Efficacy of Non-adjustable Magnetic Mandibular Advancement Appliances (2M2A) in Patients with Mild Obstructive Sleep Apnea: a Preliminary Short-term Study
Article Sidebar
Main Article Content
Abstract
Objectives: 1) to assess the efficacy of the non-adjustable mandibular advancement device, namely Magnetic Mandibular Advancement Appliances (2M2A) in patients with mild obstructive sleep apnea (OSA), compared between pretreatment and 3-month after the insertion of the 2M2A, using apnea hypopnea index (AHI) and minimum oxygen saturation 2) tTo determine changes in craniofacial and upper airway structures in patients with mild obstructive sleep apneaOSA (OSA), treated with the oral appliance, namely Magnetic Mandibular Advancement Appliances (2M2A) 2M2A , by means of lateral cephalometric analysis. Furthermore, the efficacy of 2M2A was evaluated and compared between pretreatment and 3-month posttreatment using apnea hypopnea index (AHI) and minimum oxygen saturation.
Materials and Methods: Fifteen Thai subjects aged between 20 and 69 year-old with mild OSA who have failed to previous radiofrequency ablation treatment were recruited. Lateral cephalometric radiographs were taken twice; prior to and after the during 2M2A inserted in place. Polysomnography was performed 3-month posttreatment.
Results: Three-month after insertion of the 2M2A, average AHI was significantly decreased, whereas minimum oxygen saturation was significantly increased. When the 2M2A worn inserted in place, forward position and clockwise rotation of the mandible, an increase in lower facial height and decreases in ANB, overjet and overbite were significantly observed. Significant increase of upper airway width was also found during after the 2M2A inserted in place. Three-month posttreatment, average AHI was significantly decreased, whereas minimum oxygen saturation was significantly increased.
Conclusion: During After the 2M2A inserted in place, changes of mandibular position, enlargement of upper airway, and improvement of sleep quality AHI and minimum oxygen saturation was significantly observed in mild OSA patients.
Article Details
References
Young T, Palta M, Dempsey J, et al. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993; 328(17): 1230-1235.
Suwanprathes P, Won C, Komoltri C, et al. Epidemiology of sleep-related complaints associated with sleep-disordered breathing in Bangkok, Thailand. Sleep Med 2010; 11(10): 1025-1030.
Thorpy MJ. Classification of sleep disorders. Neurotherapeutics 2012; 9(4): 687-701.
Walker RP. Snoring and obstructive sleep apnea. In: Bailey BJ, Johnson JT, Newlands SD, ed. Head & Neck surgery Otolaryngology. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2006: 645-664.
Jean-Louis G, Brown CD, Zizi F, et al. Cardiovascular disease risk reduction with sleep apnea treatment. Expert Rev Cardiovasc Ther 2010; 8(7): 995-1005.
Attanasio R, Bailey DR. Classification of sleep disorders. In: Attanasio R, Bailey DR, ed. Dental management of sleep disorders. New Delhi, India: Wiley-Blackwell; 2010: 33-69.
Chang SJ, Chae KY. Obstructive sleep apnea syndrome in children: Epidemiology, pathophysiology, diagnosis and sequelae. Korean J Pediatr 2010; 53(10): 863-871.
Gungor AY, Turkkahraman H, Yilmaz HH, et al. Cephalometric comparison of obstructive sleep apnea patients and healthy controls. Eur J Dent 2013; 7(1): 48-54.
Laxmi NV, Talla H, Meesala D, et al. Importance of cephalographs in diagnosis of patients with sleep apnea. Contemp Clin Dent 2015; 6 (Suppl 1): S221-226.
Gjerde K, Lehmann S, Berge ME, et al. Oral appliance treatment in moderate and severe obstructive sleep apnoea patients non-adherent to CPAP. J Oral Rehabil 2016; 43(4): 249-258.
