By Ronald S. Prehn, ThM, DDS Patient: Matthew is a 17-yr. old male with OSA and CPAP intolerant due to Cerebral Palsy (CP). He is a special kid who is full of happiness and brings joy to others. Diagnosis: OSA. AHI 14; RDI 15; PSO2 89%; 6 central apneas Previous Treatment: CPAP was attempted, but with his CP he was not able to keep his head from moving and keep the … [Read more...]
The Importance of Orofacial Myofunctional Therapy Before and After CO2 Laser Frenectomy in Achieving Optimal Orofacial Function
by Karen M. Wuertz, DDS, ABCDSM, ABLS, FOM, and Brooke Pettus, RDH, BSDH, COMS Frenectomy Methods Frenotomies performed with a scalpel or scissors can be accompanied by significant bleeding, obscuring the surgical field making it difficult to ensure if the restriction has been completely removed. Because of the increased risk of early primary closure of the site, … [Read more...]
Functional Frenectomy (Osteopathically Guided)
Superpulse 10,600 nm CO2 Laser Revision of Lingual Frenum Previously Released with a Diode Hot Glass Tip
By Karen Wuertz, DDS, and Peter Vitruk, PhD Lingual Frenectomy and Significance of OMT Frenectomy utilizing scissors or a scalpel is associated with several drawbacks, such as intra-operative hemorrhage (which impedes the visibility of the surgical field and may ultimately lead to scarring); the need for sutures; post-surgical pain and discomfort; and the potential for … [Read more...]
10,600-nm CO2 Laser Frenectomies in Pediatric Patients with Compromised Airway & Swallowing: Case Reports by Martin Kaplan, DMD, and Peter Vitruk, PhD
Successful Treatment of a Patient Diagnosed with Severe OSA with an Oral Appliance in a Pre-Doctoral Student Clinic
Dramatic improvement in OSA severity when oral appliance and positional therapies are combined
Treating obstructive sleep apnea with oral appliance therapy is a rewarding and challenging undertaking. Every doctor/clinician has patients who do not completely respond to oral appliance therapy (OAT.) Once this is known, decisions need to be made to modify treatment for the best possible outcome. In the case study below I will describe how an innovative device was combined … [Read more...]
Allergic to PAP!
Solving this Patient’s Dilemma This is an interesting case where the patient was allergic to the silicone in the soft liner that is the interface of the CPAP mask to the face and also allergic to the neoprene straps of the CPAP mask. This middle aged woman has been trying to use the CPAP for 8 years off and on. She states that she cannot tolerate CPAP due to “allergy to neo … [Read more...]
Nasal Surgery and Oral Appliance Therapy: Collaboration is Key to Success
by Daniel Klauer, DDS, DABCP, DABCDSM When evaluating patients with sleep disorders, it’s ok to be nosy. We have to be detectives, delving into the details of patients’ waking and sleeping hours. One of the most beneficial parts of my diagnostic exam involves evaluating the airway and the “Four Points of Obstruction” comprising the nasal valve, nasopharynx, velopharynx, and o … [Read more...]
Using Overnight Pulse Oximetry to Manage Oral Appliance Therapy during Treatment for Obstructive Sleep Apnea
by Ronald S. Prehn, ThM, DDS It is estimated that obstructive sleep apnea (OSA) affects at least 25 million Americans.1 OSA occurs when a patient’s airway gets blocked during sleep. The benefits of physicians prescribing overnight pulse oximetry testing to pre-screen for OSA are well known.2,3 In addition, studies supporting the use of overnight pulse oximetry by dental s … [Read more...]
