2009, Number 5
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ABSTRACTSnoring is one of the most prevalent sleep disturbances. It affects the patient and his couple in sleeping. It might be considered a forerunner symptom of Obstructive Sleep Apnea (OSA) which is a non-curable potentially lethal illness that can only be managed, but not cured. Once that OSA is established, snoring will be its lifetime companion.
About 35 million adult people snore in México. For this reason is specially important that Dentists have as a requirement the knowledge to detect and diagnose in a timely fashion this problems and to know that we have an available treatment which may be used with most of the patients that need it. This treatments can be in-office made and, as in the case of this report, those that should be fabricated in a dental lab with specialized technicians under the supervision of a dentists trained in the treatments for snoring and OSA. Furthermore, we should be aware that an MD with a degree in Sleep Medicine must be the captain of the team in which we work, and that the patient always should be diagnosed with a polysomnography, which is the Golden Standard in Sleep Medicine.
Treatment of sleep disorders that affect breathing can and should be treated in a multidisciplinary form, and should include the following three stages: the help of a Mandibular Positioning Device (MAP) also called Oral Appliance (which is not invasive nor includes surgical techniques), the surgical procedures (maxillofacial and ENT related, which we will not discuss here) and the employment of the CPAP and/or BiPAP, which we will also not discuss in this article.. Most specialists in sleep medicine agree in that the treatment of snoring and OSA should be treated in a multidisciplinary fashion, using several of these treatments alone or combined with the others to obtain the best possible results for the patient. In absolutely serious cases, the use of a tracheostomy is advised, although it produces serious handicaps in the patient´s lifestyle and with the problems it might carry to his or her health.
In this article, we report the availability in México and in Latin America and the fabricating procedures for a new adjustable userfriendly oral appliance, that has almost all the desirable characteristics stated by the most prestigious sleep medicine and dental sleep societies with world reputation, and that is more dependable and affordable than previous ones.
Kume, M. Roncopatía y AOS: su impacto social y en la salud. En CD. 1er Encuentro Nacional de Roncopatía y AOS.19-20 marzo 1999. Hospital Angeles del Pedregal. Méx. D.F.
Hoffstein, Victor. Snoring in Kryger, Roth, Dement, Principles and practice of sleep medicine, 3ra. Ed. United States of America: Saunders Co.; 2000, p 813.
Dement, W. C. The promise of sleep. Ed. De la Corte Press. N.Y. EE.UU. p171-173.
Farill, Manuel, Vivanco T.M., Sakar, A, Alvarado C.R. Tratamiento del Ronquido y de la Apnea Obstructiva del Sueño (AOS) con una Prótesis de Avance Mandibular (PAM). Revista ADM 1998;LV(2): 71-76.
5 . Farill, Manuel, Vivanco Marcela . El pap el del dentista en el tratamiento del ronquido y la apnea obstructiva del sueño (AOS). Práctica Odontológica 2001; 22(7): 8-13.
Andrew Genaro. Apnea del sueño. Otorrino 2009; (2): 16-21.
Carlos H. Schenck, MD. Sleep The mysteries, the problems, and the solutions, .USA: Penguin Group; 2007. Pp 30-32.
Lugaresi, E, Cirignotta, F, Montagna, P, et. al. Snoring: Pathogenic clinical and therapeutic aspects. En Kryger, M, Roth, T, Dement, W (eds): Principles and practice of sleep medicine. 2da ed. Philadelphia, USA: Saunders, Co. 1994;p 621-629.
De Uranga Cuervo, Daniel, B. ¿Por qué roncamos?. UMédico [en línea] 2 Mayo 2002 [fecha de acceso 19 Agosto 2009]. Disponible en: www.universomedico.com.mx/y/¿por-que-roncamos?.
Ramón Díaz Alersi. Guías de actuación de la Asa para la vía difícil. Revista electrónica de medicina interna [en línea] Noviembre 2002. [fecha de acceso 20 de Agosto de 2009]; 2 (11). Disponible en: REMI http://remi.uninet.edu/debate/m1/REMIM101.htm
Escalas de Riesgo Vía Aérea. [monografía en pagina web]. Dr. José Ramón Muñoz Sánchez. Imagen jpg. Caracas, Venezuela: www. mianestesia.com; 2006. Fig. 2. Clasificación de Mallampati (11) Referencia: Mallampati RS, Gatt SP, Gugino LD et al: A clinical sign topredict difficult traqueal intubation: A prospective study. Can Anaesth Soc. J 32:429, 1985.