Tratamento do Ronco com Aparelho de Avanço Mandibular e Fotoestimulação a Laser. Revisão Narrativa
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Dec 30, 2023
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Resumo
Antecedentes: O ronco é um ruído incômodo que afeta a convivência, a saúde e a qualidade de vida de quem o sofre e de quem o rodeia. Existem alternativas de tratamento que podem melhorar individualmente a situação do paciente, mas muitas vezes não resolvem completamente o problema. Surge então a possibilidade de combinar duas ou mais alternativas para poder tratar eficazmente o ronco. Objetivo: Descrever as evidências existentes sobre o uso do tratamento a laser de fotoestimulação Nightlase e dos Dispositivos de Avanço Mandibular (MAD) para tratar o ronco, e a sinergia positiva de usá-los juntos. Métodos: Este estudo consistiu em uma revisão narrativa da literatura. A busca foi realizada no PubMed com palavras-chave e foram selecionados artigos publicados após 2010. Resultados: A combinação das duas abordagens oferece sinergias no tratamento do ronco. Os MADs atuam fisicamente para expandir o espaço das vias aéreas, enquanto a terapia a laser de fotoestimulação atua no nível celular para melhorar a resistência e o tônus dos tecidos afetados. Conclusões: O tratamento combinado do ronco com aparelho e laser aborda o problema do ronco com duas abordagens diferentes que, combinadas, podem ser uma opção promissora.
Keywords
dentistry, mandibular advancement device, narrative review, photostimulation laser, sleep disorders, snoredesórdenes del sueño, dispositivo de avance mandibular, láser de fotoestimulación, odontología, revisión narrativa, ronquidodispositivo de avanço mandibular, distúrbios do sono, laser de fotoestimulação, odontologia, revisão narrativa, ronco
References
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21. Sutherland K, Takaya H, Qian J, Petocz P, Ng AT, Cistulli PA. Oral appliance treatment response and polysomnographic phenotypes of obstructive sleep apnea. J Clin Sleep Med 2015;11(8):861–868. F, Ahlberg J, Raphael KG, et al. International consensus on the assessment of bruxism: Report of a work in progress. J Oral Rehabil. 2018;45:837-844. https://doi.org/10.1111/joor.12663
22. Rombaux P, Hamoir M, Bertrand B, Aubert G, Liistro G, Rodenstein D. Postoperative Pain and Side Effects After Uvulopalatopharyngoplasty, Laser-Assisted Uvulopalatoplasty, and Radiofrequency Tissue Volume Reduction in Primary Snoring, Article first published online: 3 JAN 2009 https://doi.org/10.1097/00005537-200312000-00023.
23. Pae E-K, Harper RM. Elevated Hyoid Bone Position in Response to Mandibular Advancing Appliance Predicts Effectiveness of the Appliance for Obstructive Sleep Apnea. Front Dent Med 2021;2:1-9. https://doi.org/10.3389/fdmed.2021.672936
24. Ogawa T, Long J, Sutherland K, et al. Effect of mandibular advancement splint treatment on tongue shape in obstructive sleep apnea. Sleep Breath 2015;19:857–863. https://doi.org/10.1007/s11325-014-1101-y
25. Van Holsbeke C, De Backer J, Vos W, et al. Anatomical and functional changes in the upper airways of sleep apnea patients due to mandibular repositioning: a large scale study. J Biomech 2011;44:442–9. https://doi.org/10.1016/j.jbiomech.2010.09.026
26. Sutherland K, Chan AS, Cistulli PA. Three-dimensional assessment of anatomical balance and oral appliance treatment outcome in obstructive sleep apnea. Sleep Breath. 2016;20:903–10. https://doi.org/10.1007/s11325-015-1304-x.
