than REM-related OSA in overall sleep and non-REM sleep. $SpO_2$ saturations were improved after MAD therapy, but were not different between two groups. Epworth sleepiness scale scores were not improved after MAD therapy. Percentage of REM sleep was increased after MAD therapy but was not different between two groups. Conclusions: MAD therapy was more effective in not-REM-related OSA than REM-related OSA and REM dependency can be a predictive factor of treatment outcome of oral appliance for OSA patients.

The Distribution of Oral Candida Species in Patient with Prosthetic Appliance (보철물 장착 환자의 구강 칸디다균 분포)

  • Son, Seung Hwa;Baek, Su Min;Park, Young Min
    • Journal of dental hygiene science
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    • v.14 no.4
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    • pp.477-487
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    • 2014
  • Of the many pathogenic Candida species, Candida albicans is the main fungal pathogen of humans. The oral environmental factors considered in the Candida albicans colony forming unit test contain both host and microbial factors associated with candidiasis. In particular, Candida biofilms can develop on surfaces of prosthesis. The purpose of this study was to investigate the distribution of oral Candida species between the type of prosthesis and the situation of oral environment in patient with prosthetic appliance. The patients were 30 elderly subjects with different types of prosthesis, 7 who wore denture, 12 who wore implant and 15 who wore removable orthodontic appliance. We used Candida albicans colony forming unit test using saliva to exam the distribution of Candida albicans related with 5 oral environmental factors, gender, smoking or nonsmoking, alcohol/nonalcohol consumption, the type of prosthetic appliance and its treatment duration as well as tooth brushing frequency per day. In conclusion, for the patient's gender, site in the oral cavity and the type of prosthetic appliance and its treatment duration was associated with an increase in the distribution of Candida albicans in saliva. The distribution of Candida albicans within the oral cavity performs to be modulated to varying extents by oral environmental factors and, further investigations are required to elucidate these complex interactions.

A Study on the Effect of Mandibular Orthopedic Repositioning Appliance (MORA) on Back Muscle Strength (Mandibular orthopedic repositioning appliance(MORA)가 배근력에 미치는 영향에 관한 연구)

  • 현기용;이승우
    • Journal of Oral Medicine and Pain
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    • v.10 no.1
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    • pp.113-124
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    • 1985
  • In order to observe the effect of mandibular orthopedic repositioning appliance (MORA) on body strength, the author measured back muscle strength with Digital Back Muscle DYNAMOMETER (TAKEI KIKI KOGYO Co., Tokyo, Japan) before MORA, 15 days after and 30 days after MORA in 12 men and then analysed them statistically. The subjects were weight-lifting athletes of Seoul Athletic High School without dysfunction of masticatory system. MORA was fabricated at 1.0-1.5rnm isotonically closed position (Myocentric Occlusion Position) from mandibular rest position (Myocentric Rest Position) using Myo-monitor (MyoTronics Research Inc., Seattle, Washington, USA) and-SVT C-II (Tokyo Shizaisha Inc., Tokyo, Japan). The results were as follows : 1. The mean of back muscle strength before MORA was 150 kg, that of 15 days after MORA was 165 kg (4.43% increase than before), and that of 30 days was 175 kg (10.76% increase than before). 2. There was a significant difference among back muscle strength before MORA, 15 days after and 30 days after MORA (P<0.01: repeated measures one-way ANOVA). 3. According to the result of determining mandibular position for MORA fabrication, mandibular rest position after relaxation with Myo-monitor was 3.2mm lower, 1.0mm posterior, and 0.5 mm left from centric occlusion. And the mean of the amount of lateral deviation was 0.7 mm.

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Inflammatory Cytokine Level in Patients with Obstructive Sleep Apnea and Treatment Outcome of Oral Appliance Therapy

