Almeida Fernanda R, Lowe Alan A
Department of Oral Biological and Medical Sciences, The University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada.
Oral Maxillofac Surg Clin North Am. 2009 Nov;21(4):413-20. doi: 10.1016/j.coms.2009.07.002.
Oral appliance (OA) therapy for snoring, obstructive sleep apnea, or both is simple, reversible, quiet, and cost-effective and may be indicated in patients who are unable to tolerate nasal continuous positive airway pressure (nCPAP) or are poor surgical risks. OAs are effective in varying degrees and seem to work because of an increase in airway space, the provision of a stable anterior position of the mandible, advancement of the tongue or soft palate, and possibly a change in genioglossus muscle activity. This article provides a detailed clinical protocol and titration sequence for OAs, because this clinical procedure is often not well understood by practitioners new to the field. Prediction of treatment success is addressed, OA treatment is compared with surgery and nCPAP, OA compliance is described, and the possible adverse effects associated with this type of therapy are discussed.
用于治疗打鼾、阻塞性睡眠呼吸暂停或两者兼具的口腔矫治器（OA）疗法简单、可逆、安静且具有成本效益，适用于无法耐受鼻持续气道正压通气（nCPAP）或手术风险较高的患者。OA在不同程度上有效，其作用机制似乎是通过增加气道空间、使下颌保持稳定的前位、推进舌头或软腭，以及可能改变颏舌肌活动来实现的。本文提供了关于OA的详细临床方案和滴定顺序，因为该临床程序对于该领域的新手从业者来说往往理解不足。文中还探讨了治疗成功的预测、将OA治疗与手术和nCPAP进行了比较、描述了OA的依从性，并讨论了与这种治疗类型相关的可能不良反应。
