Alan A. Lowe
       DMD, PhD, FRCD(C), FACD

Biograph Sketch:

Alan Arthur Lowe completed his predental training at the University of Saskatchewan between 1966 and 1968. In 1972, he graduated with a D.M.D. from the University of British Columbia in Vancouver and commenced orthodontic training at the University of Toronto. After completing a Diploma in Orthodontics in 1975 and a Ph.D. in 1976 entitled "The Neural Control of Tongue Posture", he was appointed as an Assistant Professor of Orthodontics at the University of British Columbia in Vancouver. Dr. Lowe became an Associate Professor in 1979, Chairman of Orthodontics in 1980, a Fellow of the Royal College of Dentists of Canada in 1981, a full Professor in 1984 and served as Head of the Department of Clinical Dental Sciences from 1989 to 1996. Currently, he is Professor and Chair, Division of Orthodontics in the Department of Oral Health Sciences in the Faculty of Dentistry at the University of British Columbia. Dr. Lowe completed two six month study leaves as Visiting Professor in the Department of Orthodontics in Osaka, Japan and the Department of Child Dental Health in Bristol, England. He has maintained a private orthodontic specialty practice in Vancouver since 1976.

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Research Interest:

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. The testing and clinical evaluation of a Dental Titration Monitor will provide an essential tool for dentists as they titrate oral appliances. Current 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 cephalometric standards for sleep apnea subjects based on our data were published in December 1996 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 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.

iv)  The development and utilization of a computerized sonic and model 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 Digigraph, which sonically 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 in a study of the genetic craniofacial features which may predispose to sleep apnea.

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Selected Publications Since 1995:

Lowe, A.A., Fleetham, J., Adachi, S. and Ryan, F.  "Cephalometric and CT Predictors of Apnea Index Severity", Am. J. Orthod. Dentofac. Orthop., 107:589-95 (1995).

Schmidt-Nowara, W., Lowe, A.A., Wiegand, L., Cartwright, R., Perez-Guerra, F. and Menn, S.  "Oral Appliances for the Treatment of Snoring and Obstructive Sleep Apnea:  A Review", Sleep, 18:501-510, (1995).

Ferguson, K.A., Ono,T., Lowe, A.A., Ryan, C.F. and Fleetham, J.A.   "The Relationship Between Obesity and Craniofacial Structure in Obstructive Sleep Apnea", Chest, 108:375-81, (1996).

Ono, T., Lowe, A.A., Ferguson, K.A. and Fleetham J.A.  "Associations Between Upper Airway Morphology, Body Position and Obesity in Skeletal Class I Male Patients with Obstructive Sleep Apnea", Am. J. Orthod. Dentofac. Orthop., 109:625-34, (1996).

Ferguson, K.A., Ono, T., Lowe, A.A., Keenan, S.P., Love, L.L., Wiggs, B. and Fleetham, J.A.  "A Randomized Cross-Over Study of an Oral Appliance vs nCPAP in the Treatment of Mild-Moderate Obstructive Sleep Apnea", Chest, 109:1269-75, (1996).

Ono, T., Lowe, A.A., Ferguson, K.A., Pae, E. and Fleetham, J.A.  "The Effect of the Tongue Retaining Device on Awake Genioglossus Muscle Activity in Patients with Obstructive Sleep Apnea", Am. J. Orthod. Dentofac. Orthop., 110:28-35, (1996).

 Ono, T., Lowe, A.A., Ferguson, K.A. and Fleetham, J.A.  "A Tongue Retaining Device and Sleep-State Genioglossus Muscle Activity in Patients with Obstructive Sleep Apnea", Angle Orthod., 66:273-80, (1996).

 Lowe, A.A., Ono, T., Ferguson, K.A., Pae, E., Ryan, C.F. and Fleetham, J.A.   "Cephalometric comparisons of Craniofacial and Upper Airway Morphology by Skeletal Subtype and Gender in patients with Obstructive Sleep Apnea", Am. J. Orthod. Dentofac. Orthop., 110:653-664, (1996).

 Fleetham, J.A., Ferguson, K.A., Lowe, A.A. and Ryan, C.F.  "Oral Appliance Therapy for the Treatment of Obstructive Sleep Apnea", Sleep 19(10):5288-5290, (1996).

 Pae, E., Lowe, A.A and Fleetham, J.  "A Role of Pharyngeal Length in Obstructive Sleep Apnea Patients", Am. J. Orthod. Dentofac. Orthop., 111:12-17, (1997).

