Finn Geoghegan1, Anika Ahrens2, Colman McGrath3, Urban Hägg4. 1. a Former postgraduate student, Department of Orthodontics, Faculty of Dentistry, Prince Philip Dental Hospital, University of Hong Kong, HKSAR, China. 2. b Former postgraduate student, Department of Dental Public Health, Faculty of Dentistry, Prince Philip Dental Hospital, University of Hong Kong, China. 3. c Professor, Department of Dental Public Health, Faculty of Dentistry, Prince Philip Dental Hospital, University of Hong Kong, HKSAR, China. 4. d Emeritus Professor, Department of Orthodontics, Faculty of Dentistry, Prince Philip Dental Hospital, University of Hong Kong, HKSAR, China.
Abstract
OBJECTIVES: To evaluate the effects of two different mandibular advancement devices (MADs) on craniofacial characteristics and upper airway dimensions of Chinese adult patients with obstructive sleep apnea (OSA). MATERIALS AND METHODS:Forty-five patients with OSA were recruited as part of a prospective randomized crossover trial for treatment with two different MADs. Lateral cephalograms were taken, and the Epworth Sleepiness Scale and the Sleep Apnea Quality of Life Index were completed at baseline. RESULTS: The Apnea-Hypoxia Index was highly significantly reduced with the monoblock (P < .001) and significantly reduced with the twin block (P < .01). The monoblock demonstrated a superior result than the twin block (P < .05). A significant reduction was found in the distances between the hyoid bone to retrognathia (monoblock, P < .01; twin block, P < .001) as well as the distance between the hyoid bone and mandibular plane angle (P < .001). Furthermore, soft palate length increased significantly (P < .05) with both MADs. However, the changes did not differ in favor of either MAD. CONCLUSION: Monoblock was the better MAD to improve OSA severity. No difference could be found in changes of subjective OSA indicators. Significant but similar cephalometric changes were observed, indicating both MADs alter the position of the surrounding musculature and improve upper airway patency. Therefore, the different design features of the MADs suggest an impact on some OSA indicators.
RCT Entities:
OBJECTIVES: To evaluate the effects of two different mandibular advancement devices (MADs) on craniofacial characteristics and upper airway dimensions of Chinese adult patients with obstructive sleep apnea (OSA). MATERIALS AND METHODS: Forty-five patients with OSA were recruited as part of a prospective randomized crossover trial for treatment with two different MADs. Lateral cephalograms were taken, and the Epworth Sleepiness Scale and the Sleep Apnea Quality of Life Index were completed at baseline. RESULTS: The Apnea-Hypoxia Index was highly significantly reduced with the monoblock (P < .001) and significantly reduced with the twin block (P < .01). The monoblock demonstrated a superior result than the twin block (P < .05). A significant reduction was found in the distances between the hyoid bone to retrognathia (monoblock, P < .01; twin block, P < .001) as well as the distance between the hyoid bone and mandibular plane angle (P < .001). Furthermore, soft palate length increased significantly (P < .05) with both MADs. However, the changes did not differ in favor of either MAD. CONCLUSION: Monoblock was the better MAD to improve OSA severity. No difference could be found in changes of subjective OSA indicators. Significant but similar cephalometric changes were observed, indicating both MADs alter the position of the surrounding musculature and improve upper airway patency. Therefore, the different design features of the MADs suggest an impact on some OSA indicators.