Evaluation of factors that influence the success rate of OSA treatment with a customised adjustable MAD device - a retrospective study

Burlon, Giuseppe; Tepedino, Michele; Laurenziello, Michele; Troiano, Giuseppe; Cassano, Michele; Romano, Luigi; Rinaldi, Raffaella; Ciavarella, Domenico

doi:10.14639/0392-100x-n0307

Cited by 10 publications

(3 citation statements)

References 30 publications

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“…The MAD therapy is effective in patients who have an upper airway obstruction in sleep time prevalently in the supine position, or in patients who refuse the CPAP or upper airway surgery [ 1 ]. The forward and vertical movement of the mandible increases the upper airway area, improving the oxygen saturation (SO2) and inducing a reduction of AHI and ODI, recorded by HSAT or PSG [ 18 ]. The increase in oxygen saturation may reduce the risk of cardiovascular disease and stroke, as suggested for other OSA therapy such as CPAP or upper airway surgery [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

OSA Wellness Scale (OWS): A New Health-Related Quality of Life Test in Obstructive Sleep Apnea Patients Treated with Mandibular Advancement Device

Ciavarella

Campobasso

Guida

et al. 2022

International Journal of Dentistry

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Objectives. To present a new short self-test, called the OSA wellness scale (OWS), for assessing the health-related quality of life (HRQoL) changes in obstructive apnea syndrome (OSA) patients treated with mandibular advancement device (MAD). Methods. 51 OSA patients (8 women and 43 men, mean age 52.3) treated with a fully customizable MAD device (Protrusor) were retrospectively enrolled. Each patient received a home sleep apnea testing (HSAT) at baseline (T0) and after three months of MAD treatment (T1). Two self-test evaluations, the Epworth sleepiness scale (ESS), and OWS were also submitted at T0 and T1. The OWS was a short self-test of 8 questions for evaluating the daytime HRQoL. Patients gave an assessment from 0 to 3 for each question. At the end of the questionnaire, the patients had a score from 0 to 24, resulting from the sum of all 8 scores. The higher the score, the greater the patient’s perceived state of discomfort. Results. At T1, a significant decrease in the oxygen desaturation index (ODI) and apnea-hypopnea index (AHI) was shown ( p < 0.0001 ), while no significant changes in body mass index (BMI) were found. Both the ESS and the OWS records showed a significant reduction in daytime sleepiness and HRQoL ( p < 0.0001 ). Conclusion. The OWS could be a useful method to verify and numerically compare the perceived quality of life in OSA patients, before and after MAD therapy.

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Section: Discussionmentioning

confidence: 99%

OSA Wellness Scale (OWS): A New Health-Related Quality of Life Test in Obstructive Sleep Apnea Patients Treated with Mandibular Advancement Device

Ciavarella

Campobasso

Guida

et al. 2022

International Journal of Dentistry

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“…The amount of mandibular advancement was determined for each patient after a titration period. Initially, an intraoral gauge (Occlusion ® , nonrusso+ ® , Dr Giuseppe Burlon, Belluno, Italy) was used to set the advancement at 70% of the total possible mandibular advancement; then, during follow-up appointments, usually every 15 days, the therapeutic mandibular protrusion was adjusted by 1 mm or 2 mm increments until reaching the most comfortable position that allowed relief from the symptoms, as described in a previous study [30].…”

Section: Methodsmentioning

confidence: 99%

Respiratory and Cardiovascular Parameters Evaluation in OSA Patients Treated with Mandibular Advancement Device

et al. 2020

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Obstructive sleep apnea (OSA) is associated with a number of cardiovascular comorbidities, including hypertension, heart rate (HR) alterations, cardiac arrhythmias, endothelial dysfunction and atherosclerosis. HR, in particular, is an important sign correlated with cardiac stress and survival. Previous investigations on the effects of mandibular advancement device (MAD) therapy on HR resulted in contradictory findings. The aim of the present retrospective cohort study was to evaluate the effects of MAD therapy with a fully customizable appliance on respiratory and cardiovascular parameters. Fifty adult consecutive cases with mild to severe OSA underwent split-night polysomnography (SN-PSG) at baseline (T0) and after three months of MAD treatment (T1), after appropriate titration. The apnea/hypopnea index (AHI), 4% oxygen desaturation index (ODI) and HR (average, minimum and maximum) values are recorded at T0 and at T1 and statistically compared. The AHI and ODI values improved after three months of MAD treatment. The minimum HR increased after treatment, while the maximum HR decreased after treatment. MAD treatment with a fully customizable appliance was effective in improving breathing and cardiovascular parameters in adult patients with mild to severe OSA.

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“…At the end of the gradual MAD adjustment period, which can take from 3 to 5 months, a new polysomnography should be performed to quantify the obtained gains 20 . Although less effective than CPAP, MAD have given positive results in the treatment of OSAHS 90 , although limited to the moment in which patient is using the device 20 , which are preferentially indicated for mild or moderate OSAHS 91 . Compared to CPAP, these devices have the advantage of being unobtrusive, make no noise and are potentially less expensive, and are generally preferred by patients.…”

Section: Mandibular Advancement Devices (Mad)mentioning

confidence: 99%

Obstructive sleep apnoea/hypopnoea syndrome: relationship with obesity and management in obese patients

Salzano

Maglitto

Bisogno

et al. 2021

Acta Otorhinolaryngol Ital

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Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is a disease characterised by upper airway obstruction during sleep, quite frequent in the general population, even if underestimated. Snoring, sleep apnoea and diurnal hypersomnia are common in these patients. Central obesity plays a key role: it reduces the size and changes the conformation of the upper airways, besides preventing lung expansion, with consequent reduction of lung volumes. Furthermore, obese people are also resistant to leptin, which physiologically stimulates ventilation; as a result, this causes scarce awakening during apnoea. OSAHS diagnosis is based on the combination of clinical parameters, such as apnoea/hypopnoea index (AHI), medical history, physical examination and Mallampati score. The first objective reference method to identify OSAHS is polysomnography followed by sleep endoscopy. Therapy provides in the first instance reduction of body weight, followed by continuous positive airway pressure (CPAP), which still remains the treatment of choice in most patients, mandibular advancement devices (MAD) and finally otolaryngology or maxillofacial surgery. Among surgical techniques, central is barbed reposition pharyngoplasty (BRP), used in the field of multilevel surgery.

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Evaluation of factors that influence the success rate of OSA treatment with a customised adjustable MAD device - a retrospective study

Cited by 10 publications

References 30 publications

OSA Wellness Scale (OWS): A New Health-Related Quality of Life Test in Obstructive Sleep Apnea Patients Treated with Mandibular Advancement Device

OSA Wellness Scale (OWS): A New Health-Related Quality of Life Test in Obstructive Sleep Apnea Patients Treated with Mandibular Advancement Device

Respiratory and Cardiovascular Parameters Evaluation in OSA Patients Treated with Mandibular Advancement Device

Obstructive sleep apnoea/hypopnoea syndrome: relationship with obesity and management in obese patients

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