I have been using dental implants for many years to replace missing teeth, secure dentures and to secure oral appliances for treating sleep apnea. This publication in Sleep and Breathing discusses the use of orthodontic implants to support oral appliances in patients who do not tolerate CPAP. This article goes a step further and is using elastic bands attatched to the implants to hold the jaw forward. It is an interesting concept of using the implants to connect directly to the bands because of insufficient support by teeth. It would also be possible to use combinations of a single arch appliance that would connect to implants on the opposing arch.

There are many methods to utilize dental implants to improves the lives of patients. In intolerant CPAP patients would be a life saving alternative. Should medical insurance companies be required to cover the costs of dental implants if they are needed to retain a sleep appliance?

It would be possible to create a simple appliance that utilizes two dental implants in the posterior mandible (back part of lower jaw, and use a tongue bumper held by the implants to prevent airway collapse during sleep. It could attatch to the implants and go behind the tongue to prevent collapse. This would create an appliance that works in a similar matter to TRD's or Full Breath appliance. It would have minimal effect on the teeth or jaw position.

As of now I think the best treatment is to use standard implants to hold fixed bridgework ot dentures and then standard appliances for most patients. It is always possible to do custom modifications of FDA approved appliances or one of a kind unique appliances to address unique problems.


PubMed absrtact
Sleep Breath. 2009 Sep 18. [Epub ahead of print]
Orthoimplants: an alternative treatment for SAHS?
de Carlos F, Cobo J, Fernandez Mondragon MP, Alvarez Suarez A, Calvo Blanco J.

Department of Surgery and Medical-Surgical Specialities, Area of Orthodontics, Faculty of Medicine, Universidad de Oviedo, Clinica Universitaria de Odontologia, C/Catedrático José Serrano, s/n 33006, Oviedo, Spain, fcarlos@uniovi.es.
Numerous sleep studies have been published recently regarding the use of intraoral devices (ODs) for the treatment of sleep apnea-hypopnea syndrome (SAHS). The effectiveness of these devices varies, however, according to the series studied (patient characteristics, parameters assessed, type of device, etc.). Two factors should always be assessed: the presence of an appropriate dental support and a possible temporomandibular joint pathology which can, on occasions, contraindicate the use of these devices. OBJECTIVES: To use orthoimplants as orthodontic anchorages for intermaxillary elastic bands which allow a mandibular advancement to be performed as an alternative treatment to ODs in SAHS patients without appropriate dental support. MATERIALS AND METHODS: Four orthoimplants were placed in an edentulous SAHS patient who did not tolerate continuous positive airway pressure (CPAP). The mandible is pushed forward using orthodontic elastic bands anchored to the orthoimplants. RESULTS AND CONCLUSIONS: Although more studies are still required, orthoimplants could be an alternative treatment for reducing snoring and the apnea-hypopnea index and increasing SaO2, which should be considered for patients who do not tolerate CPAP and lack appropriate dental support for attaching intraoral devices.

PMID: 19763651 [PubMed - as supplied by publisher]