Sonsuwan N, Rujimethabhas K, Sawanyawisuth K. Factors associated with successful treatment by radiofrequency treatment of the soft palate in obstructive sleep apnea as the first-line treatment. Sleep Disord 2015; 2015: 690425.
Almeida FR, Bansback N. Long-term effectiveness of oral appliance versus CPAP therapy and the emerging importance of understanding patient preferences. Sleep 2013; 36(9): 1271-1272.
Phillips CL, Grunstein RR, Darendeliler MA, et al. Health outcomes of continuous positive airway pressure versus oral appliance treatment for obstructive sleep apnea: a randomized controlled trial. Am J Respir Crit Care Med 2013; 187(8): 879-887.
Lam B, Sam K, Lam JC, et al. The efficacy of oral appliances in the treatment of severe obstructive sleep apnea. Sleep Breath 2011; 15(2): 195-201.
Bernhold M, Bondemark L. A magnetic appliance for treatment of snoring patients with and without obstructive sleep apnea. Am J Orthod Dentofacial Orthop 1998; 113(2): 144-155.
Gavish A, Vardimon AD, Rachima H, et al. Cephalometric and polysomnographic analyses of functional magnetic system therapy in patients with obstructive sleep apnea. Am J Orthod Dentofacial Orthop 2001; 120(2): 169-177.
Sonsuwan N, Suchachaisri S, Chaloeykitti L. The relationships between cephalometric parameters and severity of obstructive sleep apnea. Auris Nasus Larynx 2011; 38(1): 83-87.
Engleman HM, Wild MR. Improving CPAP use by patients with the sleep apnoea/hypopnoea syndrome (SAHS). Sleep Med Rev 2003; 7(1): 81-99.
Zhu Y, Long H, Jian F, et al. The effectiveness of oral appliances for obstructive sleep apnea syndrome: A meta-analysis. J Dent 2015; 43(12): 1394-402.
Marklund M. Update on Oral Appliance Therapy for OSA. Curr Sleep Med Rep 2017; 3(3): 143-151.
Walker-Engstrom ML, Ringqvist I, Vestling O, et al. A prospective randomized study comparing two different degrees of mandibular advancement with a dental appliance in treatment of severe obstructive sleep apnea. Sleep Breath 2003; 7(3): 119-130.
Rashmikant US, Chand P, Singh SV, et al. Cephalometric evaluation of mandibular advancement at different horizontal jaw positions in obstructive sleep apnoea patients: a pilot study. Aust Dent J 2013; 58(3): 293-300.
Mehta A, Qian J, Petocz P, et al. A randomized, controlled study of a mandibular advancement splint for obstructive sleep apnea. Am J Respir Crit Care Med 2001; 163(6): 1457-1461.
Endo S, Mataki S, Kurosaki N. Cephalometric evaluation of craniofacial and upper airway structures in Japanese patients with obstructive sleep apnea. J Med Dent Sci 2003; 50(1): 109-120.
Shigeta Y, Ogawa T, Tomoko I, et al. Soft palate length and upper airway relationship in OSA and non-OSA subjects. Tex Dent J 2013; 130(3): 203-211.
Ng AT, Darendeliler MA, Petocz P, et al. Cephalometry and prediction of oral appliance treatment outcome. Sleep Breath 2012; 16(1): 47-58.
White DP, Lombard RM, Cadieux RJ, et al. Pharyngeal resistance in normal humans: influence of gender, age, and obesity. J Appl Physiol (1985) 1985; 58(2): 365-371.
Tsuiki S, Lowe AA, Almeida FR, et al. Effects of an anteriorly titrated mandibular position on awake airway and obstructive sleep apnea severity. Am J Orthod Dentofacial Orthop 2004; 125(5): 548-555.
Choi JK, Hur YK, Lee JM, et al. Effects of mandibular advancement on upper airway dimension and collapsibility in patients with obstructive sleep apnea using dynamic upper airway imaging during sleep. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109(5): 712-719.