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Research Dr. Lowe has lectured extensively both nationally
and internationally in the areas of neurophysiology and orthodontics
with particular emphasis on the control of tongue posture,
the surgical and orthodontic management of open-bite malocclusions,
the future role of undergraduate orthodontic training and
the etiology and treatment of snoring and Obstructive Sleep
Apnea. Current research projects under his direction include
an analysis of the relative effectiveness of specific oral
appliances used in the treatment of snoring and Obstructive
Sleep Apnea. His research activities have been funded by both
provincial and federal governments and he has published extensively.
In addition, he has successfully filed three U.S. patents.
Dr. Lowe was awarded a grant by the Canadian government through
the National Centres of Excellence (Inspiraplex) program to
undertake a four year multicenter clinical trial to compare
in patients with Obstructive Sleep Apnea the effectiveness,
side effects and compliance of a new oral appliance (Klearway™)
and nasal continuous positive airway pressure.
Areas of special interest and accomplishments:
i) The evaluation of specific oral appliances for the treatment
of snoring and obstructive sleep apnea. The Faculty of Dentistry
at The University of British Columbia is the leading research
center in the world in the field of oral appliances and the
treatment of snoring and obstructive sleep apnea. The results
of crossover trials of two oral appliances as compared to
nasal CPAP have impacted sleep physicians worldwide. An NCE
multicenter intent-to-treat clinical trial which compared
an adjustable oral appliance (invented by the writer and patented
by UBC) to nasal CPAP has received international acclaim.
A covert compliance monitor for intraoral use has been developed
and patented. Testing of a remotely
controlled titration device used during overnight sleep studies
may provide simpler and shorter titration protocols for sleep
apnea patients. A large retrospective survey of some 400 patients
treated in our Sleep Disorder Clinic will provide valuable
information as to subject perceptions of long term (more than
five year) wear.
ii) The quantification of dentoskeletal, neuromuscular and
soft tissue variables in subjects with snoring and Obstructive
Sleep Apnea. The first published cephalometric standards for sleep apnea
subjects based on our data and are extensively used by physicians, dentists, orthodontists
and sleep specialists. Ongoing evaluations of long term treatment
effects and the cephalometric predictors of good and poor
responders are underway.
iii) The study of the mechanisms which initiate and coordinate
tongue and jaw muscle activity as they relate to jaw
position, respiration,
snoring and sleep apnea. Our findings of atypical tongue muscle
activity related to changes in the vertical dimension in skeletal
open bite subjects have a direct influence on orthodontic
clinical practice. Abnormalities in genioglossus muscle activity
are being evaluated in both control and sleep apnea subjects
in both awake and asleep projects. Changes in jaw
position during sleep are being quantified with a JAWSENS
device during standard polysomnography
iv) The development of a computerized model and
cephalometric analysis facility for both research and clinical
purposes. Two and three dimensional analyses of specific
orofacial structures for various skeletal subtypes and in
control and sleep apnea subjects have provided clinical
standards for diagnostic and therapeutic purposes. A
Microscribe System, which records the position of a point in
three dimensions and does not expose a patient to any form of
radiation, is used to quantify craniofacial form.
v) The testing of various titration monitors for
clinical application in snoring and sleep apnea
patients. Reports from bed partners are notoriously
unreliable so we have published evaluations of two portable
monitors and are currently testing a third. Such
monitors will significantly improve the success rates of
various oral appliances as we develop reliable outcome
measures prior to traditional polysomnography obtained in a
sleep laboratory.
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