27. Wojda M, Kostrzewa-Janicka J. Influence of MAD Application on Episodes of Obstructive Apnea and Bruxism during Sleep—A Prospective Study. J Clin Med 2022;11:5809. https://doi.org/10.3390/jcm11195809
28. Brown EC, Jugé L, Knapman FL, Burke PGR, Ngiam J, Sutherland K, Butler JE, Eckert DJ, Cistulli PA, Bilston LE. Mandibular advancement splint response is associated with the pterygomandibular raphe. Sleep 2021:44(4):zsaa222. https://doi.org/10.1093/sleep/zsaa222
29. Kim DI, Lagravère Vich M, Mayoral, P, Miguez M. Three-Dimensional Changes in Skeletal/ Dental Landmarks With Use of Mandibular Advancement Devices. J Dent Sleep Med. 2020;7(2). http://dx.doi.org/10.15331/jdsm.7120
30. Van de Perck E, Dieltjens M, Vroegop AV, Verbraecken J, Braem M, Vanderveken OM. Mandibular advancement device therapy in patients with epiglottic collapse. Sleep Breath 2022;26:1915–1920. https://doi.org/10.1007/s11325-021-02532-8
31. Okuno K, et al. Endoscopy evaluation to predict oral appliance outcomes in obstructive sleep apnoea. Eur Respir J. 2016;47(5):1410–1419. https://doi.org/10.1183/13993003.01088-2015
32. Sutherland K, Cistulli PA. Oral appliance therapy for obstructive sleep apnoea: state of the art. J Clin Med 2019;8:2121. https://doi.org/10.3390/jcm8122121
33. Tsuiki S, Ryan CF, Lowe AA, Inoue Y. Functional contribution of mandibular advancement to awake upper airway patency in obstructive sleep apnea. Sleep Breath 2007;11:245-51. https://doi.org/10.1007/s11325-007-0119-9
34. Juge L, et al. Regional respiratory movement of the tongue is coordinated during wakefulness and is larger in severe obstructive sleep apnoea. J Physiol. 2020;598(3):581–597. https://doi.org/10.1113/JP279382
35. Mogell K, Blumenstock N, Mason E, Rohatgi R, Shah S, Schwartz D. Definition of an Effective Oral Appliance for the Treatment of Obstructive Sleep Apnea and Snoring: An Update for 2019. J Dent Sleep Med. 2019;6(3) http://dx.doi.org/10.15331/jdsm.7090
36. Cetinkaya EA, Turker M, Kiraz K, Gulkesen HK. Er: Yag Laser Treatment of Simple Snorers in an Outpatient Setting. ORL J Otorhinolaryngol Relat Spec. 2016;78(2):70–76
37. Lee 2015 Lee CYS, Lee CCY. Evaluation of a non-ablative Er: YAG laser procedure to increase the oropharyngeal airway volume: a pilot study. Dental Oral Craniofacial Res. 2015;1(3):56–59
38. Storchi IF, Parker S, Bovis F, Benedicenti S, Amaroli A. Outpatient erbium:YAG (2940 nm) laser treatment for snoring: a prospective study on 40 patients [published correction appears in Lasers Med Sci. 2019 Mar;34(2):431]. Lasers Med Sci. 2018;33(2):399–406
39. Frelich H, Ścierski W, Marków M, Frelich J, Frelich H, Maciej M. Minimally invasive erbium laser treatment for selected snorers. Lasers Med Sci. 2019;34(7):1413–1420. https://doi.org/10. 1007/s10103-019-02731-6
40. Monteiro L, Macedo A, Corte-Real L, Salazar F, Pacheco JJ. Treatment of snoring disorder with a non-ablactive Er:YAG laser dual mode protocol. An interventional study. J Clin Exp Dent. 2020;12(6):e561–e567. https://doi.org/10.4317/jced.56953
41. Neruntarat C, Khuancharee K, Shoowit P. Er:YAG laser for snoring: a systemic review and meta-analysis. Lasers Med Sci. 2020;35(6):1231–1238. https://doi.org/10.1007/s10103-020-02987-3
42. Unver T, Aytugar E, Ozturan O, Kıran T, Ademci E, Usumez A. Histological Effects of Er:YAG Laser Irradiation with Snoring Handpiece in the Rat Soft Palate. Photomed Laser Surg. 2016;34(8):321–325. https://doi.org/10.1089/pho.2015.4044
43. Kakkar M, Malik S, Gupta B, Vaid N, George R, Singh S. Use of Laser in Sleep Disorders: A review on low laser uvulopalatoplasty. Sleep Disord. 2021;2021:8821073. https://doi.org/10.1155/2021/8821073
44. Wang Z, Rebeiz EE, Shapshay S. Laser soft palate “stiffening”: An alternative to uvulopalatopharyngoplasty. Lasers Surg Med. 2002;30: 40–43.
