Long Term Therapeutic Efficacy of a Soft Monobloc Mandibular Advancement Device in Adults with Obstructive Sleep Apnea

Abstract

Aim. To evaluate the long term (48 months) therapeutic efficacy of a soft monobloc mandibular advancement device in adult patients with mild or moderate obstructive sleep apnea. Methods. The study population comprised 28 patients (6 female and 22 male, mean age 52.2 ± 6.8 years) affected by obstructive sleep apnea. After a baseline medical and somnographic examination, a functional examination of the stomatognathic system, and a questionnaire focused on sleep-related qualities and a daytime somnolence, each patient received an individual device. Two follow-ups were made 6 months (T1) and 48 months (T2) after soft monobloc mandibular advancement device treatment had been initiated, and all initial examinations were repeated. Results. The statistical analysis showed a significant decrease in body mass index value between T1 and T2 (ρ = 0,012), an increase of Epworth sleepiness scale value between T1 and T2 (ρ = 0,012), and a significant improvement and decrease of apnea/hypopnea index between T0 and T1 (ρ = 0,010) and between T0 and T2 (ρ = 0,013). Conclusion. Treatment with the soft monobloc mandibular advancement device is a therapeutic solution with long term and stable effects (48 months) for patients suffering from mild or moderate obstructive sleep apnea.

Orthopaedic treatment effects of functional therapy on the sagittal pharyngeal dimensions in subjects with sleep-disordered breathing and Class II malocclusion

“…The therapeutic benefit from early mandibular advancement may permanently modify nasal breathing and respiration, thereby preventing obstruction of the upper airway 18 . It is also able to enlarge the retrolingual space and at the same time promote lingual advancement 19 .…”

“…Orthodontic treatment based on oral appliances is considered to be a potential additional therapeutic approach for SDB in children. Orthodontists are playing an increasingly important role in managing snoring and respiratory problems by means of oral mandibular advancement devices 19 and rapid maxillary expansion 32 .…”

“…Oral appliances and functional orthopaedic appliances have been used in children to shift the mandible forwards, enlarge the upper airway and improve respiratory function in patients who have OSAS and craniofacial anomalies 17 18 . Mandibular advancement devices, in adult patients with mild or moderate obstructive sleep apnoea, are successful in improving AHI, and comparison with inactive appliances suggests that mandibular advancement is crucial in establishing efficacy 19 20 ; whereas only a few studies in the literature have evaluated mandibular advancement for treatment of respiratory difficulties in growing patients 2 .…”

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

“…There are numerous studies highlighting the benefits of different mandibular advancement devices in OSA 3,[5][6][7][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] . However, a review on oral appliances therapy for OSA has pointed out that most studies exclude the patients with severe OSA, thus there exists a significant source of bias 11 .…”

Patient satisfaction to evaluate the efficacy of mandibular advancement device in a treatment modality for mild to moderate sleep apnea patient in Indore Region

“…Disruption of normal sleep architecture, caused by hypopneic-apneic events during the night and the resulting daytime sleepiness, causes a poor job performance, an increased risk of traffic accidents, headaches, and neurocognitive deficits. 1 It is important to diagnose obstructive sleep apnea, if present, before any active treatment is begun. A diagnosis of obstructive sleep apnea can be made by Berlin questionnaire followed by a sleep study, sleep study are usually carried out by a specialist department of respiratory medicine.…”