USC University of Southern California

Herman Ostrow School of Dentistry of USC

Ostrow School of Dentistry-led Articles Honored by Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology & Endodontics

 Dr. Reyes Enciso

Two articles, each published by Ostrow School of Dentistry investigators in the journal Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology & Endodontics, have won awards for the journal’s best articles of 2010.

“Comparison of cone-beam CT parameters and sleep questionnaires in sleep apnea patients and control subjects” won the American Academy of Oral and Maxillofacial Radiology’s Arthur Wuehrmann Prize for Best Oral Radiology Article.

Lead author Reyes Enciso, Assistant Professor of Clinical Dentistry, said the study illustrated the correlative power of three-dimensional cone-beam CT scans in patients with possible obstructive sleep apnea (OSA), which is characterized by pauses in breathing during sleep due to the airway collapsing or soft tissues such as the tongue or palate blocking the airway.

The patients eventually diagnosed with OSA shared similar airway characteristics as discovered by the cone-beam CT scan, including smaller lateral airway widths and smaller cross-sectional area measurements of the airway. However, airway collapsibility seemed to be a bigger factor for apnea diagnosis than airway dimensions alone, Enciso said.

“We are using cone-beam CTs in patients who have an atypical response to treatment in order to examine their airway for abnormality,” she said. “We also recommend CBCT imaging for patients who are contemplating surgical intervention, because it is critical to document the shape and form of the airway in order to plan the most effective surgical approach.”

“Treatment outcomes of mandibular advancement devices in positional and non-positional OSA patients” won the H. Dean Millard Best Paper Award from the American Academy of Oral Medicine.

Principal investigator Glenn Clark, director of the Ostrow School of Dentistry’s Oral Medicine residency program, said the study examined the helpfulness of mandibular advancement devices in OSA patients. The devices, used during sleep, pull the lower jaw forward, reducing the likelihood of soft oral tissues blocking the airway.

The results suggested that the devices helped patients who had positional OSA – those whose apnea was worst when in sleeping in a certain position, usually on their backs. However, the devices didn’t seem to help as much in patients whose apnea was non-positional, or didn’t depend on what position they slept in.

“One of the important findings of the paper that we published is that when your snoring or apnea is no longer helped by turning on your side, this is a serious sign of progression of the disease,” Clark said. “We feel that paying attention to whether a patient is a positional or non-positional apnea patient is very important. People have suspected that the role of gravity on tongue relapse is important, but our paper was the first to definitively show how this influences the success rate of using dental appliances.”

Both Enciso and Clark were very proud to have their work recognized by the Journal as two of the best papers of 2010.

“We are thrilled to be recognized for these awards, especially because they were unsolicited award and based upon the recommendation of our peers,” Enciso said. “It is high-praise indeed.”

Clark said that he, Enciso and their colleagues continue to be very enthusiastic about their investigations into sleep apnea.

“Our two studies add two small pieces to the jigsaw puzzle that represents our understanding in the management of obstructive sleep apnea,” Clark said. “If we get enough of these puzzle pieces put in place, we will be able to better help our patients and give them confidence that we understand what is wrong and that we are using the best evidence-based approach to treat them.”