title: Snoring and Obstructive Sleep Apnea: Objective Efficacy and Impact of a Chairside Fabricated Mandibular Advancement Device.
abstract: OBJECTIVE
  Obstructive sleep apnea (OSA) has been described as a common sleep respiratory disorder. Its prevalence in the adult population has been reported to be high, varying from 3% to 28%. Dental practitioners play a key role in the treatment of this disease, using tailor-made mandibular advancement devices (MADs). This pilot study assessed the efficacy and compliance of a custom-fitted thermoplastic MAD for the treatment of moderate to severe OSA syndrome.
  
  
  METHODS
  In this open study without a control group, OSA syndrome sufferers were enrolled by four centers. One specific MAD was custom fitted to the patients. Polysomnography, Epworth, and snoring scales were administered from inclusion to 45 days postinclusion.
  
  
  RESULTS
  The study population consisted of 33 men and 8 women; 35 patients completed the study. Patient response was high with 69% of them considered as responders, and 60% showing a complete response. Also, 77.3% of patients with moderate OSA syndrome presented a complete response. An improvement was observed in the apnea hypopnea index, which decreased from 34.1 ± 18.9 to 12.8 ± 14.1. The Epworth Sleepiness Scale score, snoring, and quality of sleep scores decreased with the device (p < 0.0001). Compliance rates were high, with patients wearing the device 6.5 nights a week. Side effects and patient complaints were minor and transient.
  
  
  CONCLUSIONS
  This custom-fitted MAD improved respiratory and somnolence parameters, with response rates similar to those published in the literature with other devices.
authors.affiliation: Toulouse Dental School, Toulouse, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Marty
authors.affiliation: Pneumology Centre, Perpignan, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Lacaze
authors.affiliation: Pneumology Centre, Perpignan, France.
authors.forename: Charles Daniel
authors.initials: CD
authors.lastname: Arreto
authors.affiliation: Dental Surgery Department, Bretonneau Hospital, Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Pierrisnard
authors.affiliation: Neurosensorial Explorations Department, Gonesse Hospital, Gonesse, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Bour
authors.affiliation: University of Versailles-St-Quentin, UVSQ, France.
authors.forename: Fawzia
authors.initials: F
authors.lastname: Chéliout-Héraut
authors.affiliation: Pneumology department. Bicêtre Hospital, Kremlin-Bicêtre, France.
authors.forename: Gérald
authors.initials: G
authors.lastname: Simonneau
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D019186:Mandibular Advancement / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D010349:Patient Compliance; D010865:Pilot Projects; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D012913:Snoring / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Compliance; OSAS; quality of life; thermoplastic mandibular advancement device