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Evaluation of condylar and mandibular movements on the upper airway during the use of mandibular advancement device for obstructive sleep apnea treatment

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Abstract

Objectives

To evaluate the temporomandibular joint (TMJ), condylar and mandibular movements in obstructive sleep apnea (OSA) patients treated with mandibular advancement device (MAD) and to identify the influence of these anatomic factors on upper airway (UA) volume and polysomnographic outcomes after treatment.

Materials and methods

Twenty OSA patients were prospectively treated with MAD. Clinical examinations, cone-beam computed tomography, and polysomnography were performed before MAD treatment and after achieving therapeutic protrusion. Polysomnographic variables and three-dimensional measurements of the TMJ, mandible, and upper airway were statistically analyzed.

Results

Condylar rotation, anterior translation, and anterior mandibular displacement were directly correlated with total UA volume, while vertical mandibular translation was inversely correlated with the volume of the inferior oropharynx. MAD treatment resulted in an increase in the volume and area of the superior oropharynx. There was no statistically significant correlation between condylar rotation and translation and polysomnographic variables. With MAD, there was a significant increase in vertical dimension, changes in condylar position (rotation and translation), and mandibular displacement. The central and medial lengths of the articular eminence were inversely correlated with condylar rotation and translation, respectively. The lateral length of the eminence was directly correlated with condylar translation, and the lateral height was directly correlated with condylar rotation and translation.

Conclusion

Condylar and mandibular movements influenced UA volume. The articular eminence played a role in the amount of condylar rotation and translation.

Clinical relevance

Individualized anatomical evaluation of the TMJ proves to be important in the therapy of OSA with MAD.

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Funding

This work was supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brasil (CAPES)—Funding Code 001.

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Authors and Affiliations

  1. Federal University of Ceará, Fortaleza, Brazil

    Amanda Pereira, Paulo de Barros Silva, Fabio Costa & Cauby Maia Junior

  2. University of Michigan, Ann Arbor, MI, USA

    Marcela Gurgel & Lucia Cevidanes

  3. Federal University of São Paulo, São Paulo, Brazil

    Rowdley Pereira

  4. University of Montreal, Montreal, Canada

    Cibele Dal Fabbro

  5. Fortaleza General Hospital, Fortaleza, Brazil

    Leonardo Leite

  6. Federal University of Paraná, Curitiba, Brazil

    Alexandre Moro

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  1. Amanda Pereira
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Contributions

Conceptualization and proof outline: AP, MG, CDF, PBS, FC, LL, AM, LC, and CCJ; project administration and supervison: MG and CCJ; methodology, validation and writing—original draft: AP, MG, and CCJ; resources and sample: RP and CDF; writing—review and editing: all authors.

Corresponding author

Correspondence to Marcela Gurgel.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The study was approved by the Research Ethics Committee of the Federal University of São Paulo, Brazil (number 0301/10). All volunteers were provided with a written Informed Consent Form (IFC), which they were required to sign in order to participate in the study.

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The authors declare no competing interests.

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Pereira, A., Gurgel, M., Pereira, R. et al. Evaluation of condylar and mandibular movements on the upper airway during the use of mandibular advancement device for obstructive sleep apnea treatment. Clin Oral Invest 28, 122 (2024). https://doi.org/10.1007/s00784-024-05513-9

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