Moskva, Moscow, Russian Federation
Peoples’ Friendship University of Russia
Moskva, Moscow, Russian Federation
Moskva, Moscow, Russian Federation
Moskva, Moscow, Russian Federation
Moskva, Moscow, Russian Federation
Subject ― is a temporomandibular joint dysfunction. Goal ― to evaluate clinical effectiveness of an interdisciplinary approach towards dental orthopedic treatment of patients with obstructive sleep apnea and a need for a full mouth reconstruction. Methodology. A total of 95 patients (52 males and 43 females) with adentia, obstructive sleep apnea syndrome and temporomandibular disorder were assigned to comprehensive examination and treatment. All patients were in need for a full mouth reconstruction. Patients were divided into 3 groups. Group 1 (n = 32) was exposed to standard treatment procedures. Group 2 (n = 29) received certain elements of an interdisciplinary approach to dental orthopedic rehabilitation. Group 3 (n = 34) was exposed to multidisciplinary approach towards dental orthopedic rehabilitation. The follow-up period was 7 years. A key step in the treatment of group 3 patients was to conduct full patient examinations sequentially. The corresponding procedures were supplemented with a study of OSA manifestation patterns. Results. It was found that the use of the present proposal contributes to the normalization of the OSA picture in patients with temporomandibular disorder. For instance, the apnea-hypopnea index dropped, the basal nocturnal saturation increased, and the minimum saturation level decreased. Overall, the proportion of patients with better to favorable sleep increased. The revealed changes were persistent, and a positive effect was observed throughout the 5―7 years of follow-up. Conclusion. Performing restoration of the anatomical shape of the tooth with the interdisciplinary approach, the dentist should assess and relieve the manifestations of OSA while correcting the temporomandibular joint disturbances.
dental orthopedic rehabilitation, temporomandibular joint, adentia, dental restoration, obstructive sleep apnea syndrome
1. Domenyuk, D. A., Porfiriadis, M. P., Ilidzhev, D. M. et al. (2017). Razmernye i topograficheskie osobennosti elementov visochno-nizhnechelyustnogo sustava pri mezial'noj okklyuzii, oslozhnyonnoj defektami zubnyh ryadov [Dimensional and topographic features of the temporomandibular joint elements with mesial occlusion complicated by defects in the dentition]. Kubanskij nauchnyj medicinskij vestnik [Kuban Scientific Medical Bulletin], 24 (4), 54-64. (In Russ.)
2. Dorogin, V. E. (2017). Mezhdisciplinarnyj podhod k diagnostike, lecheniyu i reabilitacii pacientov s disfunkciej visochno-nizhnechelyustnogo sustava [Interdisciplinary approach to the diagnosis, treatment and rehabilitation of patients with temporomandibular joint dysfunction]. Sovremennye problemy nauki i obrazovaniya [Modern problems of science and education], 4, 7. (In Russ.)
3. Zhulev, E. N., Kupriyanova, O. G., Nikolaeva, E. Y. (2015). Sravnitel'naya harakteristika licevogo skeleta pri anomaliyah prikusa pervogo i vtorogo klassa Englya [Comparative characteristics of the facial skeleton with malocclusion of the first and second class of Engle]. Fundamental'nye issledovaniya [Fundamental Research], 1-10, 2052-2056. (In Russ.)
4. Najdanova, I. S., Pisarevskij, YU. L., Shapovalov, A. G., Pisarevskij, I. YU. (2018). Vozmozhnosti sovremennyh tekhnologij v diagnostike funkcional'nyh narushenij visochno-nizhnechelyustnogo sustava (obzor literatury) [Possibilities of modern technologies in the diagnosis of functional disorders of the temporomandibular joint (literature review)]. Problemy stomatologii [Actual problems in dentistry], 14, 4, 58-63.(In Russ.)
5. Petrikas, I. V., Kurochkin, A. P., Trapeznikov, D. V. et al. (2018). Kompleksnyj podhod k lecheniyu nejromuskulyarnogo disfunkcional'nogo sindroma VNCHS. Klinicheskoe nablyudenie [An integrated approach to the treatment of neuromuscular dysfunctional TMJ syndrome Clinical observation]. Problemy stomatologii [Actual problems in dentistry], 14, 1, 66-70.(In Russ.)
6. Pisarevskij, Y. L., Sarafanova, A. B., Pisarevskij, I. Y. et al. (2017). Klinicheskaya ocenka zubochelyustnoj sistemy pri disfunkciyah visochno-nizhnechelyustnogo sustava. CH1 [Clinical evaluation of the dentition in case of dysfunctions of the temporomandibular joint. P1]. Zabajkal'skij medicinskij vestnik [Trans-Baikal Medical Bulletin], 1, 97-106. (In Russ.)
7. Ponomarev, A. V., Postnikov, M. A., Trunin, D. A. (2018). Ocenka effektivnosti ortopedicheskogo lecheniya disfunkcii visochno-nizhnechelyustnogo sustava po dannym matematicheskogo modelirovaniya [Evaluation of the effectiveness of orthopedic treatment of dysfunction of the temporomandibular joint according to mathematical modeling]. Stomatolog. Minsk [Dentist. Minsk], 1(28), 96-100. (In Russ.)
