Immunologic and Physiologic Effects of Dental Sleep Appliance Therapy

  • G. Gary DemerjianEmail author
  • Pooja Goel


Obstructive sleep apnea (OSA) is characterized by episodes of oropharyngeal obstruction due to repetitive collapse of the oropharyngeal tissues during sleep. OSA is associated with sleep fragmentation, hypoxemia, hypercapnia, marked swings in intrathoracic pressure, increased sympathetic activity, and cardiovascular complications.There are multiple medicalrisk factors for patients diagnosed with OSA and evidence showing improvement of health factors with the treatment of positive airway pressure (PAP) therapy.

 Multiple forces contribute to oropharyngeal collapse, including the elongation of the soft palate and uvula, loss of vertical dimension resulting in a shortening of the lower 1/3rd of the face, increase in tongue size due to fat deposition in the tongue, constriction of dental arches, negative transmural pressure gradient and tissue weight. The goal of this chapter is to show the correlation and improvements on immunologic and physiologic effects of dental sleep appliance therapy based on the improvements seen with PAP therapy.



American Academy of Dental Sleep Medicine


Apnea-hypopnea index


Body mass index


Calcitonin gene-related peptide


Chronic kidney disease


Continuous positive airway pressure


Craniofacial Pain Handbook


Computerized tomography scan


Gastroesophageal reflux disorder


Glossary of Prosthodontic Terms Ninth Edition


Hormone replacement therapy


Irritable bowel syndrome


International Classification of Sleep Disorders Third Edition


Lower esophageal sphincter




Magnetic resonance imaging


Oral appliance therapy


Oxygen desaturation index


Obsessive daytime sleepiness


Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management, Fourth Edition


Obstructive sleep apnea


Positive airway pressure


Posterior airway space

PGP 9.5

Protein gene product 9.5


Portable monitors




Renin angiotensin-aldosterone system


Respiratory distress index


Rapid eye movement


Rapid maxillary expansion


Rhythmic masticatory muscle activity


Retropharyngeal space


Sleep-related bruxism


Substance P


Temporary anchorage device


Trigemino-cardiac reflex


Temporomandibular joint disorder


Total sleep time


Tension-type headache


Vertical dimension of occlusion


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Center for TMJ & Sleep TherapyGlendoraUSA
  2. 2.Smiles for Life Dental GroupSanta ClaritaUSA

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