title: Effects of varying mandibular protrusion and degrees of vertical opening on upper airway dimensions in apneic dentate subjects.
abstract: BACKGROUND
  Despite numerous studies investigating the dimensional and therapeutic effects of mandibular advancement splints (MASs), data regarding the effects of differently designed individual and non-adjustable MASs on the upper airway in fully dentate apneic subjects in the sagittal plane including comparison of these effects with a placebo device are sparse. The present study aimed to determine the dimensional changes in the sagittal plane created by differently designed MASs in the upper airway in fully dentate apneic subjects and to compare these changes with the effects of a placebo device.
  
  
  METHODS
  Magnetic resonance (MR) images of 9 dentate apneic subjects with 5 differently designed MASs and without a MAS were obtained. We measured the area of the entire pharynx (velopharynx, oropharynx, hypopharynx) on these MR images and compared the dimensional changes.
  
  
  RESULTS
  The dimensional changes triggered by two specific MASs (75% of the maximum mandibular protrusion with 5 mm vertical opening, and 75% of the maximum mandibular protrusion with 10 mm of vertical opening) in the entire pharynx in the sagittal plane were statistically significant compared to the other MASs (p < 0.05). The MAS effecting 75% of the maximum mandibular protrusion and 10 mm of vertical opening created a significant dimensional increase only in the velopharyngeal area among the three pharyngeal sites (p ≤ 0.003).
  
  
  CONCLUSIONS
  While the degree of mandibular protrusion created by the MAS affects the dimensions of the upper airway, the degree of the vertical opening exerts no significant dimensional effect in the sagittal plane in fully dentate apneic patients. The mandibular protrusion effect is comparatively larger in the velopharyngeal region.
authors.affiliation: Department of Prosthodontics, Gulhane Military Medical Academy, Ankara, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Piskin
authors.forename: O
authors.initials: O
authors.lastname: Karakoc
authors.forename: H
authors.initials: H
authors.lastname: Genc
authors.forename: S
authors.initials: S
authors.lastname: Akay
authors.forename: C
authors.initials: C
authors.lastname: Sipahi
authors.forename: M
authors.initials: M
authors.lastname: Erdem
authors.forename: B
authors.initials: B
authors.lastname: Karaman
authors.forename: S
authors.initials: S
authors.lastname: Gorgulu
authors.forename: S
authors.initials: S
authors.lastname: Yetkin
authors.forename: S
authors.initials: S
authors.lastname: Ayyildiz
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008334:Mandible / Q000473:pathology*; D019186:Mandibular Advancement / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D010614:Pharynx / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020181:Sleep Apnea, Obstructive / Q000473:pathology* / Q000517:prevention & control*; D016896:Treatment Outcome