Mandibular advancement appliance effects on obstructive sleep apnoea: a prospective threedimensional computed tomography study
Published Online: Jul 30, 2021
Page range: 14 - 23
Received: Mar 01, 2016
Accepted: Dec 01, 2016
DOI: https://doi.org/10.21307/aoj-2020-080
© 2017 Ahmed Ghoneima et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Background
The aim of this study was to determine the effects of an elastic mandibular advancement (EMA) appliance on upper airway dimensions, most constricted area (MCA) of the airway, and snoring in a sample of obstructive sleep apnoea (OSA) patients of varying severity.
Methods
Forty-seven male subjects were classified into two groups comprising12 controls and 35 suffering from OSA. The OSA group was further divided into three subgroups based on their apnoea-hypopnoea index (AHI). All subjects completed an Epworth questionnaire and an overnight home sleep test before (T1) and at the end of the study (T2). OSA subjects were provided with a custom-made EMA appliance. Cone beam computed tomographic images were obtained for each subject at T1 and T2. Airway parameters were measured and summarised by grouping. The differences in the measurements T1 – T2 were compared using repeated measures analysis of variance (rmANOVA) and
Results
The use of the EMA produced a statistically significant increase in the nasopharyngeal, oropharyngeal, MCA, and total airway volume. Although sleep apnoea patients reported a reduction in snoring time, particularly in moderate and severe OSA groups, the level of improvement was not statistically significant. Patients with moderate and severe OSA demonstrated significant decreases in their AHI and Epworth scores.
Conclusion
EMA is effective in reducing OSA severity and changing airway dimensions in OSA patients, specifically in the moderate and severe cases.