 Pae, E., Lowe, A.A. and Park, Y., “An Airway Size Analysis of Obstructive Sleep Apnea Patients”, Korean J Orthod.,27:865-870, (1997)

 Ferguson, K.A., Ono, T., Lowe, A.A., Al-Majed, S., Love, L.L. and Fleetham, J.A.         "A Short Term Controlled Trial of an Adjustable Oral Appliance for the Treatment of Mild-Moderate Obstructive Sleep Apnea", Thorax 52:362-368, (1997).

 Lowe, A.A., Özbek, M.M., Miyamoto, K., Pae, E.-K. and Fleetham, J.A.  "Cephalometric and Demographic Characteristics of Obstructive Sleep Apnea Severity: An Evaluation with Partial Least Squares Analysis", Angle Orthod., 67:143-154, (1997).

 Miyamoto, K., Özbek, M.M., Lowe, A.A. and Fleetham, J.A.  "The Effect of Body Position on Tongue Posture in Awake Patients with Obstructive Sleep Apnoea", Thorax, 57:255-259, (1997).

 Pae, E. Lowe, A. A.,and Fleetham, J.  "A Thin Plate Spline Analysis of the Face and Tongue in Obstructive Sleep Apnea Patients", Clin Oral Invest.1:178-84, (1997).

 Özbek, M.M., Miyamoto, K., Lowe, A.A. and Fleetham, J.A.  "Natural Head Posture, Upper Airway Morphology and Obstructive Sleep Apnea Severity in Adults", Europ. J. Orthod., 20:133-143, (1998).

 Ozbek M., Memikoglu, T., Gogen, H., Lowe, A.A., and Baspinar, E.  "Oropharyngeal Airway Dimensions and Functional-Orthopedic Treatment in Skeletal Class II Cases", Angle Orthod., 68:327-336, (1998)

Miyamoto, K., Ozbek, M., Lowe, A.A, Sjoholm,T., Love, L., Fleetham, J. and Ryan, F.  "Mandibular Posture During Sleep in Healthy Adults", Arch. Oral Biol. 43:269-275, (1998).

Pae, E and Lowe, A.A. "Tongue Shape in Obstructive Sleep Apnea Patients"  Angle Orthod., 69:147-150, (1999).

 Miyamoto, K., Ozbek, M., Lowe, A.A, Sjoholm, T., Love, L., Fleetham, J. and Ryan, F.  "Mandibular Posture during Sleep in Patients With Obstructive Sleep Apnea", Arch Oral Biol 44:657-664, (1999).

Ryan, C.F., Love, L., Peat, D., Fleetham, J and Lowe, A.A.  “Mandibular Advancement Oral Appliance Therapy for Obstructive Sleep Apnea: Effect on Awake Calibre of the Velopharynx”, Thorax 54:972-977, (1999).

Lowe, A.A. "Titratable Oral Appliances for the Treatement of Snoring and Obstructive Sleep Apnea", J. Can. Dent. Assoc., 65:571-574, (1999).

Pae, E., Lowe, A.A., and Fleetham, J.A., “A Shape Analysis of the Face and Tongue in Obstructive Sleep Apnea Patients – Statistical Analysis of Coordinate Data”, Clin. Orthod. Res., 2:10-18, (1999).

Lui, Y., Lowe, A.A., Zeng, X., Fu, M., and Fleetham, J.A.“Cephalometric Comparisons Between Chinese and Caucasian Patients with Obstructive Sleep Apnea”, Am. J. Orthod. Dentofac. Orthop. 117:479-485, (2000).

Lowe, A.A., Sjoholm, T.T., Ryan, C.F., Fleetham, J.A., Ferguson, K.A., and Remmers, J.R., “Treatment, Airway and Compliance Effects of a Titratable Oral Appliance”, Sleep 23:Supp4: 172-178, (2000).

Liu, Y., Zeng, X., Fu, M., Huang, X. and Lowe, A.A.“Effects of a Mandibular Repositioner on Obstructive Sleep Apnea”, Am. J. Orthod. Dentofac. Orthop., 118:248-256, (2000).

Sjoholm, T.T., Lowe, A.A., Miyamoto, K., Fleetham, J., and Ryan, F.  “Sleep Bruxism in Patients with Sleep Disordered Breathing”, Arch. Oral Biol., 45:889-896, (2000).

Liu, Y. Park, Y, Lowe, A.A.,and Fleetham, J. F., “Supine Cephalometric Characteristics of an Adjustable Oral Appliance Used in the Treatment of Obstructive Sleep Apnea”, Sleep and Breathing 4:59-66, (2000).

