0553 Non-Surgical Osseous Remodeling and Myofunctional Therapy for Skeletal class III Malocclusion with Severe OSA

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Obstructive Sleep Apnea (OSA), is a common sleep-disorder; causes of OSA vary, including decreased pharyngeal muscle tone, craniofacial obesity, and craniofacial deficiencies amongst others. Current treatments are continuous positive airway pressure therapy (CPAP), as well as MRA and MMA surgery. This study tests that if a non-surgical biomimetic oral appliance therapy (BOAT) DNA® System is used in combination with a sagittal expander and Myofunctional therapy for soft tissue remodeling and brain remapping; then AHI can be reduced in addition to oxygen desaturation. This study includes two class III adults: male A (45 years) with 65% oxygen desaturation and male B (45 years) with 78% oxygen desaturation. The cases were treated with FDA-cleared DNA Appliance© for osseous remodeling, and Myofunctional therapy for 6 months, followed by sagittal expansion. Before treatment the craniofacial region was imaged using 3D cone-beam CT scans. After 9 months of treatment, the apnea hypopnea index (AHI) was reassessed, without any appliance, by home sleep study (HST). The upper airway volume was reassessed with another 3D cone-beam CT scan and upper airway analysis. This process was repeated after the sagittal expander. For both cases, the mean AHI decreased from severe to mild, while the upper airway volume (from the posterior nasal spine to the epiglottis) increased by 15% and oxygen desaturation decreased. This preliminary study suggests that a decrease in AHI and oxygen desaturation may be associated with combined non-surgical osseous upper airway remodeling, a sagittal expander; and Myofunctional therapy, for soft tissue remodeling and brain pattern remapping, for skeletal class III with severe OSA in adults with craniofacial deficiencies. N/A.