G Vigié du Cayla1, J M Collet1, V Attali2, J B Kerbrat1, L Benslama3, P Goudot1. 1. Service de stomatologie et chirurgie maxillo-faciale, AP-HP, DHU FAST, GH Pitié - Salpêtrière - Charles-Foix, 75013, Paris, France; Sorbonne Universités, UPMC université Paris 06, UMR 8256 B2A, 75005, Paris, France. 2. Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France; Service des pathologies du Sommeil (Département ''R3S''), AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles-Foix, 75013 Paris, France. 3. Service de stomatologie et chirurgie maxillo-faciale, AP-HP, DHU FAST, GH Pitié - Salpêtrière - Charles-Foix, 75013, Paris, France; Sorbonne Universités, UPMC université Paris 06, UMR 8256 B2A, 75005, Paris, France. Electronic address: lotfibenslama@gmail.com.
Abstract
INTRODUCTION: Continuous positive airways pressure, generally used to treat obstructive sleep apnea-hypopnea syndrome (OSAHS), is not tolerated well by many patients. An alternative is to treat OSAHS with mandibular advancement devices (MAD). This research assesses the long term (> 2 years) effectiveness and the side effects on dental and skeletal parameters of these devices. MATERIAL AND METHODS: We selected 24 patients with moderate to severe OSAHS. All were treated with MADs for at least 2 years. We gathered cephalometric teleradiographs in centric relation and sleep recordings before and after the patients were treated. We evaluated the patients' apnea-hypopnea indexes (AHI) as well as their Epworth sleepiness scale (ESS) scores. We measured the inclination of the central incisors and the positions of the upper and lower jaws. RESULTS: Mandibular advancement devices were used for more than 2 years (3.9 ± 1.9 years). We observed a statistically significant decrease of the patients' AHI and their ESS scores. We also observed a modification of the inclination of the lower central incisors (+0.521; P = 0.047) and of the position of the maxilla (-0.287; P = 0.039). DISCUSSION: We demonstrated the clinical effectiveness of mandibular advancement devices for treating OSAHS, with a very low rate of side effects on dental and skeletal positions.
INTRODUCTION: Continuous positive airways pressure, generally used to treat obstructive sleep apnea-hypopnea syndrome (OSAHS), is not tolerated well by many patients. An alternative is to treat OSAHS with mandibular advancement devices (MAD). This research assesses the long term (> 2 years) effectiveness and the side effects on dental and skeletal parameters of these devices. MATERIAL AND METHODS: We selected 24 patients with moderate to severe OSAHS. All were treated with MADs for at least 2 years. We gathered cephalometric teleradiographs in centric relation and sleep recordings before and after the patients were treated. We evaluated the patients' apnea-hypopnea indexes (AHI) as well as their Epworth sleepiness scale (ESS) scores. We measured the inclination of the central incisors and the positions of the upper and lower jaws. RESULTS: Mandibular advancement devices were used for more than 2 years (3.9 ± 1.9 years). We observed a statistically significant decrease of the patients' AHI and their ESS scores. We also observed a modification of the inclination of the lower central incisors (+0.521; P = 0.047) and of the position of the maxilla (-0.287; P = 0.039). DISCUSSION: We demonstrated the clinical effectiveness of mandibular advancement devices for treating OSAHS, with a very low rate of side effects on dental and skeletal positions.
Authors: Pedro Dias Ferraz; Inês Francisco; Maria Inês Borges; Adriana Guimarães; Fátima Carvalho; Francisco Caramelo; José Pedro Figueiredo; Francisco Vale Journal: Life (Basel) Date: 2022-06-02