A Computed Tomographic Evaluation of Effect of Mandibular Advancement Device at Two Different Horizontal Jaw Positions in Patients with Obstructive Sleep Apnea

Overview

Journal J Oral Biol Craniofac Res

Publisher Elsevier

Date 2023 May 1

PMID 37124835

Authors

Pooran Chand

Neeti Solanki

Balendra Pratap Singh

Sunit Kumar Jurel

Surya Kant

Pranjali Dutt

Affiliations

Soon will be listed here.

Abstract

Statement Of Problem: Studies pertaining to the objective assessments of the efficacy of mandibular advancement device in patients with obstructive sleep apnea are scarce.

Purpose: The purpose of this clinical study was to evaluate the effect of MAD at two different horizontal positions of mandible on upper airway dimensions through computed tomography.

Material And Methods: Twenty-nine consenting participants satisfying predetermined inclusion and exclusion criteria were enrolled and an adjustable two-piece MAD was fabricated at 50% maximum mandibular protrusion and after 4 weeks was adjusted to 70% protrusion. CT scans were obtained at baseline, 4 weeks after delivering MAD with 50% mandibular protrusion, and then after 4 weeks with 70% mandibular protrusion. Cross sectional area with diameters (lateral and anteroposterior) of upper airway was measured at three specific anatomic levels (retropalatal-RP, retroglossal-RG, and epiglottal-EG). Data were analyzed using the Student t-test for parametric analysis.

Results: Intragroup comparison revealed a statistically significant increase in lateral & anteroposterior dimensions as well as cross sectional area at all three anatomical levels at 4 weeks after MAD with 50% mandibular protrusion compared with baseline and 4 weeks after MAD with 70% mandibular protrusion compared with baseline. However, the difference between lateral and anteroposterior dimensions with MAD at 70% protrusion compared with MAD at 50% protrusion was not statistically significant. The difference between cross-sectional area was found to be statistically significant.

Conclusion: Mandibular advancement device at 70% mandibular protrusion is more effective compared with the device at 50% protrusion in relieving oropharyngeal obstruction seen in OSA.

Citing Articles

The Impact of Diagnostic Imaging on Obstructive Sleep Apnea: Feedback from a Narrative Review.

Lavalle S, Caranti A, Iannella G, Pace A, Lentini M, Maniaci A Diagnostics (Basel). 2025; 15(3).

PMID: 39941168 PMC: 11816599. DOI: 10.3390/diagnostics15030238.

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