Sleep breathing disorders in adult: Role of orthodontist

OBJECTIVES: The purpose of the following work is to provide the orthodontist with a series of updated evidence based recommendations and indications for the diagnosis and treatment of snoring and obstructive sleep apnea (OSA) in adults. MATERIALS AND METHODS: A systematic analysis of the existing OSA literature in the adult was made using the PubMed database and using the following related keywords: sleep apnea AND oral appliance OR mandibular repositioning OR mandibular advancement OR Non-CPAP therapie NOT orthognatic surgery NOT osteotomy NOT children and with the following filters: article types (Clinical Trial, Guideline, Meta-Analysis), publication dates (10 years), languages (english). The analysis of the publications was limited to studies conducted on humans. The guidelines of the "Società Italiana Medicina del Sonno Odontoiatrica" and the guidelines of the Italian Ministry of Health have been added to the selected publications. RESULTS: Snoring is an inspirational noise that can originate from various anatomic sites, while obstructive sleep apnea (OSA) is attributable to the collapse of the upper airways that results in partial (hypopnea) or complete obstruction (apnea) of the passage of air, resulting in a decrease in blood oxygenation. Untreated OSAs can cause very serious complications for the patient's health, increasing the risk of cardiovascular disease and vehicular or working accidents. CONCLUSIONS Given the complexity of the etiologic and pathophysiological factors of sleep disorders, diagnostic and therapeutic management requires a multidisciplinary approach. In these phases, the orthodontist plays an important role both as a "diagnostic sentinel" and in the management of the oral device, such as mandibular advancements.