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32nd Asia Pacific Dental and Oral Health Congress

Sydney, Australia

Prof. Dr. G. Dave Singh

Prof. Dr. G. Dave Singh

Vivos BioTechnologies, Inc.,USA

Title: Long-term follow up of non-surgical upper airway remodeling for adult obstructive sleep apnea


Biography: Prof. Dr. G. Dave Singh


We investigated changes in upper airway morphology to test the hypothesis that the upper airway can be non-surgically remodeled in adult patients with obstructive sleep apnea (OSA).  After obtaining informed consent, we undertook a 3D cone-beam (CBCT) scan of a 56-year-old male patient, who was diagnosed with mild OSA by a sleep specialist prior to treatment.  The patient was treated using a biomimetic oral device (DNA appliance®).  The active treatment time was 18 months approx.  Volumetric 3D reconstruction of the upper airway from the CBCT scan was undertaken prior to treatment, and the patient was monitored with a follow up CBCT scan 5.5yrs later.  All measurements were taken with no device in the patient’s mouth during wakefulness.  The results showed that the upper airway volume increased from 13.9cm3 to 29.2cm3.  The minimal antero-posterior retropalatal distance increased from 1.5mm to 11mm in the mid-sagittal plane; the minimum medio-lateral retropalatal width increased from 4.5mm to 29mm in the coronal plane; the minimum retropalatal area in the axial plane at the same level as above increased from 67mm2 to 477.5mm2.  In addition, the minimum antero-posterior retroglossal distance increased from 6mm to 17mm in the mid-sagittal plane; the minimum medio-lateral retroglossal width increased from 14.5mm to 26.5mm in the coronal plane, and the minimum retroglossal area in the axial plane at the same level as above increased from 83.5mm2 to 423.5mm2.  We conclude that biomimetic oral appliance therapy may be able to non-surgically remodel the upper airway in adult patients diagnosed with mild OSA.  This biomimetic protocol requires further investigation to elucidate the novel mechanism of pneumopedics or physiologic upper airway remodeling.