Treatment of Long-Standing Nocturnal Enuresis by Mandibular Advancement

Enuresis, the involuntary release of urine during sleep, is one of the most common disorders of childhood. More common in boys than girls, this condition is characterized by night-time wetting in the presence of normal urinalysis and physical examination. At present, treatment can be divided into behavioral modification and pharmacological therapy, despite which many enuretic children remain untreated or are treated ineffectively. Treatment of long-standing chronic enuresis by orthodontic appliances could be used more frequently to give relief to those not responding to conventional treatment. Mandibular advancement therapy is especially beneficial in the treatment of enuretic patients presenting with anteroposterior skeletal discrepancies.

Nocturnal enuresis - mandibular advancement therapy

REFERENCES

• 1 Friman P. Nocturnal enuresis in the child. In: Ferber R, Kryger M Principles and Practice of Sleep Medicine in the Child. Philadelphia, PA; WB Saunders Co 1995: 107-113
• 2 Challamel M-J, Cochat P. Enuresis: pathophysiology and treatment.  Sleep Med Rev. 1999;  3 313-324
• 3 Guilleminault C, Stoohs R. Obstructive sleep apnea syndrome in children.  Pediatrician. 1990;  17 46-51
• 4 Leach J, Olson J, Hermann J, Mannin S. Polysomnographic and clinical findings in children with obstructive sleep apnea.  Arch Otolaryngol Head Neck Surg. 1992;  118 741-744
• 5 Wille S, Aili M, Harris A, Aronson S. Plasma and urinary levels of vasopressin in enuretic and non-enuretic children.  Scand J Urol Nephrol. 1994;  28 119-122
• 6 Rushton G. Nocturnal enuresis: epidemiology, evaluation and currently available treatment options.  J Pediatr. 1989;  114 691-696
• 7 Weider D, Sateia M, West R. Nocturnal enuresis in children with upper airway obstruction.  Otolaryngol Head Neck Surg. 1991;  105 427-432
• 8 Cinar U, Vural C, Cakir B et al.. Nocturnal enuresis and upper airway obstruction.  Int J Pediatr Otorhinolaryngol. 2001;  59 115-118
• 9 Topol H, Bogle D, Brooks L. Enuresis in children with obstructive sleep apnea.  Sleep Abst Suppl. 2000;  24 A127-A128
• 10 Timms J. Rapid maxillary expansion in the treatment of nocturnal enuresis.  Angle Orthod. 1990;  60 229-233
• 11 Kurol J, Modin H, Bjerkhoel A. Orthodontic maxillary expansion and its effect on nocturnal enuresis.  Angle Orthod. 1998;  68 225-232