Use of an oral appliance in a marked retrognathic and severe OSA patient. Three years follow-up: clinical report

The aim of this study was to show the efficacy of mandibular repositioning appliance (MRA) to treat severe obstructive sleep apnea (OSA) on a marked retrognathic patient that refused continuous positive airway pressure (CPAP) therapy. The apnea/hypopnea index (AHI) reduced from 38.5 to 12.0, despite marked retrognathia represented for the variable pog/N-perp = -15.0 mm. After six months and after three years of MRA usage, another polysomnogram (PSG) was carried out. The results showed an AHI=12.0 and 13.0, respectively, besides improvements in other physiologic variables. We concluded that MRA was effective in the treatment of severe OSA with a marked retrognathia. Sleep physicians should consider this therapy option when patients refuse CPAP and surgery approaches.