45. Badreddine AH, Couitt S, Kerbage C. Histopathological and biomechanical changes in soft palate in response to non-ablative 93-mum CO2 laser irradiation: an in vivo study. Lasers Med Sci 2021;36:413–420 https://doi.org/10.1007/s10103-020-03087-y.
46. Miracki K, Vizintin Z. Nonsurgical minimally invasive Er: YAG laser snoring treatment. J Laser Heal Acad 2013;1(1):36–41.
47. Frelich H, Marków M, Tażbirek M, Frelich-Truchel H, Misiołek M, Ścierski W. Erbium: Yttrium Aluminum Garnet (Er: YAG) Laser: A Minimally Invasive Treatment Method in Selected Patients with Impaired Breathing During Sleep—The Assessment of Treatment Effectiveness After 4 Years. Photomed. Laser Surg. 2023;41(8), 415-421.
48. Liu J, Yang J, Zhang M, Chen Y, Li Q. Clinical Efficacy Evaluation of Er: YAG Laser Treatments for Obstructive Sleep Apnea Hypopnea Syndrome. Biomed J Sci & Tech Res 2019;20(3):15010-15016. https://doi.org/10.26717/BJSTR.2019.20.003447
49. Liu 2017 20Liu H-W, Chen Y-J, Lai Y-C, Huang C-Y, Huang Y-L, Lin M-T. Combining MAD and CPAP as an effective strategy for treating patients with severe sleep apnea intolerant to high-pressure PAP and unresponsive to MAD. PLoS ONE 2017;12(10): e0187032. https://doi.org/10.1371/ journal.pone.0187032
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2. De Meyer MMD, Vanderveken OM, De Weerdt S, Marks LAM, Carcamo BA, Chavez AM, et al. Use of mandibular advancement devices for the treatment of primary snoring with or without obstructive sleep apnea (OSA): a systematic review. Sleep Med Rev. 2021;56:101407. https://doi.org/10.1016/j.smrv.2020.101407
3. Heinzer R, Vat S, Marques-Vidal P, et al. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med. 2015;3(4):310-318. https://doi.org/10.1016/S2213- 2600(15)00043-0
4. Bisheimer M, Ng ET, Lagravere MO, Mayoral P. Combined oral appliance therapy and adjunctive minimally invasive Er:YAG laser therapy for complete resolution of severe obstructive sleep apnea: A clinical case report. J Dent Sleep Med. 2022;10(1). http://dx.doi.org/10.15331/jdsm.xx
5. Bilston LE, Gandevia SC. Biomechanical properties of the human upper airway and their effect on its behavior during breathing and in obstructive sleep apnea. J Appl Physiol 2014;116:314–324. https://doi.org/10.1152/japplphysiol.00539.2013
6. Martinot J-B and Pépin J-L (2023) Mandibular jaw movements as a non-invasive measure of respiratory effort during sleep: application in clinical practice. Front. Sleep 2:1145620. https://doi.org/10.3389/frsle.2023.114562
7. Jo JH, Park JW, Jang JH, Chung JW. Hyoid bone position as an indicator of severe obstructive sleep apnea. BMC Pulm Med. 2022;22(1):1–10. https://doi.org/10.1186/s12890-022-02146-0.
