Recently, OrthoApnea had the opportunity to participate in the 26th Annual Meeting of the American Academy of Dental Sleep Medicine (AADSM), held in Boston from 2dn till 4th June
At this occasion we witnessed educational programmes and conferences aimed at researchers, physicians, dentists and specialists who have been characterized by taking a deep insight in the use and use of mandibular advancement devices (MAD) in the treatment of obstructive sleep apnea (OSAS), as described in its final program that can be seen here.
During the event we carried out the presentation of two scientific posters:
- CBCT in the study of different phenotypes of responders and non-responders of treatment of mandibular advancement device: a preliminary study.
- Maximum normal range of mandibular protrusion as a first step in the design and construction of a custom mandibular advancement device.
In brief, we share with you the content of the first of the two studies mentioned above. All scientific studies presented can be seen here.
CBCT in the study of different phenotypes of responders and non-responders of mandibular advance device treatment: a preliminar study
Pedro Mayoral Sanz, DDS, MsC, PhD1,4; Manuel Míguez Contreras, DDS, MsC, PhD2; Ramón Domínguez-Mompell, DDS, MsC3
1 Professor of Orthodontics at Alfonso X University of Madrid, Spain.
2 Professor of Orthodontics Master at Rey Juan Carlos University of Madrid, Spain.
3 International PhD, University of California Los Ángeles (UCLA), USA.
4 Board Member Scientific Committee Orthoapnea Málaga Spain.
Mandibular advancement devices (MAD) are increasingly being used in the treatment of obstructive sleep apnea (OSA) as an effective alternative to continuous positive airway pressure (CPAP). MAD protrude the mandible with the aim of increasing upper airway calibre and thereby preventing collapse of the upper airway during sleep. However, the mechanisms by which MAD improve OSA are not well understood. Limited studies have identified an effect of mandibular advancement on aspects of the structure and function of the upper airway. Therefore, the aim of this study was to study the changes on the airway structures and determine the different phenotype of responders and non-responders of MAD treatment.
10 patients mild to moderate OSA treated with MAD , 7 responders and 3 non-responders, were included in this study. A custom-made two-piece MAS Orthoapnea was used. Home sleep monitoring was performed at baseline and 6 weeks after of treatment. Cone-beam computed tomography (CBCT) scans were obtained for all patients with and without MAD.
Mean mandibular advancement was 8.2 ± 1.6 mm (mean ± standard deviation). This produced movement through a connection from the ramus of the mandible to the pharyngeal lateral walls in all subjects. In the sagittal plane, 2 patterns of posterior tongue deformation were seen with mandibular advancement—(A) bidirectional motion pattern in responders and (B) minimal anterior movement in non-responders. Baseline AHI (events/h) responders 19.7+/-8.3 non-responders 20.6+/-8.5 and AHI with MAS (events/h) responders 7.7+/-4.3 and non-responders 22.0+/-7.8
Mandibular advancement in responders has two mechanisms of action which increase airway size: forward movement of the tongue and lateral airway expansion. CBCT is useful in identifying upper airway form and size changes of MAD treatment.
Fig. 1 Example of responder patient
Fig. 2 Example of non-responder