Vertical Displacement with Increased Mandibular Advancement-Comparisons between Two Oral Appliances for Sleep Apnea
Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
Obstructive sleep apnea (OSA) is a chronic condition that is increasing in prevalence around the world as a result of overweight and obesity epidemics. In mild and moderate OSA, an oral appliance (OA) is an effective treatment alternative. This appliance holds the mandible forward and downwards during sleep in order to increase the upper airway dimension and reduce snoring and sleep apneas. More advancement increases the efficacy of the device. A large vertical opening of the mandible may reduce the cross sectional area of the velopharynx and reduce the positive effects on sleep apneas and decrease comfort. The aim of the present study was to test the hypothesis that the vertical opening changes with an increase in mandibular advancement and that the change differed between one type of OA (OA1) compared with another type of OA (OA2). The vertical opening in the appliances was measured in the two positions, using a digital sliding calliper. The two mandibular positions in each device were measured twice on separate occasions in a random order. The opening changed a median of 0.09 mm (IQR 0.02 to 0.16 mm) with OA2 (p=0.002) and 0.04 mm (IQR -0.04 to 0.12 mm) with OA1 (p=0.38), with no difference in change between them (p=0.14). In conclusion, this pilot study indicates that there is no clinically significant change in opening with increased advancement and also no difference between devices and therefore no indications to change the designs of the two investigated devices.
Place, publisher, year, edition, pages
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:umu:diva-113651OAI: oai:DiVA.org:umu-113651DiVA: diva2:886310