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Effects of an oral appliance with different mandibular protrusion positions at a constant vertical dimension on obstructive sleep apnea.

Abstract
The aim of the study was to assess the influence of four mandibular protrusion positions, at a constant vertical dimension, on obstructive sleep apnea (OSA). Seventeen OSA patients (49.2 +/- 8.5 years) received an adjustable mandibular advancement device (MAD). The patients underwent four polysomnographic recordings with their MAD in situ at, in random order, 0%, 25%, 50%, and 75% of the maximum protrusion. The mean apnea-hypopnea index (AHI) values of the patients differed significantly between the protrusion positions (P < 0.000). The 25% protrusion position resulted in a significant reduction of the AHI with respect to the 0% position, while in the 50% and 75% positions, even lower AHI values were found. The number of side effects was larger starting at the 50% protrusion position. We therefore recommend coming to a weighted compromise between efficacy and side effects by starting a MAD treatment in the 50% protrusion position.
AuthorsGhizlane Aarab, Frank Lobbezoo, Hans L Hamburger, Machiel Naeije
JournalClinical oral investigations (Clin Oral Investig) Vol. 14 Issue 3 Pg. 339-45 (Jun 2010) ISSN: 1436-3771 [Electronic] Germany
PMID19536571 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Oxygen
Topics
  • Adult
  • Aged
  • Body Mass Index
  • Deglutition Disorders (etiology)
  • Facial Pain (etiology)
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mandibular Advancement (instrumentation)
  • Masseter Muscle (physiopathology)
  • Middle Aged
  • Monitoring, Ambulatory (instrumentation)
  • Orthodontic Appliance Design
  • Orthodontic Appliances (adverse effects)
  • Oxygen (blood)
  • Polysomnography (instrumentation)
  • Respiration
  • Sleep Apnea, Obstructive (therapy)
  • Sleep Stages (physiology)
  • Snoring (therapy)
  • Supine Position (physiology)
  • Time Factors
  • Tooth (physiopathology)
  • Vertical Dimension

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