[Dr. James Poyak, DDS]

I’d like to throw out a topic for discussion. How effective you you believe expansion of the maxillary arch (either by RPA or functional appliance) is in reducing the AHI in mild, moderate, or severe sleep apnea patients? After there are enough responses, I’ll share the research data with everyone.

[Dr. Adrian J. Palencar, DDS]

Dear James, I do not know the research, however from my 37 years of experience, using MX & MN arch development appliances, the results are positive in improvement of respiration. If the airway is patent and the pt. is not a habitual mouth breather, the majority (particularly patients with CVMS 2 – 5) feel that there iS an improvement. Nevertheless, it is just an anecdotal evidence.

[Dr. Cesar O. Cruz, DDS]

Hello,
I am not finding articles on this link to improving the airway. However, we know that by obtaining MX expansion, the nasal flow is also expanded thus it must be a benefit on that regards.

[Dr. Robert M. Pasch, DDS, MSc]

Hello to you all. This is a very important topic, thank you for posting it. The answer is multi factorial and is age related. The common denominator is the airway the numerator is age
There are a lot of treatments starting with early surgical removal of adenoids and tonsils to CPAP devices and even surgical mandibular advancements in adults. The accepted norm (MacNamara) is 10-15 mm space between the posterior pharyngeal wall and the dorsum of the soft palate (seen and measured on the Ceph) Patent nares (seen on the pan) and no noise when sleeping. Studies have linked the accumulation of amyloids in the brain due to poor airation (no REM sleep) is linked to adult altzheimer and dementias.
Mandibular advancement with upper expansion utilizing appliances like Twin Blocks definitely help increase the airway.
We as GP’s are in an ideal position to ask questions relating to the airway of our young patients so we can suggest treatment guidance related to breathing tongue position posture etc.
ENT referral may be necessary or for our older patient a referral to a somnologist for sleepstudies. Your patients will thank you
“DONT IGNORE THE SNORE”
IAO rocks!!!Hello

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