運用3D列印技術開發客製化下顎前置及舌導引止鼾器治療睡眠呼吸中止症－初步病例報告

阻塞型睡眠呼吸中止症會造成患者睡眠期間血氧水平下降，增加心血管疾病、糖尿病等系統性疾病的罹病風險。當阻塞型睡眠呼吸中止症患者無法配合呼吸機治療時，可使用止鼾器作為替代治療方式。本病例為60歲男性，被診斷為重度阻塞型睡眠呼吸中止症，因夜間配戴正壓呼吸機後，引起鼻塞造成呼吸困難而無法接受正壓呼吸機療程，由三軍總醫院睡眠中心轉診至牙科部。我們使用全數位流程來製作止鼾器，設計舌頭導引板、開窗構造、軟顎靠板以輔助舌頭吞嚥的功能訓練並降低副作用。使用全數位製程可以增進臨床與技工端的效率，且增加止鼾器精準度。本病例報告為無法配戴呼吸機案例，利用止鼾器提高治療效果，提供臨床醫師一個有效的治療流程。

關鍵字

阻塞型睡眠呼吸中止症；數位牙科； 3D列印；下顎前置舌導引裝置；正壓呼吸機

並列摘要

During sleep, obstructive sleep apnea will reduce the amount of oxygen in the blood. Additionally, it will raise the risk of cardiovascular disease, diabetes, and other systemic diseases. When a patient can't utilize a ventilator, the American Academy of Sleep Medicine suggests an anti-snoring brace as an alternate treatment. A 60-year-old man was diagnosed with severe obstructive sleep apnea(OSA) with well-controlled systemic diseases. Due to the patient's inability to use a positive pressure ventilator, the treatment was discontinued. The patient was referred to the dental department by the sleep center. We design tongue blocks, hollow structures, and soft palate cushion to aid in precision position and myofunctional training of the tongue and reduce adverse effects of the brace, hence increasing treatment compliance. Using an all-digital approach can improve the clinical and laboratory side's productivity and the device's accuracy. Using 3D printed anti-snoring braces can boost airway patency while using a positive pressure ventilator. This case report provides clinicians with a therapeutic strategy for severe OSA patients who are unable to use a ventilator.

並列關鍵字

obstructive sleep apnea ； digital dentistry ； 3D printing ； mandibular advancement with tongue-guided device ； continued positive airway pressure

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