title: An evaluation of two different mandibular advancement devices on craniofacial characteristics and upper airway dimensions of Chinese adult obstructive sleep apnea patients.
abstract: OBJECTIVE
  To evaluate the effects of two different mandibular advancement devices (MADs) on craniofacial characteristics and upper airway dimensions of Chinese adult patients with obstructive sleep apnea (OSA).
  
  
  METHODS
  Forty-five patients with OSA were recruited as part of a prospective randomized crossover trial for treatment with two different MADs. Lateral cephalograms were taken, and the Epworth Sleepiness Scale and the Sleep Apnea Quality of Life Index were completed at baseline.
  
  
  RESULTS
  The Apnea-Hypoxia Index was highly significantly reduced with the monoblock (P < .001) and significantly reduced with the twin block (P < .01). The monoblock demonstrated a superior result than the twin block (P < .05). A significant reduction was found in the distances between the hyoid bone to retrognathia (monoblock, P < .01; twin block, P < .001) as well as the distance between the hyoid bone and mandibular plane angle (P < .001). Furthermore, soft palate length increased significantly (P < .05) with both MADs. However, the changes did not differ in favor of either MAD.
  
  
  CONCLUSIONS
  Monoblock was the better MAD to improve OSA severity. No difference could be found in changes of subjective OSA indicators. Significant but similar cephalometric changes were observed, indicating both MADs alter the position of the surrounding musculature and improve upper airway patency. Therefore, the different design features of the MADs suggest an impact on some OSA indicators.
authors: a   Former postgraduate student, Department of Orthodontics, Faculty of Dentistry, Prince Philip Dental Hospital, University of Hong Kong, HKSAR, China.
authors: Finn
authors: F
authors: Geoghegan
authors: b   Former postgraduate student, Department of Dental Public Health, Faculty of Dentistry, Prince Philip Dental Hospital, University of Hong Kong, China.
authors: Anika
authors: A
authors: Ahrens
authors: c   Professor, Department of Dental Public Health, Faculty of Dentistry, Prince Philip Dental Hospital, University of Hong Kong, HKSAR, China.
authors: Colman
authors: C
authors: McGrath
authors: d   Emeritus Professor, Department of Orthodontics, Faculty of Dentistry, Prince Philip Dental Hospital, University of Hong Kong, HKSAR, China.
authors: Urban
authors: U
authors: Hägg
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D002508:Cephalometry; D018592:Cross-Over Studies; D005260:Female; D006257:Head / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D019186:Mandibular Advancement / Q000295:instrumentation* / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012137:Respiratory System / Q000000981:diagnostic imaging / Q000473:pathology*; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D016896:Treatment Outcome
keywords: Adult; Chinese; MAD; Sleep apnea
references: Sleep Med. 2008 May;9(4):403-10
references: 17658296
references: Am J Orthod Dentofacial Orthop. 1992 Jun;101(6):533-42
references: 1598893
references: Chest. 1996 Jun;109(6):1470-6
references: 8769496
references: Angle Orthod. 2006 Nov;76(6):962-9
references: 17090158
references: Am J Respir Crit Care Med. 2008 Jul 15;178(2):197-202
references: 17673699
references: Am J Orthod Dentofacial Orthop. 2000 Sep;118(3):248-56
references: 10982924
references: N Engl J Med. 2000 May 11;342(19):1378-84
references: 10805822
references: Acta Otolaryngol. 1990 Jul-Aug;110(1-2):136-40
references: 2386028
references: Am J Respir Crit Care Med. 1994 Apr;149(4 Pt 1):905-9
references: 8143054
references: Sleep Breath. 2007 Mar;11(1):1-22
references: 17136406
references: Chest. 1994 Feb;105(2):429-33
references: 8306741
references: Am J Respir Crit Care Med. 1998 Jan;157(1):144-8
references: 9445292
references: Eur J Orthod. 2002 Jun;24(3):251-62
references: 12143089
references: J Sleep Res. 2009 Sep;18(3):321-8
references: 19493297
references: Treat Respir Med. 2005;4(6):409-22
references: 16336026
references: Respir Physiol. 1987 Nov;70(2):183-93
references: 3671898
references: Am J Orthod Dentofacial Orthop. 1986 Dec;90(6):484-91
references: 3098087
references: Angle Orthod. 1997;67(2):143-53
references: 9107379
references: Expert Rev Med Devices. 2005 Nov;2(6):749-63
references: 16293102
references: Am J Respir Crit Care Med. 1995 May;151(5):1459-65
references: 7735600
references: Hong Kong Med J. 2003 Feb;9(1):25-30
references: 12547953
references: J Eval Clin Pract. 2007 Feb;13(1):3-9
references: 17286716
references: Sleep. 2009 May;32(5):648-53
references: 19480232
references: N Engl J Med. 1993 Apr 29;328(17):1230-5
references: 8464434
references: Cochrane Database Syst Rev. 2006 Jul 19;(3):CD001106
references: 16855960
references: Am J Orthod Dentofacial Orthop. 1988 Nov;94(5):384-92
references: 3189241
references: Int J Oral Maxillofac Surg. 1991 Jun;20(3):159-62
references: 1890323
references: Nurs Times. 2003 Jun 3-9;99(22):26-7
references: 12808745
references: Chest. 2004 Jan;125(1):127-34
references: 14718431