Acoustic Reflection: Review and Clinical Applications for Sleep-Disordered Breathing
Viviano, JS. Sleep and Breathing, volume 6, number 3, 2002 p. 129-149
Abstracted / Indexed by Index Medicus / MEDLINE
Summary: Sleep-disordered breathing (SDB) affects more than 4% of the adult population with an even higher prevalence within high risk groups. Nasal continuous positive air pressure (nCPAP), although considered the current gold standard treatment for SDB demonstrates poor patient compliance. Alternative therapies, such as palatal surgeries and airway orthotics lack validated candidacy selection protocols; resulting in varying success rates. Although much has been published over the last several years regarding the effect of these therapies on the upper airway, no publication has presented an accounting of the use of acoustic reflection (AR) to evaluate airway characteristics pre and post treatment with these alternative therapies. MORE...
Assessing Orthotic Normalization of Pharyngeal Dynamics
Viviano JS, CRANIO, volume 22, number 3, 2004 p. 192-208
Abstracted / Indexed by Index Medicus / MEDLINE
Summary: Airway orthotic therapy, considered mainstream in the treatment of sleep disordered breathing, has been demonstrated to normalize both structure and function of the pathological airway through manipulation of mandibular posture. Although effective, the literature reports a variable rate of success and no validated candidacy selection protocol. Acoustic reflection has been used to evaluate and document the upper airway and its dynamics with and without an orthotic in place. This paper will discuss use of acoustic reflection to assess the level of airway normalization resulting from protrusive and vertical repositioning of the mandible, and its utility to establish orthotic candidacy, construction, titration and maintenance parameters. MORE...
Normalizing the Pathological Airway
Sleep Review: The Journal for Sleep Specialists
Viviano JS, Sleep Review, Volume 3, number 1, 2002 p.
The term “airway orthotic” (AO) is derived from the belief that these tooth-retained oral devices work by manipulating the jaw into the posture that best stabilizes the airway, thus normalizing airway behavior. Several studies have demonstrated their ability to normalize both airway structure and function through manipulation of mandibular posture.1-4 Although officially condoned for the treatment of sleep-disordered breathing (SDB) by the American Academy of Sleep Medicine in 1995,5 to date, issues such as AO candidacy selection, construction parameters, and titration settings continue to be dealt with through mostly anecdotal findings and subjective evaluation. MORE...
Mandibular Advancement Achieved through a Stepped Mouthpiece Mouthpiece Design
Can Change the Size of the Upper Airways
Nikander, K. Petherbridge, I. Scarberry, E. Von Hollen, D. Viviano, J. Chrystyn, H
1. Viviano J. Dental Sleep Medicine: The Future is Now! Dentistry Today. Sept 2018
2. Viviano J. Sleep Apnea: Is Dentistry Doing Enough? OD May 2021
3. Viviano J. Why are Sleep Physicians sending patients to untrained dentists? Sleep Review Sept 2023
4. Viviano J. Oral Appliance Therapy: The Definition of Effectiveness. DSP Spring. 2021
5. Viviano J. et al. Physician-Dentist Collaboration: A Call to Action for Allied Troops. DSP. Fall 2021
6. Viviano J. Sleep Apnea Oral Appliances: A Progress Review. JDT June/July 2021
7. Viviano J. Oral Appliances and Tooth Movement: Caveat Emptor. DSP Fall 2021
8. Viviano J. Dental Sleep Medicine: Are You Ready to Step Up? OD April 2023
9. Viviano J. Please Stop the Oral Appliance Efficacy Comparison Claims. Sleep Review May 19, 2023
10. Viviano J. Oral Appliance Management of Sleep Apnea: Why Bother? Panthera White Paper 2023
11. Viviano J. Retrospective comparison of the George Gauge Registration and the Sibilant Phoneme Registration for Constructing OSA Oral Appliances. CRANIO 2019
12. Viviano J. An Exploratory in-vitro study on the effect on Pharyngograms of Acoustic Leaks Through the Velopharyngeal Port. JDSM 2021; 8(4)
13. Viviano J. The Multidisciplinary Collaborative Patient Journey: From Referral to Treatment and Follow-up. Panthera White Paper 2023
14. Viviano J. Bruxism and Obstructive Sleep Apnea. Ontario Dentist March / April 2024