Lowe, A.A. “The Durability of Intraoral Devices for Snoring and Sleep Apnea: Another View”, J. Can. Dent. Assoc., 66:486-487, (2000).

Tsuiki, S., Hiyama, S., Ono, T., Imamura, N., Ishiwata, Y., Kuroda, T., and Lowe, A. A., “Effects of a Titratable Oral Appliance on Supine Airway Size”, Sleep 24:554-560, (2001).

Liu. Y, Lowe, A. A., Fleetham, J. F., and Park, Y., “Cephalometric and Phsiological Predictors of the Efficacy of an Adjustable Oral Appliance for the Treatment of Obstructive Sleep Apnea”, Am. J. Orthod. Dentofac Orthop. 120:639:647, (2001).

Almeida, F., Bittencourrt, L., Almeida, C., Tsuiki, S., Lowe, A. A., and Tufik, S. "Effects of Mandibular Posture on Obstructive Sleep Apnea Severity and the Temporomandibular Joints in Patients Fitted with an Oral Appliance", Sleep 25(5):505-511, (2002)

Ferguson, K.A., Ono, T., Lowe, A.A. and Fleetham, J.A.  "The Effect of Gender on Upper Airway Structures in Obstructive Sleep Apnea", Chest, In Press, (2002).

Sjöholm, T.T., Piha, S.J., Mäntyvaara, J., Lehtinen, I., Polo, O. and Lowe, A.A.  "Spectral Analysis of Circulation in Teethgrinders: Correlation with Masseter Activity during Sleep", J. Dent. Res., In Press, (2002).

Blasberg, B, Lowe, A. A., Petty, R, and Malleson, P.  "Clinical and Electromyographic Abnormalities in Children with Chronic Arthritis involving the Temporomandibular Joint (TMJ)”, Arthritis and Rheumatism, In Press, (2001).

Tsai, W.H., Vasquez, J.C., Oshima, T., Dort, L., Roycroft, B., Lowe, A.A., Hadjuk, E., and Remmers, J.E.  “Remotely Controlled Mandibular Positioner Predicts Efficacy of Oral Appliances in Sleep Apnea”, Am. J. Resp. Crit. Care, In Press, (2002).

Tsuiki, S., Lowe, A. A., and Fleetham, J. A.,  “Effects of an Anteriorly-titrated Mandibular Position on Awake Airway Size and Obstructive Sleep Apnea Severity”, Am. J. Orthod. Dentofac. Orthop., In Press, (2002).

Tsuiki, S., Almeida, F., Bhalla, P.,  Lowe, A. A., and Fleetham, J. A.,  “Supine-dependent Changes in Upper Airway Size in Awake Obstructive Sleep Apnea Patients”, Sleep and Breathing, In Press, (2002).

Tsuiki, S., Almeida, F., Lowe, A. A., Su, J.  and Fleetham, J. A.,  “An Interaction Between Changes in Upright Mandibular Position and Supine Airway Size in OSA Patients”, Submitted to Am. J. Orthod. Dentofac. Orthop., (2002).

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Book Chapters :

1.   Lowe, A.A.  "Neural Control of Tongue Posture", In:  Neurophysiology of the Jaws and Teeth, A. Taylor (Ed.), McMillan Press Ltd., London, 322-368, (1990).

2.   Lowe, A.A., Fleetham, J., Ryan, F. and Matthews, B.  "Effects of a Mandibular Repositioning Appliance Used in the Treatment of Obstructive Sleep Apnea on Tongue Muscle Activity", In:  Sleep and Respiration, F. Issa, P. Suratt and J. Remmers (Eds.), Wildy-Liss Inc., 395-405, (1990).

3.   Lowe, A.A.  "The Tongue and Airway", In:  Otolaryngologic Clinics of North America, C. Koupmann (Ed.), Vol 23:677-698, (1990).
 
4.   Lowe, A.A. and Fleetham, J.A.  "Two- and Three-Dimensional Analysis of Tongue, Airway and Soft Palate Size", In:  Atlas of the Difficult Airway, ML Norton and AC Brown (Eds.), Year Book Medical Pub. Inc. 74-82, (1991).
 
5.   Lowe, A.A. and Bookstein, F.L.  "Airway/Tongue Interactions in Obstructive Sleep Apnea", In:  The Biological Mechanisms of Tooth Movement and Craniofacial Adaptation, Z. Davidovitch (Ed.), EBSCO Media, Birmingham, Alabama, 261-267, (1991).

