Using Dentofacial Orthopedics to Treat Sleep Apnea

Dentofacial orthopedics is, “The control or modification of facial growth” and can, in some patients, improve nasal valve function and nasal airway patency.

12 Months of treatment with the Homeoblock™ Appliance
· Increases Mid-face Volume
· Produces a Wider Oropharyngeal Airway
· Improves the Nasopharyngeal Airway
· Severe Sleep Apnea Reduced to Mild Sleep Apnea

*Note: Nasal resistance has been shown to negatively impact the result of MAS and CPAP treatment for sleep apnea. The HB appliance can be provided as an adjunct to MAS and CPAP treatment.

*Influence of nasal resistance on oral appliance treatment outcome in obstructive sleep apnea.
Sleep. 2008 Apr 1;31(4):543- Zeng B Ng AT, Sian J, Petocz P, Darendeliler MA, Cistulli PA.
Centre for Sleep Health & Research, Department of Respiratory Medicine, Royal North Shore Hospital, University of Sydney, Australia.

Influence of nasal resistance on initial acceptance of continuous positive airway pressure in treatment for obstructive sleep apnea syndrome.
Sugiura T, Noda A, Nakata S, Yasuda Y, Soga T, Miyata S, Nakai S, Koike Y.
CONCLUSIONS: Nasal resistance before the beginning of CPAP treatment has a significant effect on the acceptance of CPAP in OSAS patients, and hence, could be a predictive parameter for the initial acceptance

A CASE STUDY

HB appliances after 12 months of slow advancement

Facial development after 12 months.



The pattern of facial development
Note: The changes around the nasal base.




Increased volume right side 0.71cc


Increased volume left side 1.11cc

Red shows axial airway development. Green shows mandibular anterior movement

Before After

Improved nasal valve function

Improved nasal function; improved airflow at the nasal valves and around the turbinates.

Improved Hyoid position indicates better muscle tone.

November 2009 ODI 13.4

November 2010 ODI 4.5

CONCLUSION

Dentofacial orthopedics is an alternative treatment for sleep apnea patients. Twelve months of Homeoblock™ treatment can provide an exit strategy for certain severe sleep apnea patients that do not desire to wear a CPAP or a dental appliance for the rest of their lives.

We are currently working out the protocol to determine which patients are best suited for this type of treatment.