  • Oh, Jae-Tak;Chung, Jin-Woo
    • Journal of Oral Medicine and Pain
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    • v.41 no.3
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    • pp.126-132
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    • 2016
  • Purpose: The aims of this study were to analyze the association between inflammatory cytokine and obstructive sleep apnea (OSA), and to evaluate treatment outcome and changes of plasma inflammatory cytokine levels after oral appliance therapy. Methods: Twenty-seven subjects who visited Department of Oral Medicine in Seoul National University Dental Hospital were performed nocturnal polysomnography and analyzed plasma C-reactive protein (CRP), interleukin (IL)-$1{\beta}$, IL-6, IL-10, and tumor necrosis factor (TNF)-${\alpha}$ levels. Each subject was evaluated with Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). The subjects were classified into 12 OSA patients (apnea-hypopnea index [AHI] >5) and 15 control (AHI ${\leq}5$) groups. The OSA group was treated with mandibular advancement device (MAD) for 3 months and re-evaluated nocturnal polysomnography and plasma inflammatory cytokine levels. Results: Plasma TNF-${\alpha}$, IL-10, and IL-6 levels were significantly higher in OSA patients compared to controls. Total AHI showed significant positive correlations with plasma IL-6 and TNF-${\alpha}$ levels. Percentage time of $SpO_2$ <90 and lowest $SpO_2$ were significantly correlated with plasma TNF-${\alpha}$ level. ESS showed significant positive correlation with plasma IL-10 level. Total AHI, percentage time of $SpO_2$ <90, lowest $SpO_2$, and mean $SpO_2$ were significantly improved after the MAD therapy. Plasma TNF-${\alpha}$ level was significantly decreased after MAD therapy. Conclusions: We suggest that MAD therapy is an effective treatment modality for patients with OSA and can decrease plasma cytokine level.

The Effect of Water Immersion on the Surface Strength and the Flexural Strength of the Acrylic Resin for Occlusal Appliances (교합장치용 아크릴레진의 표면경도와 굴곡강도에 대한 침수의 영향)

  • Lee, Hoy-Youn;Im, Yeong-Gwan;Kim, Byung-Gook;Lim, Hoi-Soon;Kim, Jae-Hyung
    • Journal of Oral Medicine and Pain
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    • v.35 no.1
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    • pp.75-81
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    • 2010
  • By repeating nocturnal bruxism occlusal appliance's wearing condition that is used to cure temporomandibular disorders into the vitro experiment, research aims to find out how moisture infiltrated and drying cycle process affects on the surface microhardness of the resin for occlusal appliance and flexural strength. By utilizing resin for occlusal appliance which is the main component of poly methyl methacrylate, bar shaped sample was produced. For the resin sample utilized as the controlled group 1, the sample was infiltrated in the moisture for 7 days in the temperature of 37C. Then, the resin sample of the controlled group 2 was maintained in a dry condition for 7 days in the normal temperature. After that, each sample's surface microhardness and flexural strength were measured. For the resin sample that is utilized as the experimental sample, the sample was infiltrated in the moisture for 7 days in the temperature of 37C. Then, it was inundated for 8 hours a day and dried in the normal temperature for 16 hours with the continuous process of moisture infiltration and dry cycle process for 30 days. During this cycle process, sample's surface and flexural strength were measured in the 1st day, 7th day, and 30th day. Then, it was statistically analyzed to find out the difference of controlled and experiment group's surface microhardness and flexural strength. Results are 1. For the experimental and controlled group's surface microhardness of the resin for the occlusal appliance, it did not show any significant differences after moisture infiltration and dry cycle process repetition. 2. In case of the flexural strength for resin for the occlusal appliance, experimental group with moisture infiltration and dry cycle for 30 day process had greater effect than the experimental group at the 1st day and controlled group These results can be considered to be utilized from the patients of the temporomandibular disorders towards occlusal appliance used and maintained method.

Case Report : Treatment of Burning mouth Syndrome Using a Removable Anti-Nociceptive Appliance (가철성 유해자극차단장치를 이용한 구강작열감증후군의 치료 증례)

  • Roh, Byung-Yoon;Ahn, Jong-Mo;Yoon, Chang-Lyuk;Ryu, Ji-Won
    • Journal of Oral Medicine and Pain
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    • v.37 no.1
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    • pp.1-7
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    • 2012
  • Burning mouth syndrome(BMS) refers to a chronic orofacial pain disorder usually unaccompanied by mucosal lesions or other clinical signs. Tongue(anterior and lateral border) is found to be the most common site for the burning sensations in the oral cavity, and various oral sites may be affected including hard palate and lips. The etiology of this disorder remains poorly understood, but the various factors might be related with the pathogenesis of the BMS. These factors have been devided into local, systemic and psychological. Recently, there have been increasing reports that the pain of BMS may be neuropathic in origin. The complex and multifactorial etiology of BMS necessitates multidisciplinary approach for the management of these patients. Recently, several studies have reported that oral parafunctional habits could be related the pathogenesis of BMS, and tried to control the symptom of BMS with various methods. We reported the cases who had the symptom of burning mouth syndrome with removable anti-nociceptive appliance in the lower dentition.

