OSAS (Obstructive Sleep Apnea Syndrome): evaluations and main therapeutic solutions in dentistry

Obstructive sleep apneasyndrome (OSAS) is a common chronic disorder (with a prevalence of about 2-4%) characterized by repetitive episodes of breathing cessation due to complete or partial collapse of the upper airway therefore affecting ventilation. If untreated, OSAS can lead to significant neurological problems (such as stroke, cognitive decline, depression, headaches, peripheral neuropathy, and nonarteritic ischemic optic neuropathy), but treatment reverses some of these neurological problems. The treatment for OSAS depends on the factors causing the obstruction: there are several possible treatments, that range from a change in behavior to facial surgery. Treatment includes weight loss, continuous positive airway pressure (CPAP), oral appliances and upper airway surgery. Oral appliance is an effective treatment option for people with mild to moderate OSAS who either prefer it to CPAP or are unable to successfu l ly comply wi th CPAP therapy. They increase the size of the upper airway (by either advancing the mandible or the tongue) and offer an alternative that may be attractive for OSAS patients dissatisfied with other therapies or unwilling to accept more complex interventions. This article provides an update to previous recent reviews. It provides an overview of the effectiveness of treatment, the predictors of treatment success, adherence and the potential adverse effects associated with this treatment. This chapter only focuses on the use of oral appliances in the adult population.