Summary Background Tongue plays an important part in oral and maxillofacial system. Measurement of tongue pressure helps to evaluate the performance of tongue movement. Objectives To establish a system for measuring tongue pressure against hard palate and to preliminarily explore pressure distribution of individual normal occlusions and the relationship with dental arch form. Methods A total of 19 volunteers of individual normal occlusions out of 189 dental students met inclusion criteria (nine males, ten females, aged 25.53 ± 0.96 years). A force‐sensing resistor device was used to measure tongue pressure at rest and functional state (swallowing). We observed tongue pressure of four channel (anterior, posterior and lateral sides of hard palate) in sitting, supine position and swallowing. We analysed pressure differences according to gender and explored correlation relationship between tongue pressure and dental arch width and length using 3D digital maxillary image. Results In rest, tongue pressure against hard palate increased from front to back in both sitting and supine position, without gender differences. When swallowing saliva, the pressure at lateral sides of females was found significantly higher than that of males. Bivariate correlation analysis revealed duration of swallowing was positively correlated with BMI and weight at posterior region and positively correlated with palatal length at anterior palate. The greater the dental arch width, the smaller the pressure of swallowing in the anterior and lateral region. Conclusion In rest, there was consistent pressure of tongue against hard palate. The pressure increased significantly during swallowing, especially in females. Tongue pressure was related to dental arch length, width, BMI and weight.
Background: Mandibular advancement device (MAD) is a good alternative for patients with obstructive sleep apnea (OSA). However, the treatment response varies amongst individuals.Objective: This study aimed to explore the role of craniofacial features in the response to MADs to improve prognostication and patient selection. Methods:The retrospective trial contained 42 males aged 41.5 ± 9.0 years, and with an apnea-hypopnea index (AHI) of 21.5 ± 13.8 events/h. According to the mandibular plane angle, participants were divided into three groups: low angle (n = 13), average angle (n = 14) and high angle (n = 15). Under the monitoring of home sleep testing, adjustable MADs were used to titrate the mandible forward from 0 mm with an increment of 0.5 mm every day. The polysomnography outcomes, mandibular protrusion amounts, changes in upper airway MRI measurements and nasal resistance were compared amongst the three groups. Results:The normalisation rate (AHI <5 /h) was 92.3%, 57.1% and 46.7%, respectively, in the low-, average-and high-angle groups (p = .027). The effective protrusion where AHI was reduced by half was 20 (11.3 ~ 37.5) %, 31.3 (23.6 ~ 50) % and 50 (36.9 ~ 64.9) % of the maximal mandibular protrusion, in the low-, average-and high-angle groups (p = .004). Multivariate logistic regression revealed that increased gonion angle (OR = 0.878) and baseline AHI(OR = 0.868) can reduce the probability of normalisation. Conclusion:The high mandibular plane angle might be an unfavourable factor to MAD treatment and more protrusion was needed to achieve a 50% reduction in AHI.Vertical craniofacial pattern (gonion angle) and baseline AHI constituted the model for predicting the effect of MADs.
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