8. Edwards B, White DP. Control of the pharyngeal musculature during wakefulness and sleep: Implications in normal controls and sleep apnea. Head Neck 2011;33:Suppl. 1, S37–S45. https://doi.org/10.1002/hed.21841
9. Cazan D, Mehrmann U, Wenzel A, Maurer JT. The effect on snoring of using a pillow to change the head position. Sleep Breath 2017;1(3):615e21. https://doi.org/10.1007/s11325-017-1461-1
10. Orjatsalo M, Toppila J, Heimola M, et al. Snoring was related to self-reported daytime sleepiness and tiredness in young adults performing compulsory conscript service. J Clin Sleep Med. 2023;19(2):243–251. https://doi.org/10.5664/jcsm.10294
11. Brown LK. Mild obstructive sleep apnea syndrome should be treated: pro. J Clin Sleep Med 2007;3:259–262.
12. Niu Y, Sui X, He Y, Xi H, Zhu R, Xu H, et al. Association between self-reported snoring and hypertension: a systematic review and meta-analysis. Sleep Med. 2021;88:140–8. https://doi.org/10.1016/j.sleep.2021.10.016
13. Wei Y, Lv J, Guo Y, et al. Age-specific associations between habitual snoring and cardiovascular diseases in China: a 10-year cohort study. Chest. 2021;160:1053-1063. https://doi.org/10.1016/j.chest.2021.04.070
14. Wang J, Campos AI, Rentería ME, Xu L. Causal associations of sleep apnea, snoring with cardiovascular diseases, and the role of body mass index: a two-sample Mendelian randomization study. European Journal of Preventive Cardiology. 2023:30(7);552-560. https://doi.org/10.1093/eurjpc/zwad005
15. Wang X, Fan J, Guo R, Hao W, Gong W, Yan Y, Zheng W, Ai H, Que B, Hu D, et al. Association of OSA with cardiovascular events in women and men with acute coronary syndrome. Eur Respir J. 2022. https://doi.org/10.1183/13993003.01110-2022.
16. Patel JA, Ray BJ, Fernandez-Salvador C, Gouveia C, Zaghi S, Camacho M. Neuromuscular function of the soft palate and uvula in snoring and obstructive sleep apnea: a systematic review. Am J Otolaryngol. 2018;39:327-337. https://doi.org/10.1016/j.amjoto.2018.03.006
17. Miracki K, Vizinti Z. Nonsurgical Minimally Invasive Er:YAG Laser Snoring Treatment. J LA&HA, J Laser and Health Academy 2013(1):36-42
18. Picavet VA, Dellian M, Gehrking E, Sauter A, Hasselbacher K. Treatment of snoring using a non-invasive Er: YAG laser with SMOOTH mode (NightLase): a randomized controlled trial. Eur Arch Otorhinolaryngol. 2023;280:307–312. https://doi.org/10.1007/s00405-022-0
19. Gianoni-Capenakas S, Kim DI, Mayoral P, Lagravère Vich. Mandibular advancement device effects on the upper airway anatomy and function: An umbrella review. J Dent Sleep Med. 2023;10(2). http://dx.doi.org/10.15331/jdsm.7290
20. Ramar K, Dort LC, Katz SG, Lettieri CJ, Harrod CG, Thomas SM, Chervin RD. Clinical practice guideline for the treatment of obstructive sleep apnea and snoring with oral appliance therapy: an update for 2015. J Clin Sleep Med 2015;11(7):773–827. https://doi.org/10.5664/jcsm.4858
21. Sutherland K, Takaya H, Qian J, Petocz P, Ng AT, Cistulli PA. Oral appliance treatment response and polysomnographic phenotypes of obstructive sleep apnea. J Clin Sleep Med 2015;11(8):861–868. F, Ahlberg J, Raphael KG, et al. International consensus on the assessment of bruxism: Report of a work in progress. J Oral Rehabil. 2018;45:837-844. https://doi.org/10.1111/joor.12663
22. Rombaux P, Hamoir M, Bertrand B, Aubert G, Liistro G, Rodenstein D. Postoperative Pain and Side Effects After Uvulopalatopharyngoplasty, Laser-Assisted Uvulopalatoplasty, and Radiofrequency Tissue Volume Reduction in Primary Snoring, Article first published online: 3 JAN 2009 https://doi.org/10.1097/00005537-200312000-00023.
