Role of Oral Appliances in Obstructive Sleep Apnea as a Treatment Modality

Mandibular repositioning splints (MRSs) and continuous positive airway pressure (CPAP) are used to treat the sleep apnea/hypopnea syndrome (SAHS). There are some data suggesting that patients with milder symptoms prefer MRS, but there are few comparative data on outcomes. The main morphological feature of OSA is upper airway narrowing during sleep, which is associated with snoring, excessive daytime sleepiness, hypertension, increased risk of cardiovascular diseases etc. Some evidence links OSA to an increased risk of mortality but the pathogenesis of this relationship is still not entirely clear. It has been postulated that upper airway dilator muscle activity is crucial for counter-acting the negative intraluminal pharyngeal pressure. Diminution of this activity during sleep is the major reason for pharyngeal collapse and obstruction in patients with obstructive sleep apnoea.