Research team

Translational Neurosciences (TNW)

Expertise

Dynamic / cyclic loading of mini-samples at low loads and evaluation of dental damage.

Development of a predictive model for endotype-based patient selection for obstructive sleep apnea treatment. 01/10/2021 - 30/09/2024

Abstract

Obstructive sleep apnea (OSA) is a highly prevalent disease, associated with several cardiovascular and cerebrovascular comorbidities. Adequate treatment is thus crucial. Based on the current guidelines, continuous positive airway pressure (CPAP) is considered the standard OSA treatment. While CPAP efficacy is high, patient tolerance and acceptance is only moderate. In general, alternative non-CPAP treatments like mandibular advancement devices, hypoglossal nerve stimulation or pharmacotherapy are well-received, however, their efficacy is potent in some patients but incomplete in others. Efficacy of emerging therapies depends largely on the site of obstruction of the upper airway, key diagnostic information that is notoriously challenging to obtain. In current clinical practice this information is captured during drug-induced sleep endoscopy (DISE), assessing the upper airway during sedation. However, this DISE procedure still requires an additional step in the clinical path involving specialized personnel, time and equipment at the operating theatre. Therefore, I aim to 1) correlate the collapse patterns during DISE with parameters extracted from baseline clinical data in order to develop a prediction model to predict collapse patterns without the need of drug-induced sedation and 2) to apply this model to patients treated with a non-CPAP treatment. In this way, I aim to attain precision OSA medicine using endotype-driven instead of guideline-based OSA treatment.

Researcher(s)

Research team(s)

The development of a multifactorial model to predict the outcome of mandibular advancement device therapy for obstructive sleep apnea based on the patients' phenotype. 01/10/2019 - 30/09/2023

Abstract

Obstructive sleep apnea (OSA) is a prevalent public health issue with an attributable risk of cardio- and cerebrovascular morbidity and mortality. Furthermore, OSA is related to a high socioeconomic burden due to its clinical daytime consequences such as excessive daytime sleepiness, impaired cognitive performance and reduced quality of life. Oral appliances that protrude the mandible, the mandibular advancement devices (MAD), significantly reduce OSA severity in the majority of patients. However, in a third of patients, the efficacy is not medically appropriate to reduce the long-term consequences of OSA. Furthermore, the efficacy of MAD therapy is inconsistent among patients. Therefore, a high need exists for upfront prediction of treatment outcome in the individual OSA patient. There is no validated method that can achieve upfront selection of candidates for MAD therapy in an accurate and reliable way. Nowadays, it is increasingly recognized that OSA is a multifactorial disease. In the proposed research project, a prospective prediction model with a combination of different pathophysiological traits will be assessed. Furthermore, up to now, our understanding of MAD therapy relies on relatively small studies lacking power. Therefore, we will evaluate this predictive model, as well as the long-term effectiveness, morbidity and mortality in a large international cohort of patients treated with MAD.

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Research team(s)

Integrated approach for the assessment of the anatomical traits for the prospective selection of obstructive sleep apnea patients for upper airway stimulation or its combination therapy with mandibular advancement device. 01/10/2017 - 30/09/2021

Abstract

Obstructive sleep apnea (OSA) is a chronic disease that is caused by partial or complete upper airway collapse during sleep. OSA is a highly prevalent disorder linked to a range of considerable health risks. Application of continuous positive airway pressure (CPAP) is regarded as the gold standard treatment for more severe OSA. The clinical effectiveness of CPAP is often hampered by the inadequate adherence to CPAP mainly due to limited tolerance of the treatment. The techniques that are currently used for the selection of OSA patients for alternative, non-CPAP treatment options such as oral appliance therapy, with mandibular advancement device (MAD), or upper airway stimulation (UAS) synchronized with ventilation, are rather invasive. An integrated, innovative approach that might allow for non-invasive assessment of the anatomical traits of the individual upper airway will be evaluated. The hypothesis of this research project is that these anatomical traits, site of upper airway collapse and degree of pharyngeal collapsibility, can be derived from the respiratory flow signal that is measured during each routine sleep study anyway. The predictive value of this innovative and non-invasive method will be analyzed, also in comparison to the techniques that are currently employed for this purpose of patients' selection. Whether the innovative and non-invasive approach has a better predictive value towards a successful treatment outcome with UAS with or without MAD will be investigated. The main goal is to improve the results with these treatment options for OSA based on the non-invasive assessment of the anatomical traits of the upper airway in the individual OSA patient.

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Pathophysiologic and cardiovascular alterations during continuous positive airway pressure and oral appliance therapies in the optimal therapeutic dose for patients with obstructive sleep apnea. 01/10/2015 - 30/09/2018

Abstract

Obstructive sleep apnea (OSA) is a prevalent public health issue and strong and independent risk factor for cardio- and cerebrovascular diseases. Therefore, adequate treatment is important. Continuous positive airway pressure (CPAP) is considered the gold standard non-invasive treatment modality, although oral appliances that protrude the mandible are increasingly prescribed. Both non-invasive treatment modalities are symptomatic treatments and therefore lifelong device therapies, so the patient's compliance is of primary importance since it is only effective when appropriately used. The therapeutic effectiveness of both therapies is given by the product of efficacy with objective compliance. For both CPAP and oral appliance therapies, it is important to determine the therapeutic effectiveness in the optimal 'dose', being pressure for CPAP and mandibular protrusion for oral appliances. However, in the absence of a gold standard protocol to find the optimal mandibular protrusion for oral appliance therapy, the titration procedure remains 'trial and error'. Therefore, in the proposed research project, the feasibility of a titration procedure during polysomnography will be assessed and compared with a titration procedure under direct visualization of upper airway collapse during drug-induced sedation endoscopy, for both therapies. Furthermore, the pathophysiologic and cardiovascular alterations during both treatment modalities in the established optimal dose will be studied.

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Research team(s)

In vitro fatigue of dental adhesives. 01/01/2001 - 31/12/2002

Abstract

Adhesion to dental tissues is an absolute prerequisite for succesful restorative dentistry. The composite materials have proven to perform in a clinical acceptable way when tested under cyclic fatigue conditions. Adhesives are only tested in a static or quasi-static way. It is the aim of the present project to isolate the conditions in which cyclic fatigue testing of adhesive bonds can be carried out.

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    01/10/1996 - 30/09/1997

    Abstract

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    Research team(s)

      Study of the influence of occlusion variants on the contraction state of the mm. temporalis and mm. Masseter. 01/05/1996 - 30/04/1998

      Abstract

      Generally it is accepted that the state of the chewing muscles , a.o. as a result of the inter-occlusal contacts, has an important influence on both chewing joints. The purpose of the investigation is to determine in how far the removal of disturbing inter-occlusal contacts influences the respons of both m. Temporalis and both m. Masseter, and to track this respons in time by means of surface electromyography.

      Researcher(s)

      • Promotor: Braem Marc
      • Co-promotor: Van Bogaert Pierre-Paul

      Research team(s)

        In-vitro investigation into the response of composite and glasionomer restoratives, with and without the use of adhesives, under cyclic loading in Class V restorations. 01/01/1996 - 31/12/1998

        Abstract

        The purpose is the study of the in-vitro behaviour of composite and glasionomer restoratives in Class V cavities under cyclic loading, dependent of parameters such as the rigidity of the restoratives, the adhesive used, the loading, etc.

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        Research team(s)