title: 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.
authors.affiliation: Department of Oral Function, Academic Centre for Dentistry Amsterdam ACTA, University of Amsterdam and VU University Amsterdam, Louwesweg 1, 1066 EA Amsterdam, The Netherlands. g.aarab@acta.nl
authors.forename: Ghizlane
authors.initials: G
authors.lastname: Aarab
authors.forename: Frank
authors.initials: F
authors.lastname: Lobbezoo
authors.forename: Hans L
authors.initials: HL
authors.lastname: Hamburger
authors.forename: Machiel
authors.initials: M
authors.lastname: Naeije
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003680:Deglutition Disorders / Q000209:etiology; D005157:Facial Pain / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019186:Mandibular Advancement / Q000295:instrumentation*; D008406:Masseter Muscle / Q000503:physiopathology; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation; D016382:Orthodontic Appliance Design; D009967:Orthodontic Appliances / Q000009:adverse effects; D010100:Oxygen / Q000097:blood; D017286:Polysomnography / Q000295:instrumentation; D012119:Respiration; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D012894:Sleep Stages / Q000502:physiology; D012913:Snoring / Q000628:therapy; D016683:Supine Position / Q000502:physiology; D013997:Time Factors; D014070:Tooth / Q000503:physiopathology; D014716:Vertical Dimension
chemical_list: D010100:Oxygen