Use of an individual mandibular advancement device for an obstructive sleep apnoea patient with facial paralysis: a short‐term follow‐up case report

Abstract

This case report aimed to describe the fabrication procedure and treatment efficacy of an individual, one-piece, non-adjustable mandibular advancement device (MAD) for a moderate obstructive sleep apnoea patient with facial paralysis (FP). Mandibular advancement device was fabricated with autopolymerising acrylic resin. The intermaxillary relations were recorded such as to fix the mandible at a protruded position with increased vertical dimension. Initial evaluation of the MAD was made with axial magnetic resonance imaging and polysomnography on the first day of usage. Following evaluations were made on the third and sixth month. After a follow-up period of 6 months, Apnoea/Hypopnea Index (AHI) significantly decreased from 26·7 to 3·0. However, the average oxygen saturation did not improve as expected initially. The MAD therapy decreased the AHI scores of a patient with FP. At the end of a follow-up period of 6 months, the patient did not report any serious complaint except temporary tooth pains.

Comparison of efficacy and usability of custom mandibular advancement devices fabricated with the conventional method and digital workflow: A pilot clinical study

“…In the monoblock MADs, maxillary and mandibular devices are joined at the region of canines and 1st premolars with the same material that they are fabricated. 18 However, in the biblock MADs, two devices are attached with a mechanism that enables adjusting the amount of mandibular protrusion. 17 Unlike monoblock MADs, biblock MADs are adjustable devices with the capability of adjusting the protrusion extent of the mandible.…”

“…13,20 In the conventional method, devices are made with acrylic resin materials on the casts obtained from conventional impressions. 18 In the CAD-CAM method, the MAD is designed on the virtual casts and produced by the additive manufacturing technique using 3-dimensional (3D) printers. 20 As an applied science, human factors and usability encompass all user evaluations that explore human behavior, abilities, and limitations, and should always be considered in the design and manufacture of any type of medical device.…”

Fabrication of a Mandibular Advancement Device Using a Fully Digital Workflow: A Clinical Report

“…These titratable duobloc MADs allow the clinician to adjust the optimal protruded position. To make a custom acrylic resin MAD, it is essential to make impressions, record the amount of advancement and vertical opening, and transfer these records to an articulator 11,12,15–18 . The dimensional stability of each material used in the fabrication process ‐impression materials, dental stone, and resin materials‐ contribute to the precision of the completed appliance 19–22 .…”

Analysis of the dynamic changes in the soft palate and uvula in obstructive sleep apnea-hypopnea using ultrafast magnetic resonance imaging

“…The dynamic alterations in the soft palate and the uvula during sleep remain unreported. Ultrafast MRI (UMRI) is a recently developed technique that can obtain images at multiple locations with sufficient quality and temporal resolution (<1 s) to assess the upper airway and surrounding soft tissues dynamically (Ciscar et al, 2001;Rama et al, 2002;Piskin et al, 2012). The aim of this report is to study the dynamic alterations of the soft palate and uvula during wakefulness and sleep using UMRI to provide reference data for the pathogenesis and treatment of OSAH.…”