Evaluation of Therapeutic Efficacy of Adjustable Mandibular Advancement Device in the Management of Obstructive Sleep Apnea

Abstract

Background: Medical Dental Sleep Appliance (MDSA) is an adjustable MAD recommended for treatment of snoring and OSA. There are very few studies on Indian population which evaluate the therapeutic efficacy of mandibular advancement devices in the management of OSA. Material and methods: A prospective clinical study was carried out. 20 Polysomnography diagnosed Obstructive Sleep Apnea patients fulfilling the inclusion and exclusion criteria were treated with MDSA and changes in pre and post treatment sleep parameters (AHI, ESS) were recorded. Results: Mean differences in Pre-treatment (T1 = 30.7 ± 5.0) and post-treatment (T2 = 17.2 ± 3.9) AHI values and ESS pre-treatment (T1 = 17.2 ± 0.6) and post-treatment (T2 = 10.9 ± 0.9) were highly statistically significant (p < 0.001). Clinically the maximum improvement was observed in mild and moderate OSA cases. Although significant clinical improvement was also observed in severe OSA cases, the post treatment AHI and ESS were still high. Conclusion: MDSA is a non invasive, low risk and cost-effective treatment option for patients suffering from mild and moderate obstructive sleep apnea and also in cases of severe OSA who are not comfortable with CPAP or not willing for surgery.