**17. Efficacy and success of oral appliance therapy**

OA therapy is an effective and safe long-term therapy for patients with snoring, mild to moderate OSAS. However, the efficiency varies on many factors including the type of OA, materials used for fabrication, piece number of appliance (monobloc or bibloc), titration ability (titrable or untitrable), and degree of sagittal and vertical mandibular displacement.

The efficacy criteria of oral appliance therapy in OSA are:


#### **17.1. To summarize**


compliance are investigated. If the OA is found to be less effective, the titration of OA or

Contemporary Treatment Approaches to Obstructive Sleep Apnea Syndrome

http://dx.doi.org/10.5772/intechopen.81911

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Obstructive sleep apnea in pediatric and adolescent patients is characterized by episodic partial or complete upper airway obstruction during sleep. All children with OSAS snore. It has been estimated to occur in 5–6% of children. It is most seen in preschool children; the peak age is 3–6 years, which coincides with the growth of adenoids and tonsils. Pediatric OSAS is similar to adult OSAS, but there are differences. Sleep disruption occurred by respiratory pauses less than ten seconds. Hypopneic episodes can be seen, usually more than five to ten episodes per night with oxygen saturations less than 85%. Pediatric OSAS effects both gender at the same ratios, different from adult OSA. Seven percent to nine percent of children snore every night; 18% of them snore in nasal, ear, or throat infection periods. The prevalence of pediatric OSAS is estimated about 0.5–3%. AHI scores of pediatric sleep apnea is controversial. Some protocols of AHI score greater than 1 should be accepted as a pediatric OSA predictor; some

Hypertrophic adenoids, hypertrophic tonsils, maxillary transverse deficiency, class 3 maxillary skeletal deficiency, class 2 mandibular skeletal deficiency, overweight and obesity, and craniofacial anomalies. (Pierre Robin Sequence, Goldenhar syndrome, Crouzon syndrome, Apert syndrome, cleft lip and/or palate, vertical face anomalies, Marfan syndrome, and asso-

Abnormal breathing during sleeping, frequent awakenings or restlessness, frequent nightmares, enuresis, difficult awakening, excessive daytime sleepiness, hyperactivity-behavior problems, daytime mouth breathing, poor or irregular sleep patterns, early recognition of mouth breathing and airway obstruction; symptoms of recurrent blocked nose; recurrent nasal, ear, and throat infections; parents concerned about snoring should alert the dental pro-

**b.** Snoring is irregular and interrupted with apneic-hypopneic events in adult OSAS. In pedi-

**c.** Daytime sleepiness is mostly seen in adult OSA. In pediatric OSA behavioral changes and

fabrication of a new OA should be done.

**19. Pediatric and adolescent obstructive sleep apnea**

protocols accepting AHI score greater than 5 is pathognomonic.

**19.1. Pediatric and adolescent OSA etiology**

fessional for definitive diagnosis for pediatric OSA.

**19.3. Differences between pediatric and adult OSA**

growth retardation are seen more than daytime sleepiness.

**a.** Pediatric OSAS effects both genders equally.

atric OSAS snoring can be continuous.

ciated 22q deletion syndromes).

**19.2. OSA symptoms in children**