8. Rasskazova, E. I., Thostov, A. S. (2012). Klinicheskaya psihologiya sna i ego narushenij [Clinical psychology of sleep and its disorders]. Moscow : Smysl. 320. (In Russ.)
9. Soldatova, L. N., Serikov, A. A., Iordanishvili, A. K. (2017). Lechenie zubochelyustnyh anomalij v profilaktike vozniknoveniya i progressirovaniya zabolevanij visochno-nizhnechelyustnogo sustava i zhevatel'nyh myshc (rezul'taty 5-letnego nablyudeniya) [Treatment of dentofacial anomalies in the prevention of the onset and progression of diseases of the temporomandibular joint and chewing muscles (results of a 5-year observation)]. Stomatologiya detskogo vozrasta i profilaktika [Pediatric Dentistry and Prevention], 16 (2), 58-61. (In Russ.)
10. Chajka, Z. S. (2017). Sovremennye metody planirovaniya optimal'nogo esteticheskogo rezul'tata vo frontal'nom uchastke zubnogo ryada s ispol'zovaniem pryamyh i nepryamyh restavracij [Modern methods of planning the optimal aesthetic result in the frontal area of the dentition using direct and indirect restorations]. Problemy stomatologii [Actual problems in dentistry], 13, 3, 80-84. (In Russ.)
11. Balaji, S. M. (2017). Bilateral pediatric mandibular distraction for micrognathia with temporomandibular joint ankylosis and sleep apnea. Indian J Dent Res, 28(5), 588-591.
12. Barbero, M., Flores-Mir C., Blanco J. C. et al. (2020). Tridimensional upper airway assessment in male patients with OSA using oral advancement devices modifying their vertical dimension. J Clin Sleep Med, 6. doi:https://doi.org/10.5664/jcsm.8666. Online ahead of print.
13. Beddis, H., Pemberton, M., Davies, S. (2018). Sleep bruxism: an overview for clinicians. Br Dent J., 225 (6), 497-501.
14. Brunzini, A., Gracco, A., Mazzoli, A. et al. (2018). Preliminary simulation model toward the study of the effects caused by different mandibular advancement devices in OSAS treatment. Comput Methods Biomech Biomed Engin, 21 (13), 693-702.
15. de Barros Pascoal, A. L., de Freitas, R. F. C., da Silva, L. F. et al. (2020). Effectiveness of Counseling on Chronic Pain Management in Patients with Temporomandibular Disorders. J Oral Facial Pain Headache, 34 (1), 77-82.
16. Di Francesco, R., Monteiro, R., Paulo, M. et al. (2012). Craniofacial morphology and sleep apnea in children with obstructed upper airways: differences between genders. Sleep Med, 13 (6), 616-620.
17. He, H., Liu, Z. J. (2019). Risk of temporomandibular joint and its management in orthodontic treatment. Zhonghua Kou Qiang Yi Xue Za Zhi, 54 (12), 808-814.
18. Herrero Babiloni, A., Lam, J. T., Exposto, F. G. et al. (2020). Interprofessional Collaboration in Dentistry: Role of physiotherapists to improve care and outcomes for chronic pain conditions and sleep disorders. Oral Pathol Med, 2020, 12. doi:https://doi.org/10.1111/jop.13068. Online ahead of print.
19. Islam, S., Taylor, C. J., Ormiston, I. W. (2015). The predictive value of obstructive sleep apnoea severity on clinical outcomes following maxillomandibular advancement surgery. Br J Oral Maxillofac Surg, 53 (3), 263-267.
20. Lin, H. Y., Su, P. L., Lin, C. Y., Hung, C. H. (2019). Models of anatomically based oropharyngeal rehabilitation with a multilevel approach for patients with obstructive sleep apnea: a meta-synthesis and meta-analysis. Sleep Breath, 14. doi:https://doi.org/10.1007/s11325-019-01971-8. Online ahead of print.
21. Martins, O. F., Chaves Junior, C. M., Rossi, R. R. et al. (2018). Side effects of mandibular advancement splints for the treatment of snoring and obstructive sleep apnea: a systematic review. Dental Press J Orthod, 23 (4), 45-54.
22. Mehta, N. R., Correa, L. P. (2018). Oral Appliance Therapy and Temporomandibular Disorders. Sleep Med Clin, 13 (4), 513-519.
23. Modesti-Vedolin, G., Chies, C., Chaves-Fagondes, S. et al. (2018). Efficacy of a mandibular advancement intraoral appliance (MOA) for the treatment of obstructive sleep apnea syndrome (OSAS) in pediatric patients: A pilot-study. Med Oral Patol Oral Cir Bucal, 23 (6), 656-663.
24. Shaeran, T. A., Samsudin, A. R. (2019). Temporomandibular Joint Ankylosis Leading to Obstructive Sleep Apnea. J Craniofac Surg, 30 (8), 714-717.
25. Tomonari, H., Takada, H., Hamada, T. et al. (2017). Micrognathia with temporomandibular joint ankylosis and obstructive sleep apnea treated with mandibular distraction osteogenesis using skeletal anchorage: a case report. Head Face Med, 13 (1), 20.
26. Zhou, J., Li, D. H., Zhu, P. F. et al. (2002). Effect of mandibular advancement device on the stomatognathic system in patients with mild-to-moderate obstructive sleep apnoea-hypopnoea syndrome. J Oral Rehabil, 47 (7), 889-901.
