Effects of an oral appliance with different mandibular protrusion positions at a constant vertical dimension on obstructive sleep apnea
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The aim of the study was to assess the influence of four mandibular protrusion positions, at a constant vertical dimension, on obstructive sleep apnea (OSA). Seventeen OSA patients (49.2 ± 8.5 years) received an adjustable mandibular advancement device (MAD). The patients underwent four polysomnographic recordings with their MAD in situ at, in random order, 0%, 25%, 50%, and 75% of the maximum protrusion. The mean apnea–hypopnea index (AHI) values of the patients differed significantly between the protrusion positions (P < 0.000). The 25% protrusion position resulted in a significant reduction of the AHI with respect to the 0% position, while in the 50% and 75% positions, even lower AHI values were found. The number of side effects was larger starting at the 50% protrusion position. We therefore recommend coming to a weighted compromise between efficacy and side effects by starting a MAD treatment in the 50% protrusion position.
KeywordsObstructive sleep apnea Oral appliance Mandibular advancement device Protrusion Vertical dimension
The authors would like to thank the staff of the Center for Sleep–Wake Disorders of Slotervaart Medical Center in Amsterdam, The Netherlands for their assistance with this work. The Netherlands Institute for Dental Sciences (IOT) supported this work.
Conflict of interest
All authors declare that they have no conflict of interest in this study.
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