Eur J Orthod
Department of Orthodontics, Dental Institute, St Bartholomew's and The Royal London School of Medicine and Dentistry, London, UK.
Published: December 2005
This prospective, cohort study evaluated the role of sleep nasendoscopy (SNE) with simultaneous mandibular protrusion in predicting successful mandibular advancement splint (MAS) therapy in subjects with obstructive sleep apnoea (OSA). Nineteen OSA subjects diagnosed by overnight polysomnography were referred for MAS therapy, following SNE investigation. A Herbst MAS was fabricated for each subject. Once this had been adjusted for maximal, subjective, therapeutic effect, follow-up sleep studies were undertaken with the appliance in situ. The SNE was repeated with the appliance in place to allow the effects of the original mandibular protrusion and the actual effect of the MAS to be compared. The MAS was removed and the original and current site(s) of obstruction evaluated. Pre-treatment SNE showed airway obstruction at the following levels: intermittent multi-level (16 subjects), sustained multi-level (two subjects) and tongue base (one subject). In all individuals, gentle advancement of the mandible during SNE improved airway patency and reduced snoring. When the SNE was repeated with the MAS in situ, all subjects showed improvements in snoring and airway patency. Follow-up sleep studies confirmed the efficacy of the MAS, with all patients showing a reduction in the apnoea/hypopnoea index (AHI). Median reductions in AHI (from 28.1 to 6.1, P < 0.001) and Epworth Sleepiness Scale (ESS) scores (from 9 to 6, P < 0.001) were highly statistically significant. The results suggest that SNE with concomitant mandibular advancement to mimic MAS wear, could be a valuable prognostic indicator of successful MAS treatment.
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http://dx.doi.org/10.1093/ejo/cji063 | DOI Listing |
Front Oral Health
January 2025
Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Orthodontics and Temporomandibular Disorders, University of Naples Federico II, Naples, Italy.
Introduction: In recent years, the use of Clear aligners (CA) has been diffused among children and adolescents. This systematic review aimed to summarize the literature regarding the effects of CA therapy in growing patients, including dentoalveolar and skeletal effects, periodontal changes, and quality of life measurements.
Methods: An electronic search on four databases was performed until September 2023, and studies including patients <18 years, treated with CA were selected.
Sleep Breath
January 2025
Department of Oral Medicine, Sedation and Imaging, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Background: The repeated airway obstructions in the common disorder Obstructive Sleep Apnea (OSA) cause health risks. Continuous Positive Airway Pressure (CPAP), the standard treatment, faces adherence challenges. Mandibular Advancement Devices (MADs) have been used successfully for mild to moderate OSA, as a good alternative for these patients.
View Article and Find Full Text PDFSleep Med
January 2025
CHU Angers, Department of Respiratory and Sleep Medicine, F-49933, Angers, France; Univ Angers, Faculty of Medicine, F-49000 Angers, France.
Objectives: Treatment-emergent central sleep apnea (TECSA) is well established in continuous positive airway pressure therapy but was barely studied in mandibular advancement device (MAD) treatment. This study aims to evaluate the prevalence of TECSA in patients treated with a MAD and to determine its risk factors and clinical relevance.
Materials And Methods: A total of 139 patients from the IRSR Pays de la Loire Sleep Cohort suffering from snores or obstructive sleep apnea syndrome (OSAS) and treated with a custom-made titratable MAD were included.
Clin Oral Investig
January 2025
Department of Oral and Maxillofacial Surgery, Klinikum Rechts Der Isar, School of Medicine and Health, Technische Universität München, Ismaninger Str. 22, Munich, D-81679, Germany.
Objectives: The presented study aimed to evaluate the effect of mandibular protrusion with a temporarily applied mandibular advancement device (MAD) on the posterior airway space and to determine a reliable metric constant based on a three-dimensional computed tomography (CT) evaluation.
Materials And Methods: The study population consisted of patients with oral squamous cell carcinoma who were treated at least six months prior to the follow-up CT in supine position. Each patient received an individually adjusted MAD that was temporarily applied with three different protrusion distances (P = 0 mm, P = 4 mm, and P = 8 mm) during follow-up CT.
Objectives: To examine tooth root length and root volume in cone beam computed tomography (CBCT) images in patients with skeletal Class II and III anomalies who have undergone single-jaw (SJ) and double-jaw (DJ) orthognathic surgery, and to compare the changes between jaws with and without osteotomy.
Materials And Methods: This study was conducted on the archive records of a total of 60 adults: 36 women and 24 men with an average age of 21.1 ± 3.
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