Precision Oral Appliance for Sequential Mandibular Anterior Repositioning in Management of Adult Severe Obstructive Sleep Apnea: A Case Report

Mandibular advancement devices are known to be effective in treating mild to moderate obstructive sleep apnea (OSA) and provide a viable treatment alternative for patients intolerant to continuous positive airway pressure therapy.This case report describes the treatment of severe OSA in a 42-year-old patient using a customized mandibular repositioning appliance.The patient underwent specific investigations for a sleep study, including subjective sleep study questionnaire evaluation, radiographic assessment, and polysomnography, following which a titrable precision fit mandibular repositioning appliance was fabricated with an advancement of 60% of maximum mandibular protrusion.The 2-year follow-up results confirmed significant improvement in pharyngeal airway width, substantiated through a marked decline in apnea/hypopnea index values, providing relief from daytime discomforts associated with sleep apnea and improving quality of sleep.The case report concluded that customized mandibular repositioning appliances can be used as an effective and efficient alternative therapeutic option for patients with severe obstructive sleep apnea.