Harvey S. Shiffman

J Dent Res Pract (2020). doi: 10.15761/JDRP.1000117

There are a multitude of treatment options for sleep-disordered breathing (SDB), which can be classified into conservative, apparatus, and surgical methods. The choice of the method used will depend on the patient’s tolerance of the procedure, and most importantly, on the severity of the patient’s SDB. Nightlase C3 (concentric) falls into the Laser-assisted uvulopalatoplasty (LAUP) group but is unique as we are not removing any tissue but addressing several possible areas of collapse. However, we are modifying the tissue, the protocol addresses the floor of the mouth, posterior tongue and soft palate, uvula, and the tonsillar pillars. The LAUP method, which was originally introduced as a variant of the standard and relatively invasive surgical uvulopalatopharyngoplasty (UPPP) method, was modified in the early 90’s to address mainly palatal flutter, which was found to be the most important factor in the mechanism of snoring. Therefore, instead of surgically shortening the palate as in UPPP, which inevitably risks impairing its function, the Nightlase C3 approach focuses on shrinking of the palatal tissue, reducing inflammation, reducing collapsibility and tongue repositioning. This is accomplished by thermally injuring the surface of the tissues, which heals by collagen shrinkage and neocollagenesis, thus producing the desired results. When performed at sub-ablative laser fluences, this type of LAUP is a “walk-in, walk out” procedure that typically does not require any anaesthesia. In this paper, clinical experience is reported on the use of an Nd: YAG/Er: YAG dental laser system to perform the LAUP procedure to reduce symptoms of sleep-disordered breathing.

Key words

sleep-disordered breathing, SDB, snoring, laser-assisted uvulopalatoplasty, LAUP, nightlase, Nd: YAG, Er: YAG, nightlase C3

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