(A1217) Precision Oral Appliance Therapy: The Leading Non-surgical Alternative to CPAP in the Treatment of OSA

Introduction: In 1981, Dr Colin Sullivan in a landmark paper in the Lancent introduced CPAP for the treatment of Obstructive Sleep Apnea (OSA). Despite being labeled as the "gold standard", compliance has not improved significantly over the last 44 years. Precision Oral Appliance Therapy has now emerged as the leading non-surgical alternative to CPAP. The latest studies and research will be reviewed in detail to support the improved effectiveness in Precision Oral Appliance Therapy compared to Oral Appliance Therapy in the past.

Methods: This oral scientific session will review 15 clinical studies that involved 1431 patients over multiple clinical sites. This review is from studies utilizing Precision Oral Appliance therapy for treatment of all levels of severity in the treatment of OSA. The studies were conducted in the US Army, Portugal, Belgium, England and multiple sits throughout the United States. Success criteria varied in several of the studies involved the standard criteria utilized in determining surgical success (Sher's Criteria: > 50% reduction on the AHI and/or AHI < 20).

Results: 15 Clinical studies involving 1431 patients across multiple sites showed a Mean efficacy and Median Efficacy of 85% when utilizing the Sher's Criteria for surgical success. Patient compliance averaged 90% and side effects including jaw pain, tooth movement and TMJ dysfunction were minimal.

Conclusions: Despite the high "efficacy" of CPAP in the treatment of OSA, it's real world "effectiveness" is compromised by poor compliance or adherence. While Precision Oral Appliance Therapy has lower efficacy than CPAP in the treatment of OSA, it's "effectiveness" mat be equal to or greater than CPAP when compliance is taken into account. Since mean disease alleviation and health outcomes show little difference between CPAP and Precision Oral Appliance Therapy these studies support an alternative treatment paradigm. Precision Oral Appliance Therapy may now be considered as non-inferior to CPAP in the treatment of all levels of severity of OSA with the results presented in this scientific session.