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Sleep Apnea Articles Honored

Sleep Apnea Articles Honored
Reyes Enciso

Two articles published by Herman Ostrow School of Dentistry of USC investigators in the journal Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology have won awards for the journal’s best articles of 2010.

“Comparison of cone-beam CT parameters and sleep questionnaires in sleep apnea patients and control subjects” won the American Academy of Oral and Maxillofacial Radiology’s Arthur Wuehrmann Prize for best oral radiology article.

Lead author Reyes Enciso, assistant professor of clinical dentistry, said the study illustrated the correlative power of three-dimensional cone-beam CT scans in patients with possible obstructive sleep apnea, which is characterized by pauses in breathing during sleep due to the airway collapsing or soft tissues such as the tongue or palate blocking the airway.

The patients eventually diagnosed with the condition shared similar airway characteristics as discovered by the cone-beam CT scan, including smaller lateral airway widths and smaller cross-sectional area measurements of the airway. However, airway collapsibility seemed to be a bigger factor for apnea diagnosis than airway dimensions alone, Enciso said.

“We are using cone-beam CTs in patients who have an atypical response to treatment in order to examine their airway for abnormality,” she said.

“Treatment outcomes of mandibular advancement devices in positional and non-positional obstructive sleep apnea patients” won the H. Dean Millard best paper award from the American Academy of Oral Medicine.

Principal investigator Glenn Clark, director of the Ostrow School’s oral medicine residency program, said the study examined the helpfulness of mandibular advancement devices in sleep apnea patients. The devices, used during sleep, pull the lower jaw forward, reducing the likelihood of soft oral tissues blocking the airway.

The results suggested that the devices helped patients who had positional sleep apnea – those whose apnea was worst when sleeping in a certain position, usually on their backs. However, the devices did not seem to help as much in patients whose apnea was non-positional or those whose apnea did not depend on the position in which they slept.

“One of the important findings of the paper that we published is that when your snoring or apnea is no longer helped by turning on your side, this is a serious sign of progression of the disease,” Clark said. “We feel that paying attention to whether a patient is a positional or non-positional apnea patient is very important. People have suspected that the role of gravity on tongue relapse is important, but our paper was the first to definitively show how this influences the success rate of using dental appliances.”

Enciso and Clark were proud to have their work recognized by the journal as two of last year’s best papers.

“We are thrilled to be recognized for these awards, especially because they were unsolicited and based upon the recommendation of our peers,” Enciso said. “It is high praise indeed.”

Clark said that he, Enciso and their colleagues continue to be enthusiastic about their investigations into sleep apnea.

“Our studies add two small pieces to the jigsaw puzzle that represents our understanding in the management of obstructive sleep apnea,” Clark said. “If we get enough of these puzzle pieces put in place, we will be able to better help our patients and give them confidence that we understand what is wrong and that we are using the best evidence-based approach to treat them.”

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