荷蘭2007年6月；人工植體（Implant-retained）口腔矯治器...
Clinical Oral Implants Research Volume 18 Issue 3 Page 383-387, June 2007
Implant-retained oral appliances: a novel treatment for edentulous patients with obstructive sleep apnea–hypopnea syndrome
Aarnoud Hoekema11Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands, Frist de Vries22Department of Oral and Maxillofacial Prosthetics, Rijnstate Medical Center, Arnhem, The Netherlands, Kees Heydenrijk33Department of Oral and Maxillofacial Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands and Boudewijn Stegenga11Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
1Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
2Department of Oral and Maxillofacial Prosthetics, Rijnstate Medical Center, Arnhem, The Netherlands
3Department of Oral and Maxillofacial Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands
Abstract摘要
Objectives: Mandibular repositioning appliances (MRAs) are a viable treatment alternative in patients with obstructive sleep apnea–hypopnea syndrome (OSAHS). Because these appliances require retention in the patient's dentition, edentelous patients generally do not qualify for this treatment. This study describes our experiences with an implant-retained MRA in the treatment of edentulous OSAHS patients.
Patients and methods: Six edentulous OSAHS patients were included in this study. Standard treatment consisted of the placement of four endosseous dental implants in the mandible and the construction of a new maxillary denture and a mandibular overdenture. Subsequently, an MRA was made. After a habituation and adjustment period, the effect of treatment was evaluated with polysomnography. Treatment was considered effective in cases where it yielded an apnea–hypopnea index <5.
Results
Of the six patients included, two did not tolerate the MRA because of pressure-induced discomfort on the labial mucosa in the maxilla. These two patients were offered an implant-retained overdenture and MRA in the maxilla. One of the two patients proceeded with this secondary treatment. Of the five patients completing the follow-up polysomnography, effective OSAHS treatment was attained in four.
Conclusions
The results from this study suggest that an implant-retained MRA in the mandible is a viable treatment modality in edentulous OSAHS patients. Because the therapeutic effectiveness of this treatment may be compromised by excessive pressure of the MRA on the labial mucosa in the maxilla, we suggest that an implant-retained MRA in the maxilla be offered as a secondary treatment in selected patients.
人工植體（Implant-retained）口腔矯治器：
針對有阻塞性睡眠呼吸暫停低通氣綜合症(OSAHS)的缺齒患者
荷蘭2007年6月
人工植體固位性（Implant-retained）口腔矯治器：針對有阻塞性睡眠呼吸暫停低通氣綜合症(OSAHS)的缺齒患者進行的一項新療法
Abstract摘要
目的：下頜重新定位口腔矯治器是治療有阻塞性睡眠呼吸暫停低通氣綜合症的缺齒患者的一項可行方法。因為這些矯治器必須固位於患者的齒列，所以通常不能對缺齒患者做這項治療。本研究描述我們在以人工植體固位性口腔矯治器治療有阻塞性睡眠呼吸暫停低通氣綜合症的缺齒患者上的經驗。
患者＆方法：6位缺齒的阻塞性睡眠呼吸暫停低通氣綜合症(OSAHS)患者。標準治療包括：定位下頷內的4顆牙齒植體、建構一副新的上頜義齒和一副下頜覆蓋式義齒（mandibular overdenture）。結果，做了一個下頜重新定位口腔矯治器。適應與調整期過後，用多重睡眠電圖(polysomnography)評估療效。它若產生<5的睡眠呼吸暫停低通氣指數（apnea-hypopnea index, AHI），則治療是有效的。
Results結果
其中2位患者因為頜內的唇粘膜上有壓力引起的不舒適，而無法耐受下頜重新定位口腔矯治器。這2位患者的頜內裝有人工植體固位性覆蓋義齒（implant-retained overdenture）和下頜重新定位口腔矯治器。這2位患者中的一位進行了這項次要治療。5位完成了多重睡眠電圖的患者中，有4位做了有效的阻塞性睡眠呼吸暫停低通氣綜合症(OSAHS) 治療。
Conclusions結論
本研究的結果顯示下頜內的人工植體固位性（implant-retained）下頜重新定位口腔矯治器用在缺齒的阻塞性睡眠呼吸暫停低通氣綜合症患者身上，是一個可行的治療模式。這項治療的療效可能因為頜內的唇粘膜上有下頜重新定位口腔矯治器造成的過多壓力而減少，但我們建議把頜內的人工植體固位性（implant-retained）