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Finally - concrete data on the connection between OAT and inflammatory biomarkers.

With patient adherence averaging 6.6 hours per night (beating typical CPAP compliance), here's why tracking more than AHI matters.

In Today’s Edition:

• Anti-Inflammatory Effects of OAT

• CE Opportunities / Events

• [Video] How Does OSA Affect Arterial Inflammation?

5-minute read👇

Clinical Corner

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Key Takeaways🔑

What New Biomarker Research Reveals About OSA Treatment

When a patient's AHI drops from 24 to 7 events per hour, we typically celebrate. But what's happening beneath those numbers? Recent research reveals a complex story about mandibular advancement therapy (MAT) and its effects on inflammatory biomarkers - insights that could transform how you approach OSA treatment.

The Stakes Are Higher Than We Thought

Consider this: every time your OSA patient's airway collapses, it triggers more than just a spike in their AHI. Each episode launches a cascade of inflammatory responses that could increase their risk of cardiovascular disease. With OSA affecting up to 13% of your patient population, understanding these inflammatory markers isn't just academic - it's crucial for comprehensive care.

What the Latest Research Shows

A groundbreaking systematic review analyzing 148 OSA patients has revealed critical patterns in how MAT affects inflammatory biomarkers. Here's what you need to know:

The Numbers That Matter

• Treatment adherence hit 6.6 hours per night - significantly higher than typical CPAP compliance

• Patient improvement tracked across 2-3 months showed consistent AHI reduction

• A striking 53% reduction in AHI was observed in effective MAT users

• Three-month follow-up data showed AHI dropping from 24 to 13.1 events/hour, further improving to 7.05 at six months

The Biomarker Breakthrough

Previous assumptions about inflammatory markers are being challenged. While MAT consistently improved AHI, its impact on inflammatory biomarkers tells a more nuanced story:

• Short-term treatment (2 months) showed minimal effect on CRP and TNF-α

• Extended therapy (3+ months) demonstrated improvements in specific markers:

  • IL-1β levels showed significant reduction

  • D-dimer concentrations decreased

  • TAFIa measurements improved

  • No significant impact on IL-6 or IL-10

Transforming Your Practice Approach

Immediate Implementation Steps

1. Revise Your Assessment Protocol

   • Add cardiovascular risk screening to initial evaluations

   • Document baseline inflammatory markers when available

   • Set three and six-month follow-up benchmarks

2. Upgrade Patient Communication Instead of: "Your AHI is improving." Try: "We're seeing improvements in both your breathing patterns and potential cardiovascular risk factors."

The Bottom Line for Your Practice

1. Treatment Duration Matters

   • Consider extending initial treatment evaluation periods

   • Plan for longer-term monitoring of inflammatory markers

   • Set patient expectations for extended therapy timelines

2. Success Metrics Are Evolving

   • Look beyond AHI as the sole indicator of success

   • Include cardiovascular health markers in progress assessments

   • Document inflammatory marker changes when possible

3. Patient Education Is Key

   • Explain the connection between OSA and cardiovascular health

   • Emphasize the importance of consistent, long-term therapy

   • Share specific biomarker improvements to encourage compliance

Moving Forward

The evidence is clear: MAT's impact extends far beyond airway metrics. While a 53% reduction in AHI is impressive, the potential to influence inflammatory biomarkers opens new frontiers in OSA treatment. As you integrate these findings into your practice, remember that patient education and extended treatment protocols could be the key to unlocking better outcomes.

Consider this your call to action: review your current treatment protocols and ask yourself - are you monitoring the complete picture of your patients' health improvement? The answer could transform your approach to dental sleep medicine.

Priyadarshini, Pooja; Singh, Deepak; Sharma, Vipul Kumar; Chaturvedi, T P; Singh, Akhilesh Kumar. Effect of mandibular advancement therapy on inflammatory biomarkers in obstructive sleep apnea: A systematic review. National Journal of Maxillofacial Surgery 15(2):p 177-182, May–Aug 2024. | DOI: 10.4103/njms.njms_79_22

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Miscellaneous

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