구강장치를 이용한 코골이 및 폐쇄성 수면무호흡증 치료를 위한 치료 권고안: 2005년 개정 |
윤승현, 최영찬, 신영주, 김성택 |
연세대학교 치과대학병원 구강내과, 턱관절 및 안면통증클리닉 |
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Practice Parameters for the Treatment of Snoring and OSA with Oral Appliances: An Update for 2005 |
Seung Hyun Yoon, Yeong Chan Choi, Young Ju Shin, Seong Taek Kim |
TMJ & Orofacial Pain Clinic, Department of Oral Medicine, Dental Hospital, Yonsei University, Seoul, Korea |
Corresponding Author:
Seong Taek Kim ,Tel: +82-2-2228-8880, Fax: +82-2-362-8578, Email: k8756050@hotmail.com |
Received: December 5, 2007 Accepted: December 18, 2007 Published online: December 31, 2007 |
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ABSTRACT |
These practice parameters are an update of the previously published recommendations regarding use of oral appliances in the treatment
of snoring and Obstructive Sleep Apnea (OSA). Oral appliances (OAs) are indicated for use in patients with mild to moderate OSA
who prefer them to continuous positive airway pressure (CPAP) therapy, or who do not respond to, are not appropriate candidates for,
or who fail treatment attempts with CPAP. Until there is higher quality evidence to suggest efficacy, CPAP is indicated whenever possible
for patients with severe OSA before considering OAs. Oral appliances should be fitted by qualified dental personnel who are trained
and experienced in the over-all care of oral health, the temporomandibular joint, dental occlusion and associated oral structures. Follow-up
polysomnography or an attended cardiorespiratory (Type 3) sleep study is needed to verify efficacy, and may be needed when symptoms
of OSA worsen or recur. Patients with OSA who are treated with oral appliances should return for follow-up office visits with the
dental specialist at regular intervals to monitor patient adherence, evaluate device deterioration or maladjustment, and to evaluate the
health of the oral structures and integrity of the occlusion. Regular follow up is also needed to assess the patient for signs and symptoms
of worsening OSA. Research to define patient characteristics more clearly for OAs acceptance, success, and adherence is needed. |
Keywords:
Practice parameters | Practice guidelines | Standads of practice | Snoring | Obstructive sleep apnea syndrome | Oral appliances | Dental devices |
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