title: Cephalometry and prediction of oral appliance treatment outcome.
abstract: BACKGROUND
  Predicting which patients with obstructive sleep apnea (OSA) will be successfully treated with mandibular advancement splints (MAS) remains elusive. Developing simple daytime measurements and tests to predict treatment outcome would enhance MAS treatment.
  
  
  OBJECTIVE
  The purpose of this study was to assess the clinical utility of anthropomorphic measurements and cephalometric X-rays in the prediction of MAS treatment outcome in OSA.
  
  
  METHODS
  Anthropomorphic measurements and cephalometric X-rays from 72 OSA patients who had presented to a tertiary referral sleep clinic were analyzed retrospectively.
  
  
  RESULTS
  Treatment response was defined as ≥50% reduction in Apnea/Hypopnea Index (AHI; criterion 1); ≥50% reduction and residual AHI less than 20/h (criterion 2); ≥50% reduction in AHI and residual AHI less than 10/h (criterion 3); and ≥50% reduction in AHI and residual AHI less than 5/h (criterion 4). This was done to reflect the differences in the clinical definition of treatment success in the literature. A good response occurred in 56% (40 patients) according to criterion 1; 54% (39 patients) according to criterion 2; 46% (33 patients) according to criterion 3; or 39% (28 patients) according to criterion 4. Age and gender were found to be significant predictors for criteria 1 and 2. Age and soft palate length were found to be significant predictors for criteria 3 and 4. Equations to predict MAS treatment response were derived as equations were to predict final AHI.
  
  
  CONCLUSIONS
  Certain cephalometric and anthropomorphic measurements impact on MAS treatment outcome. This study adds to the current literature and implies that MAS success is (to some degree) related to anatomical characteristics.
authors.affiliation: Centre for Sleep Disorders and Respiratory Failure, St. George Hospital, Sydney, Australia. ashs_ng@hotmail.com
authors.forename: Andrew Tze Ming
authors.initials: AT
authors.lastname: Ng
authors.forename: M Ali
authors.initials: MA
authors.lastname: Darendeliler
authors.forename: Peter
authors.initials: P
authors.lastname: Petocz
authors.forename: Peter A
authors.initials: PA
authors.lastname: Cistulli
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D019540:Area Under Curve; D002508:Cephalometry / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D019186:Mandibular Advancement / Q000295:instrumentation*; D008875:Middle Aged; D009517:New South Wales; D017090:Occlusal Splints; D016382:Orthodontic Appliance Design; D017286:Polysomnography; D012372:ROC Curve; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome