title: [First intention management of obstructive sleep apnea syndrome (OSAS) by custom-made mandibular advancement device: the medium-term results. Prospective study by the General Hospital Pneumologists College (CPHG)].
abstract: OBJECTIVE
  To demonstrate the efficacy and tolerance of present generation mandibular advancement devices in the first intention treatment for obstructive sleep apnea syndrome (OSAS), even when severe, after one year.
  
  
  METHODS
  Between June 2006 and December 2007, 152 patients (male: 77%; age: 50.9±10.9 years; BMI: 26.3±3.6 kg/m(2); AHI: 25.5±13.9), without previous treatment, requesting management other than continuous positive pressure and dentally apt for a mandibular advancement device, were pre-included in a prospective one-year multicenter study (13 general hospitals).
  
  
  RESULTS
  One hundred and twenty-nine patients were assessed at least once after fitting. The efficacy was noted as of day 90: the overall AHI fell from 24.8 to 10.8 (from 40.6 to 17.7 in the 40 patients with AHI>30) and the Epworth index decreased from 11.2 to 6.9 (12.8 to 8.1 for AHI>30). The AHI reduction was independent of gender, age, BMI and baseline AHI. The efficacy was maintained throughout the study period. Only eight patients withdrew for adverse events and seven for reasons of therapeutic failure.
  
  
  CONCLUSIONS
  Mandibular advancement devices proved effective in first intention, including severe OSAS. No predictive individual efficacy factors emerged.
authors.affiliation: Service de pneumologie, centre hospitalier, Auxerre, France. gerards@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Geraads
authors.forename: P
authors.initials: P
authors.lastname: d'Athis
authors.forename: L
authors.initials: L
authors.lastname: Lerousseau
authors.forename: J-J
authors.initials: JJ
authors.lastname: Larzul
authors.forename: M
authors.initials: M
authors.lastname: Bénichou
authors.forename: C
authors.initials: C
authors.lastname: Guyonnaud
authors.forename: M
authors.initials: M
authors.lastname: Figueredo
authors.forename: J
authors.initials: J
authors.lastname: Steinbauer
authors.forename: J-M
authors.initials: JM
authors.lastname: Bedicam
authors.forename: F
authors.initials: F
authors.lastname: Martin
authors.forename: N
authors.initials: N
authors.lastname: Just
authors.forename: G
authors.initials: G
authors.lastname: Gonzalez
authors.forename: E
authors.initials: E
authors.lastname: Devin
authors.forename: A-S
authors.initials: AS
authors.lastname: Veyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004867:Equipment Design; D005221:Fatigue / Q000145:classification; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019186:Mandibular Advancement / Q000295:instrumentation*; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D017060:Patient Satisfaction; D017286:Polysomnography; D011446:Prospective Studies; D011788:Quality of Life; D011862:Radiography, Panoramic; D012890:Sleep / Q000502:physiology; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D012894:Sleep Stages / Q000502:physiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010100:Oxygen