title: OSAS treatment with oral appliance: assessment of our experience through the use of a new device.
abstract: BACKGROUND
  Obstructive sleep apnea syndrome (OSAS) is defined as repeated episodes of obstruction of the upper airway and oxygen desaturation of the arterial hemoglobin. OSAS is associated with loud snoring, excessive daytime sleepiness, cardiovascular and neurocognitive disease, increase risk of road accidents.
  
  
  OBJECTIVE
  The aim of this study is to evaluate non-surgical therapy for OSAS using a mandibular advancement device (MAD) that provides for lower jaw protrusion and for an adequate vertical opening, that allows for greater airflow.
  
  
  METHODS
  The device was assembled using the working principles of "Herbst-like" appliances and splints of neuromuscular deprogramming of the "Federici" type used for gnathologic treatments. We selected 17 males and 4 females, with an average age of 42 years, and an average BMI of 29. Eighteen patients were treated with our oral appliance, 1 patient was treated with the orthesis proposed by Schmidt-Nowara et al and 2 patients were treated with the oral appliance proposed by Johal and Battagel. All patients used the appliance for at least 6 months.
  
  
  RESULTS
  After treatment with the oral appliance, the posterior airway space increased (p = 0.0002); no statistically significant difference for the improvement degree of OSAS severity (p = 0.1085) was shown; an improvement was found in: AHI (p = 0.0028); Nadir O2 (p = 0.0035); TO2 < 90% (p = 0.0140); 2 patients presented with temporomandibular joint (TMJ) discomfort.
  
  
  CONCLUSIONS
  Our MAD has proved effective in improving the polysomnographic and radiographic parameters and assures good TMJ compliance.
authors: U.O. MaxilloFacial Surgery, School of Medicine, Catholic University of the Sacred Heart, Rome, Italy.
authors: G
authors: G
authors: Gasparini
authors: C
authors: C
authors: Azzuni
authors: F M D
authors: FM
authors: Rinaldo
authors: D
authors: D
authors: Cervelli
authors: T M
authors: TM
authors: Marianetti
authors: A
authors: A
authors: Sferrazza
authors: S
authors: S
authors: Pelo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D019186:Mandibular Advancement / Q000379:methods*; D008875:Middle Aged; D017090:Occlusal Splints; D016382:Orthodontic Appliance Design; D010100:Oxygen / Q000378:metabolism; D017286:Polysomnography; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000628:therapy*; D012913:Snoring; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010100:Oxygen