6.    Lowe, A.A.  "Dental Appliances for the Treatment of Snoring and/or Obstructive Sleep Apnea".  In:  Principles and Practice of Sleep Medicine, Second Edition, M. Kryger, T. Roth and W. Dement (Eds.), W.B. Saunders Co., 722-735, (1994).

7.   Lowe, A.A.  "Oral Appliances for Sleep Breathing Disorders",  In: Principles and Practice of Sleep Medicine, Third Edition, M. Kryger, T. Roth and W. Dement (Eds.), W.B. Saunders Co., pp929-939, (2000).

8.   Lowe, A.A. and Schmidt-Nowara, W.W.  "Oral Appliance Therapy for Snoring and Apnea", In:  Pathogenesis, Diagnosis and Treatment of Sleep Apnea, A. Pack (Ed), Marcel Dekker Inc., New York, pp 555-573, (2002).

9.    Liu, Y. and Lowe, A.A.  “The Treatment of Snoring and Obstructive Sleep Apnea with Oral Appliances”, In:  Handbook of Orthodontics, X. Feng (Ed.), In Press, (2002).

10.  Lowe, A. A. "Principles of Oral Appliance Therapy for the Management of Sleep Disordered Breathing", In: Oral and Maxillofacial Surgery Clinics of North America, R. Lee (Ed.), W.B. Saunders Co., In Press, (2002).

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Patents And Licenses

(a)  Invention Disclosures filed with the University of British Columbia University-Industry Liaison Office on October 4, 1993:

  (i)  Oral appliance for the treatment of Snoring and Obstructive Sleep Apnea

  (ii)  Oral appliance for the incremental repositioning of the mandible for the treatment of Snoring and Obstructive Sleep Apnea

  (iii)  Oral appliance wear monitor.

(b)  U.S. patent #5,409,617 issued on April 25, 1995 for a Mandibular Repositioning Appliance.

(c)  U.S. Food and Drug Administration 510k market approval issued on May 25, 1995 for Klearway™ Appliance.

(d)  Patent Convention Treaty publication WO95/19746 on July 27, 1995 for a Mandibular Repositioning Appliance for Snoring Prevention.

(e)  Canada, United Kingdom, Spain, Japan, Australia Patent Applications filed August, 1996 for a Mandibular Repositioning Appliance for Snoring Prevention.

(f)  License Agreement on May 31, 1995 between The University of British Columbia, Space Maintainers Laboratories Canada Ltd., Space Maintainers Laboratories (Vancouver) Canada Ltd. and Space Maintainers Laboratories (Ottawa) Canada Ltd. to manufacture, distribute, market and sell Klearway™  to dentists in Canada. Amended July 1, 1995 and September, 1996.

(g)  License Agreement on January 26, 1995 between The University of British Columbia and Great Lakes Orthodontics Ltd. to manufacture, distribute, market and sell Klearway™ to dentists in the United States.

(h)  Distributor Agreement approved on November 12, 1996 between The University of British Columbia and Great Lakes Orthodontics Ltd. to manufacture, distribute, market and sell Klearway™  to physicians and sleep laboratories in the United States.

(i)  U.S. patent applied for on November 18, 1996 for a Time Monitoring Appliance with A Ivanov.

(j)  Assignment Agreement filed on September 17, 1996 with University Technologies International Inc. for a Remotely-Controlled Mandibular Positioner.

(k)  U.S. patent applied for on January 14, 1997 for a Remotely-Controlled Mandibular Positioner.

(l)  Australian Patent #679316 issued on June 26,1997 for a Mandibular Repositioning Appliance.

(m)  European Patent # EP0740538B1 issued on November 26, 1997 for a Mandibular Repositioning Appliance.

(n)  U.S. patent #5774425 issued on June 30, 1998 for a Time Monitoring Appliance.

(o)  U.S. patent #5826579 issued on October 27, 1998 for a Remotely-Controlled Mandibular Repositioner with J. Remmers, E. Hajduk, and R. Platt.

(p)  Patent Cooperation Treaty publication CA/00853 applied for on April 15, 1999 for a Time Monitoring Appliance with A. Ivanov.

(q)  Term Sheet for UBC License Agreement with Pro-Tech Services, Inc of Seattle, Washington for an oral appliance compliance monitor finalized on March 23, 2002. 

(r)  Patents and Patent Applications for an oral appliance compliance monitor include US Patent 5,774,425; 2,271,160, Canadian Patent Application 2,271,160; Australian Patent Application 49389/97; European Patent Application 97912003.7; Japanese Patent Application HEI.10-523026

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