Luca Guarda-Nardini1, Daniele Manfredini2, Marta Mion2, Gary Heir3, Rosario Marchese-Ragona2. 1. Department of Maxillofacial Surgery, TMD Clinic, University of Padova, Padova, Italy. 2. Institute of Otolaryngology, Department of Neurosciences, Padova University, Padova, Italy. 3. Center for Temporomandibular Disorders and Orofacial Pain, Rutgers University School of Dental Medicine, Newark, NJ.
Abstract
AIMS: The aim of this review is to summarize data from the literature on the predictive value of anatomy-based parameters, as identified by cephalometry, for the efficacy of mandibular advancement devices (MAD) for the treatment of obstructive sleep apnea (OSA). METHODS: Articles were initially selected based on their titles or abstracts. Full articles were then retrieved and further scrutinized according to predetermined criteria. Reference lists of selected articles were searched for any missed publications. The selected articles were methodologically evaluated. RESULTS: Of an initial 311 references, 13 were selected that assessed correlations between polysomnographic and cephalometric variables. The majority of studies demonstrated a correlation between treatment effectiveness and features as determined by cephalometric analysis, such as the mandibular plane angle, hyoid bone distance to mandible, antero-posterior diameter of the maxilla, tongue area, cranial base, and soft palate. CONCLUSIONS: The mandibular plane angle and the distance between hyoid bone and mandibular plane was found to have a predictive value for MAD effectiveness in OSA patients. However, the relative weak and somewhat inconsistent cephalometric data suggest that decisions based solely on these factors cannot be recommended, especially because an integrated analysis of other risk factors (e.g., age, sex, BMI) should also be taken into account.
AIMS: The aim of this review is to summarize data from the literature on the predictive value of anatomy-based parameters, as identified by cephalometry, for the efficacy of mandibular advancement devices (MAD) for the treatment of obstructive sleep apnea (OSA). METHODS: Articles were initially selected based on their titles or abstracts. Full articles were then retrieved and further scrutinized according to predetermined criteria. Reference lists of selected articles were searched for any missed publications. The selected articles were methodologically evaluated. RESULTS: Of an initial 311 references, 13 were selected that assessed correlations between polysomnographic and cephalometric variables. The majority of studies demonstrated a correlation between treatment effectiveness and features as determined by cephalometric analysis, such as the mandibular plane angle, hyoid bone distance to mandible, antero-posterior diameter of the maxilla, tongue area, cranial base, and soft palate. CONCLUSIONS: The mandibular plane angle and the distance between hyoid bone and mandibular plane was found to have a predictive value for MAD effectiveness in OSA patients. However, the relative weak and somewhat inconsistent cephalometric data suggest that decisions based solely on these factors cannot be recommended, especially because an integrated analysis of other risk factors (e.g., age, sex, BMI) should also be taken into account.
Authors: Paul E Peppard; Terry Young; Jodi H Barnet; Mari Palta; Erika W Hagen; Khin Mae Hla Journal: Am J Epidemiol Date: 2013-04-14 Impact factor: 4.897
Authors: Maree Barnes; R Douglas McEvoy; Siobhan Banks; Natalie Tarquinio; Christopher G Murray; Norman Vowles; Robert J Pierce Journal: Am J Respir Crit Care Med Date: 2004-06-16 Impact factor: 21.405