23. Pae E-K, Harper RM. Elevated Hyoid Bone Position in Response to Mandibular Advancing Appliance Predicts Effectiveness of the Appliance for Obstructive Sleep Apnea. Front Dent Med 2021;2:1-9. https://doi.org/10.3389/fdmed.2021.672936
24. Ogawa T, Long J, Sutherland K, et al. Effect of mandibular advancement splint treatment on tongue shape in obstructive sleep apnea. Sleep Breath 2015;19:857–863. https://doi.org/10.1007/s11325-014-1101-y
25. Van Holsbeke C, De Backer J, Vos W, et al. Anatomical and functional changes in the upper airways of sleep apnea patients due to mandibular repositioning: a large scale study. J Biomech 2011;44:442–9. https://doi.org/10.1016/j.jbiomech.2010.09.026
26. Sutherland K, Chan AS, Cistulli PA. Three-dimensional assessment of anatomical balance and oral appliance treatment outcome in obstructive sleep apnea. Sleep Breath. 2016;20:903–10. https://doi.org/10.1007/s11325-015-1304-x.
27. Wojda M, Kostrzewa-Janicka J. Influence of MAD Application on Episodes of Obstructive Apnea and Bruxism during Sleep—A Prospective Study. J Clin Med 2022;11:5809. https://doi.org/10.3390/jcm11195809
28. Brown EC, Jugé L, Knapman FL, Burke PGR, Ngiam J, Sutherland K, Butler JE, Eckert DJ, Cistulli PA, Bilston LE. Mandibular advancement splint response is associated with the pterygomandibular raphe. Sleep 2021:44(4):zsaa222. https://doi.org/10.1093/sleep/zsaa222
29. Kim DI, Lagravère Vich M, Mayoral, P, Miguez M. Three-Dimensional Changes in Skeletal/ Dental Landmarks With Use of Mandibular Advancement Devices. J Dent Sleep Med. 2020;7(2). http://dx.doi.org/10.15331/jdsm.7120
30. Van de Perck E, Dieltjens M, Vroegop AV, Verbraecken J, Braem M, Vanderveken OM. Mandibular advancement device therapy in patients with epiglottic collapse. Sleep Breath 2022;26:1915–1920. https://doi.org/10.1007/s11325-021-02532-8
31. Okuno K, et al. Endoscopy evaluation to predict oral appliance outcomes in obstructive sleep apnoea. Eur Respir J. 2016;47(5):1410–1419. https://doi.org/10.1183/13993003.01088-2015
32. Sutherland K, Cistulli PA. Oral appliance therapy for obstructive sleep apnoea: state of the art. J Clin Med 2019;8:2121. https://doi.org/10.3390/jcm8122121
33. Tsuiki S, Ryan CF, Lowe AA, Inoue Y. Functional contribution of mandibular advancement to awake upper airway patency in obstructive sleep apnea. Sleep Breath 2007;11:245-51. https://doi.org/10.1007/s11325-007-0119-9
34. Juge L, et al. Regional respiratory movement of the tongue is coordinated during wakefulness and is larger in severe obstructive sleep apnoea. J Physiol. 2020;598(3):581–597. https://doi.org/10.1113/JP279382
35. Mogell K, Blumenstock N, Mason E, Rohatgi R, Shah S, Schwartz D. Definition of an Effective Oral Appliance for the Treatment of Obstructive Sleep Apnea and Snoring: An Update for 2019. J Dent Sleep Med. 2019;6(3) http://dx.doi.org/10.15331/jdsm.7090
36. Cetinkaya EA, Turker M, Kiraz K, Gulkesen HK. Er: Yag Laser Treatment of Simple Snorers in an Outpatient Setting. ORL J Otorhinolaryngol Relat Spec. 2016;78(2):70–76
37. Lee 2015 Lee CYS, Lee CCY. Evaluation of a non-ablative Er: YAG laser procedure to increase the oropharyngeal airway volume: a pilot study. Dental Oral Craniofacial Res. 2015;1(3):56–59
