Plastic Mandibular Advancement Oral Appliances For The Treatment Of Obstructive Sleep Apnea Syndrome

Objective: Oral mandibular advancement appliances are becoming an increasingly important alternative for obstructive sleep apnea(OS A) .To assess the efficacy of mandibular advancement prosthesis (OA) for treating obstructive sleep apnea syndrome (OSAS) on 41 cases and analyze the relevant factors of the OA therapy. Methods:Mandibular advancement appliances were employed for 41 patients (39 men and 2 women) with OSAS .The diagnosis was established by polysomnography in this study. Mean age was 44.17?0.76years (range 24-64years) ,BMI was 28.44?.76kg/m2 (range 23.88-35.92), and the apnea-hypopnea index (AHI) was 39.6 ?29.21. If the device was well tolerated, regardless of clinical response, polysomnography was repeated between 3 to 6 months after treating. The device was considered effective if the AHI decreased to < 10/h and the symptoms related to OSAS disappeared. Meantime, utilized a kind of TMJ(Temporary mandibular joint) Questionnare to investigate the effect of this therapeutic method on TMJ before and after the period of treatment. In addition, employed Epworth sleep scale (ESS) to evaluate the virtue of the oral appliances. Then enumerate all of the data with the noted statistical software SPSS 11.0. And Establish a control experiment group with the treatment of nCPAP (Nasal-Continuous Positive Airway Pressure) on 47 cases. Results: Two patients withdrew from the treating only after a few weeks. The remaining 41 patients (95.3%) tolerated the treatment well and the second polysomnogram was performed. In 26 of the 41 (63.41%), the device proved effective for correcting OSAS. In seven more patients, the AHI decreased but failed tobecome normal. In the remaining eight patients, no improvement was observed. Improvement in the AHI was unrelated to the severity of OSAS. But in the control group, it showed that the nCPAP is more effective to the severity patients. The efficiency of Oral appliances has no statistical significance vs. nCPAP on mild-moderate obstructive sleep apnea. Conclusion: The mandibular advancement prosthesis is effective for some patients with mild or moderate OSAS, even including those in whom the AHI is high. Larger studies are still needed to allow us to define which type of patients that might benefit. The oral appliances helped to widen the upper airway, stabilized the lower jaw bone on a forward position to make the tongue and the mandible move forward, increased the effective amount of inhaled air while sleeping and improved sleeping quality. It is an effective method for the treatment of mild and moderate OSAS.