Myofunctional Therapy as a Combined Treatment to Reduce Occlusal Side Effects of MAD Therapy in OSA Patients: A Clinical Case Report

Obstructive sleep apnea (OSA) syndrome is the most common sleep-disordered breathing disorder and is included in the International Classification of Sleep Disorders, Third Edition sleep-disordered breathing category.The adequate treatment of OSA depends on the severity of symptoms and disease, as well as the anatomic characteristics and the patient's health status.A multidisciplinary approach to the treatment of OSA is mandatory.Although positive airway pressure is the recommended treatment, in some patients a mandibular advancement device (MAD) is beneficial, especially for those with mild to moderate OSA.However, mild and transient adverse effects have been reported in the early stages of therapy.Myofunctional therapy as a combined therapy has shown great results in controlling MAD adverse effects and improving muscle tone.Case Report: A selected patient with mild OSA, presenting with diurnal and nocturnal signs and symptoms such as muscular discomfort and temporomandibular joint noises during mouth opening and closing movements, underwent MAD therapy combined with myofunctional therapy using an individualized protocol.Conclusions: Myofunctional exercises seem to positively control the adverse effects of MAD by improving muscle tone, reducing muscle discomfort, and stabilizing occlusal contacts.Myofunctional therapy, as a combined treatment, also appears to improve OSA results.