38. Storchi IF, Parker S, Bovis F, Benedicenti S, Amaroli A. Outpatient erbium:YAG (2940 nm) laser treatment for snoring: a prospective study on 40 patients [published correction appears in Lasers Med Sci. 2019 Mar;34(2):431]. Lasers Med Sci. 2018;33(2):399–406
39. Frelich H, Ścierski W, Marków M, Frelich J, Frelich H, Maciej M. Minimally invasive erbium laser treatment for selected snorers. Lasers Med Sci. 2019;34(7):1413–1420. https://doi.org/10. 1007/s10103-019-02731-6
40. Monteiro L, Macedo A, Corte-Real L, Salazar F, Pacheco JJ. Treatment of snoring disorder with a non-ablactive Er:YAG laser dual mode protocol. An interventional study. J Clin Exp Dent. 2020;12(6):e561–e567. https://doi.org/10.4317/jced.56953
41. Neruntarat C, Khuancharee K, Shoowit P. Er:YAG laser for snoring: a systemic review and meta-analysis. Lasers Med Sci. 2020;35(6):1231–1238. https://doi.org/10.1007/s10103-020-02987-3
42. Unver T, Aytugar E, Ozturan O, Kıran T, Ademci E, Usumez A. Histological Effects of Er:YAG Laser Irradiation with Snoring Handpiece in the Rat Soft Palate. Photomed Laser Surg. 2016;34(8):321–325. https://doi.org/10.1089/pho.2015.4044
43. Kakkar M, Malik S, Gupta B, Vaid N, George R, Singh S. Use of Laser in Sleep Disorders: A review on low laser uvulopalatoplasty. Sleep Disord. 2021;2021:8821073. https://doi.org/10.1155/2021/8821073
44. Wang Z, Rebeiz EE, Shapshay S. Laser soft palate “stiffening”: An alternative to uvulopalatopharyngoplasty. Lasers Surg Med. 2002;30: 40–43.
45. Badreddine AH, Couitt S, Kerbage C. Histopathological and biomechanical changes in soft palate in response to non-ablative 93-mum CO2 laser irradiation: an in vivo study. Lasers Med Sci 2021;36:413–420 https://doi.org/10.1007/s10103-020-03087-y.
46. Miracki K, Vizintin Z. Nonsurgical minimally invasive Er: YAG laser snoring treatment. J Laser Heal Acad 2013;1(1):36–41.
47. Frelich H, Marków M, Tażbirek M, Frelich-Truchel H, Misiołek M, Ścierski W. Erbium: Yttrium Aluminum Garnet (Er: YAG) Laser: A Minimally Invasive Treatment Method in Selected Patients with Impaired Breathing During Sleep—The Assessment of Treatment Effectiveness After 4 Years. Photomed. Laser Surg. 2023;41(8), 415-421.
48. Liu J, Yang J, Zhang M, Chen Y, Li Q. Clinical Efficacy Evaluation of Er: YAG Laser Treatments for Obstructive Sleep Apnea Hypopnea Syndrome. Biomed J Sci & Tech Res 2019;20(3):15010-15016. https://doi.org/10.26717/BJSTR.2019.20.003447
49. Liu 2017 20Liu H-W, Chen Y-J, Lai Y-C, Huang C-Y, Huang Y-L, Lin M-T. Combining MAD and CPAP as an effective strategy for treating patients with severe sleep apnea intolerant to high-pressure PAP and unresponsive to MAD. PLoS ONE 2017;12(10): e0187032. https://doi.org/10.1371/ journal.pone.0187032
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Como Citar
Mayoral Sanz, P., & Bisheimer Chemez, M. (2023). Tratamento do Ronco com Aparelho de Avanço Mandibular e Fotoestimulação a Laser. Revisão Narrativa. Uiversitas Odontologica, 42. https://doi.org/10.11144/Javeriana.uo42.tsma
Edição
Seção
Dossiê: Disfunção Temporomandibular, Dor Orofacial, Bruxismo e Apneia do Sono
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