Patient Profile:
- Initial Sleep Study Date: 2019
- Treatment Start Date: 2022
- Location: Tucson, AZ
Initial Diagnosis:
CBCT Findings: Narrow airway with history of loud snoring
Home Sleep Test (HST): Apnea levels within normal range
Symptoms: Loud snoring, noted by spouse
Follow-up HST (2022):
Apnea Hypopnea Index (AHI): Elevated
Respiratory Distress Index (RDI): Elevated
Treatment Plan:
Following a noticeable increase in snoring and observed cessation of breathing during sleep by March 2022, a new CBCT scan and airway report were completed. A second HST revealed a concerning elevation in both AHI and RDI. The patient was placed on a rescue appliance while a custom appliance was fabricated. Treatment began using a custom-designed oral appliance in combination with myofunctional therapy.
Evaluation and Monitoring:
Initial CBCT Scan: 2019
Follow-up CBCT Scan: July 2025
Appliance Use: Intermittent and irregular over 2 years due to work and sleep schedule
Myofunctional Therapy Compliance: Inconsistent
Outcome:
Despite low compliance, the July 2025 CBCT scan revealed clear remodeling and improvement of the airway structure. This indicates that even with irregular use, the oral appliance and therapy produced meaningful anatomical changes in the airway.
Conclusion:
This case highlights the potential impact of oral appliance therapy even under less-than-ideal conditions. Significant airway improvement was observed over time, underscoring the effectiveness of the treatment approach.
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