An evaluation of two different mandibular advancement devices on craniofacial characteristics and upper airway dimensions of Chinese adult obstructive sleep apnea patients

ABSTRACT Objectives: To evaluate the effects of two different mandibular advancement devices (MADs) on craniofacial characteristics and upper airway dimensions of Chinese adult patients with obstructive sleep apnea (OSA). Materials and Methods: Forty-five patients with OSA were recruited as part of a prospective randomized crossover trial for treatment with two different MADs. Lateral cephalograms were taken, and the Epworth Sleepiness Scale and the Sleep Apnea Quality of Life Index were completed at baseline. Results: The Apnea-Hypoxia Index was highly significantly reduced with the monoblock (P < .001) and significantly reduced with the twin block (P < .01). The monoblock demonstrated a superior result than the twin block (P < .05). A significant reduction was found in the distances between the hyoid bone to retrognathia (monoblock, P < .01; twin block, P < .001) as well as the distance between the hyoid bone and mandibular plane angle (P < .001). Furthermore, soft palate length increased significantly (P < .05) with both MADs. However, the changes did not differ in favor of either MAD. Conclusion: Monoblock was the better MAD to improve OSA severity. No difference could be found in changes of subjective OSA indicators. Significant but similar cephalometric changes were observed, indicating both MADs alter the position of the surrounding musculature and improve upper airway patency. Therefore, the different design features of the MADs suggest an impact on some OSA indicators.

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Do Mandibular Advancement Devices Influence Patients' Snoring and Obstructive Sleep Apnea? A Cone-Beam Computed Tomography Analysis of the Upper Airway Volume

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2015.02.023 ◽

2015 ◽

Vol 73 (9) ◽

pp. 1816-1826 ◽

Cited By ~ 10

Author(s):

Lillian Marcussen ◽

Jan Erik Henriksen ◽

Torben Thygesen

Keyword(s):

Computed Tomography ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Cone Beam Computed Tomography ◽

Upper Airway ◽

Mandibular Advancement ◽

Cone Beam ◽

Obstructive Sleep ◽

Mandibular Advancement Devices ◽

Tomography Analysis

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Correlation between Polysomnographic Parameters and Tridimensional Changes in the Upper Airway of Obstructive Sleep Apnea Patients Treated with Mandibular Advancement Devices

Journal of Clinical Medicine ◽

10.3390/jcm10225255 ◽

2021 ◽

Vol 10 (22) ◽

pp. 5255

Author(s):

Sara Camañes-Gonzalvo ◽

Rocío Marco-Pitarch ◽

Andrés Plaza-Espín ◽

Javier Puertas-Cuesta ◽

Rubén Agustín-Panadero ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Oxygen Saturation ◽

Upper Airway ◽

Mandibular Advancement Device ◽

Mandibular Advancement ◽

Apnea Hypopnea Index ◽

Percentage Increase ◽

Obstructive Sleep ◽

Mandibular Advancement Devices

Background. The effectiveness of mandibular advancement devices has been solidly demonstrated in the past. They are considered a valid alternative treatment to continuous positive airway pressure for patients with obstructive sleep apnea. Nevertheless, the relationship between polysomnographic parameters and the increase in the volume of the upper airway in patients with obstructive sleep apnea syndrome has not been clearly established so far. This study aimed to determine the impact of these oral appliances upon the volume of the airway after the device titration phase and correlate it with the degree of mandibular advancement and the improvement of polysomnographic parameters. Methods. All patients were diagnosed by polysomnography and were treated with a customized, titratable mandibular advancement device. Three-dimensional volumetric measurements were performed using cone beam computed tomography. Results. The present study included 45 patients diagnosed with obstructive sleep apnea hypopnea syndrome (mild in 23 patients, moderate in 11 and severe in 11). Forty-four percent of the patients presented with an apnea hypopnea index <5/h at the end of treatment. The volume of the upper airway increased an average of 4.3 ± 5.9 cm3, this represents a percentage increase of 20.9%, which was significantly correlated with an apnea hypopnea index and a minimum oxygen saturation improvement. Conclusions. The mandibular advancement device used was found to be effective in improving polysomnographic parameters. Moreover, the oral appliance was able to significantly increase the tridimensional dimensions of the upper airway. Moreover, this finding was correlated with a reduction in the apnea hypopnea index (p = 0.007) and an increase on minimum oxygen saturation (p = 0.033).

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