齒顎矯正對上呼吸道的影響系列之六：不同設計之止鼾器及其治療的長期影響

The Sixth Series of “Orthodontic Treatment's Influence Over Upper Airway”: Different Designs and Long-term Consequences of Oral Appliance

一篇1995年的研究報告指出止鼾器在輕度至中度的睡眠呼吸中止症患者的治療效果和連續性正壓呼吸輔助器相似。這讓牙科正式跨足到睡眠障礙治療的領域。止鼾器的原理是將舌頭或下顎骨往前位移，以提供更大的呼吸道空間。目前臨床使用的止鼾器有下顎前移器、舌頭固定器等。長期追蹤止鼾器的治療效果，本文分三部分來看：（1）呼吸道的變化──整體呼吸道的體積會增加。（2）齒列的變化－－水平及垂直覆蓋減少。（3）對於顳顎關節的問題－－戴上止鼾器之後並不會使顳顎關節的問題惡化。

The effect of oral appliances in treating mild to moderate obstructive sleep apnea syndrome (OSAS) patientis found to be similar to continuous positive airway pressure in a study in 1955. Oral appliances make tongue or mandible forward position to increase airway space. Mandibular advancement devices and tongue retaining devices are oral appliances used in clinic today. Long term effects of oral appliances are discussed in three parts in this article: airway, dentition and temporomadibular joint. Total airway volume increases after using oral appliances. Overbite and overjet are found decreasing. Oral appliances cannot worsen the temporomadibular joint problems.