コウクウナイ ソウチ オ モチイタ ヘイソクガタ スイミンジ ムコキュウ ショウコウグン ノ イチショウレイ

We experienced a case of obstructive sleep apnea syndrome (OSAS) improved by treatment with an oral appliance. The patient was a 60-year-old female with OSAS. Using the polysomnography, we evaluated apnea by AHI (apnea hypopnea index) and the lowest oxygen saturation (SpO_2) ; before and after wearing an oral appliance. Using the cephalometrics radiogram, we evaluated the airway area magnification by comparing the airway area in each part of upper airway ; before and after wearing an oral appliance. Using 3 dimensional-computed tomography (3D-CT), we diagnosed the airway volume magnification by comparing the airway volume behind the soft palate and the tongue ; before and after wearing an oral appliance. The results were as follows ; 1. AHI was improved from 33.8 to 7.6 and the lowest SpO_2 was improved from 82% to 90%. 2. The airway area behind the soft palate and the tongue remarkably increased. 3. Wearing the oral appliance made the airway magnify up to 162%. The above results showed that wearing an oral appliance magnified space of airway, and the bad effect to circulatory organ was decreased by the improvement of apnea. So we recognized that oral appliance therapy was an effective treatment for OSAS

Simultaneous Sinus Lifting and Alveolar Distraction of a Severely Atrophic Posterior Maxilla for Oral Rehabilitation with Dental Implants

We retrospectively reviewed a new preimplantation regenerative augmentation technique for a severely atrophic posterior maxilla using sinus lifting with simultaneous alveolar distraction, together with long-term oral rehabilitation with implants. We also analyzed the regenerated bone histomorphologically. This study included 25 maxillary sinus sites in 17 patients. The technique consisted of alveolar osteotomy combined with simultaneous sinus lifting. After sufficient sinus lifting, a track-type vertical alveolar distractor was placed. Following a latent period, patient self-distraction was started. After the required augmentation was achieved, the distractor was left in place to allow consolidation. The distractor was then removed, and osseointegrated implants (average of 3.2 implants per sinus site, 80 implants) were placed. Bone for histomorphometric analysis was sampled from six patients and compared with samples collected after sinus lifting alone as controls (n=4). A sufficient alveolus was regenerated, and all patients achieved stable oral rehabilitation. The implant survival rate was 96.3% (77/80) after an average postloading followup of 47.5 months. Good bone regeneration was observed in a morphological study, with no significant difference in the rate of bone formation compared with control samples. This new regenerative technique could be a useful option for a severely atrophic maxilla requiring implant rehabilitation