Pregled in izdelava ustnega aparata za zdravljenje obstruktivne spalne apneje : diplomsko delo

Erjavec, Bojan (author), Rener-Sitar, Ksenija (mentor), Rojko, Franc (reviewer)

Uvod: Obstruktivna spalna apneja (OSA) je s spanjem povezana motnja dihanja, pri kateri prihaja do prekinitev dihanja v spanju, ki trajajo vsaj 10 sekund. OSA prizadene od 3 do 10 % populacije, pri starejših od 65 let pa do 70 %. Pogostejša je pri moških in osebah z višjim indeksom telesne mase. Ustni aparati za OSA postajajo tudi v slovenskem zobozdravstvu vse bolj znani. Njihov namen je pacientu omogočiti lažje dihanje brez prekinitev v spanju. Poznamo dve skupini ustnih aparatov za zdravljenje OSA, in sicer zadrževalnike spodnje čeljusti in zadrževalnike jezika. Namen: Glavni namen dela je pregledati dostopne ustne aparate za zdravljenje OSA na angleško govorečih tržiščih, jih opisati, predstaviti prednosti in slabosti vsakega izmed njih ter jih med seboj primerjati. Dodaten namen je podrobneje predstaviti laboratorijske faze izdelave aparatov Silensor (Erkodent, Nemčija) in Liberty Bielle (RMO, Francija). Oba aparata sta izdelana iz plastične folije z metodo globokega vleka, prvi s plastičnimi vodili, drugi z dodanim hladno polimerizirajočim akrilatom in kovinskimi vodili. Primerjali smo ju z vidika stroškov in časa izdelave ter zahtevnosti izdelave. Metode dela: Uporabili smo angleško in slovensko strokovno literaturo ter spletne strani, ki so povezane z OSA. Uporabili smo iskalnike Google, PubMed, Google Učenjak in OVID Medline, s katerimi smo s ključnimi besedami iskali članke in vire. Uporabili smo opisno oz. deskriptivno metodo, metodo proučevanja, v zobotehničnem laboratoriju pa smo izdelali dva ustna aparata. Naredili smo časovni in stroškovni obračun izdelave teh dveh aparatov. Rezultati: V literaturi in na svetovnem spletu smo našli 25 različnih izvedb ustnih aparatov za zdravljenje OSA. Čas izdelave aparata s plastičnimi vodili je bil 330 minut, aparata s kovinskimi vodili pa 465 minut. Ocena laboratorijskih stroškov je 83,14 € za prvi aparat in 147,28 € za drugi aparat. Razprava in sklep: Na angleško govorečih tržiščih po svetu je dostopnih najmanj 25 oblikovno različnih vrst ustnih aparatov za zdravljenje OSA. Aparat s kovinskimi vodili je trajnejši od aparata s plastičnimi vodili, omogoča boljše gibanje spodnje čeljusti, vendar je skoraj dvakrat dražji in v primerjavi z aparatom s plastičnimi vodili zamudnejši za izdelavo.

• Language: Slovenian
• Keywords: diplomska dela, laboratorijska zobna protetika, obstruktivna spalna apneja, dihanje, spalne motnje, ustni aparati, zobozdravstvo, zobotehniki
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [B. Erjavec]
• Year: 2020
• Number of pages: 56 str.
• PID: 20.500.12556/RUL-116090
• COBISS.SI-ID: 15724803
• Publication date in RUL: 14.05.2020

Secondary language

• Language: English
• Title: Overview and fabrication of oral appliance for obstructive sleep apnea : diploma work

Abstract

Introduction: Obstructive Sleep Apnea (OSA) is a sleep-related breathing disorder, in which there are cessations of breathing lasting for at least 10 seconds. OSA affects 3-10% of the population, and 70% of the patients are over 65 years of age. It is more common in men and subjects with a higher body mass index. OSA appliances are also becoming more widely known in Slovenian dentistry. Their purpose is to make it easier for the patient to breathe without interruptions in sleep. There are two main types of OSA oral appliances; one that keeps a mandible in a protruded position, and the other that pulls a tongue forward. Objectives: The main objective was to perform an overview of OSA oral appliances in the English-speaking market, to describe, compare, and present the advantages and limitations for each of them. An additional objective was a detailed presentation of the laboratory phases of the manufactured Silensor oral appliance (Erkodent, Germany) and Liberty Bielle oral appliance (RMO, France). Both appliances are made of vacuum-formed foil. The Silensor appliance has plastic connectors, while the Liberty Bielle oral appliance has cold polymerizing acrylate and metal connectors. We compared them from the manufacturing point of view, as well as the costs and time required to complete the appliance. Methods: We used English in Slovenian scientific literature related to OSA. We used Google search engines, PubMed, Google Scholar, and OVID Medline databases to search the literature. We searched according to the keywords related to OSA and then produced two oral appliances in the dental laboratory. We made the time and cost calculations for processing these two appliances. Results: We found 25 different structural variations of OSA oral appliances in the literature and electronic databases. The time required to manufacture the appliance with plastic connectors was 330 min, and for the one with metal connectors, it was 465 min. The laboratory cost estimate was €83.44 for the first appliance and €147.28 for the second appliance. Discussion in conclusions: In general, there are at least 25 different structural variations of OSA oral appliances worldwide. The oral appliance with metal connectors enables the better movement of the lower jaw but is almost twice as expensive and more difficult to manufacture in comparison to the one with plastic connectors.

• Keywords: diploma theses, laboratory dental prosthetics, obstructive sleep apnea, breathing, sleep disorders, oral appliances, dentistry, dental technicians