title: Mandibular tori size is related to obstructive sleep apnea and treatment success with an oral appliance.
abstract: OBJECTIVE
  Obstructive sleep apnea (OSA) is a common disorder characterized by repetitive upper airway obstruction during sleep. We aimed to investigate whether mandibular tori, exostoses that appear on the lingual surface of the lower jaw, are related to OSA and the effect of an oral appliance (OA) in OSA patients.
  
  
  METHODS
  Six hundred snoring patients with a mean age of 52 years (range 23-75 years) and a mean respiratory disturbance index (RDI) of 15 (range 0-76), who were consecutively referred for OA treatment, were included. The size of the tori was measured on plaster casts with a digital sliding caliper.
  
  
  RESULTS
  Twenty-seven percent of the patients had mandibular tori, with a similar prevalence in snorers and patients with mild, moderate and severe OSA. Tori size differed between severity groups. Thick tori (≥2.9 mm) were associated with an RDI of <30, odds ratio (OR) 4.7 (p = 0.01), adjusted for age, gender and body mass index (BMI; kg/m(2)). Complete treatment response with OA was related to thick tori, OR = 2.5 (p = 0.02), adjusted for disease severity, age, gender, BMI (kg/m(2)), weight changes (kg) and mandibular repositioning.
  
  
  CONCLUSIONS
  Patients with milder disease are more likely to have larger tori than patients with severe OSA. Treatment success with an OA occurs more frequently in patients with larger tori than in patients with no tori or small tori.
authors.affiliation: Folktandvården Alingsås, Västra Götalandsregionen, Alingsås, Sweden.
authors.forename: Emma
authors.initials: E
authors.lastname: Palm
authors.forename: Karl A
authors.initials: KA
authors.lastname: Franklin
authors.forename: Marie
authors.initials: M
authors.lastname: Marklund
mesh_terms: D000328:Adult; D000368:Aged; D005096:Exostoses / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D019186:Mandibular Advancement / Q000295:instrumentation*; D008336:Mandibular Diseases / Q000150:complications* / Q000175:diagnosis*; D008875:Middle Aged; D009967:Orthodontic Appliances; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000209:etiology* / Q000628:therapy*; D016896:Treatment Outcome