Maxillary molar derotation and distalization by using a nickel-titanium wire fabricated on a setup model

  • Jung, Jong Moon;Wi, Young Joo;Koo, Hyun Mo;Kim, Min Ji;Chun, Youn Sic
    • The korean journal of orthodontics
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    • v.47 no.4
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    • pp.268-274
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    • 2017
  • The purpose of this article is to introduce a simple appliance that uses a setup model and a nickel-titanium (Ni-Ti) wire for correcting the mesial rotation and drift of the permanent maxillary first molar. The technique involves bonding a Ni-Ti wire to the proper position of the target tooth on a setup model, followed by the fabrication of the transfer cap for indirect bonding and its transfer to the patient's teeth. This appliance causes less discomfort and provides better oral hygiene for the patients than do conventional appliances such as the bracket, pendulum, and distal jet. The treatment time is also shorter with the new appliance than with full-fixed appliances. Moreover, the applicability of the new appliance can be expanded to many cases by using screws or splinting with adjacent teeth to improve anchorage.

Preventive Cares for Orthodontic Dental Patients

  • Lee, Kyu-Hwan
    • International Journal of Clinical Preventive Dentistry
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    • v.14 no.4
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    • pp.209-215
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    • 2018
  • In recent years, the numbers of the orthodontic dental patients have been rapidly increased in adolescent or young adult aged generation. It has been well known that it would be very hard to control the oral hygiene cares for orthodontic applied dental patient because of the complexity of the appliance. So the caries prevalence of the orthodontic dental patients would be higher than non-appliance persons, and it might be easy to cause the dental caries especially on the labial or buccal surface of the tooth through equipping the fixed type appliance with a long period, even though the alignment of the teeth would be arranged well. So, the massive preventive program for preventive dentistry should be needed for the dental patients for orthodontic treatment, in order to protect the dental caries and the periodontal disease for them. But, lots of the dentists or dental hygienists sometimes neglect of this point for preventive dental cares orthodontic dental patients, or do not know the importance and how to manage the skill for the preventive dental works in clinical. In this article, it will be introduced the basic theories and skills for preventive cares as tooth-brushing instruction, fluoride topical application and pit and fissure sealant, scaling and professional mechanical tooth cleansing and the diet control, for the dental patients with the fixed type of the orthodontic appliance, in case by case.

Efficacy of the Anteriorly Adjustable Mandibular Advancement Device on the Treatment of Obstructive Sleep Apnea

  • Jang, Hoon-Ho;Kim, Hye-Kyoung;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.41 no.1
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    • pp.7-15
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    • 2016
  • Purpose: Mandibular advancement device (MAD) is widely recognized as an important treatment option for obstructive sleep apnea (OSA) and is readily accepted than any other treatment options owing to its simplicity and ambulatory nature. At this time, there are a multitude of MAD designs and their efficacies may be influenced by adjustment and retention mechanism. The MAD with the anterior connector (anteriorly adjustable mandibular advancement device, AAMAD) was newly developed in the Department of Oral Medicine, Dankook University Dental Hospital (Cheonan, Korea) and was prescribed for the OSA patients including snoring patients. Thus, this study was aimed to objectively investigate the effectiveness of the AAMAD on the OSA patients using the self-applied portable device (ApneaLink), and evaluate the treatment outcomes among patients with various severity of OSA level. Methods: Results of the treatment of fourteen patients (13 male, 1 female) with the AAMAD were retrospectively analyzed. Each patient underwent home sleep test before treatment and were divided into two groups, i.e., those with mild (apnea-hypopnea index [AHI] ${\geq}5$ and <15) to moderate OSA (AHI ${\geq}15$ and <30) and severe OSA (AHI ${\geq}30$). After treatment, home sleep test was conducted again and treatment outcomes were compared between mild to moderate and severe OSA patients. Results: Of all patients, 78.6% showed more than 50% AHI reduction. We found a significant reduction (85.3%) of AHI in the severe OSA patients. Patients with mild to moderate OSA showed the reduced AHI (56.1%). Conclusions: We concluded that AAMAD is an effective oral appliance for the majority of OSA patients.

FUNCTIONAL DYNAMIC REDUCTION OF THE FRACTURED MANDIBULAR CONDYLE IN THE CHILDREN: REPORTOF CASES (Benoist 장치에 의한 성장기 하악과두 골절 치험 3예)

  • Kim, Jong-Hoon;Oh, Bong-Woon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.3
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    • pp.211-216
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    • 1993
  • This is to report functional treatment, as mechano-therapy, of condylar fracture in cases of growing patients. Benoist's appliance was used in 3 cases condylar fractures, provides extraoral elastic forces to external pterygoid muscle. The appliance providing guided exercise of masticatory muscles induces transformative growth of trauma-tic condyles. The results were as follow; 1. Early exercise preventes ankylosis of fractured condyle. 2. Optimal physical exercise therapy induces the normal growth pattern by muscular training and bony remodeling of fractured condyle in children.

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