Treatment of snoring and sleep apnea syndrome with a removable mandibular advancement device in patients without TMD

Abstract

Introduction: Among the sleep disorders reported by the American Academy of Sleep, the most common is obstructive sleep apnea-hypopnea syndrome (OSAHS), which is caused by difficulties in air passage and complete interruption of air flow in the airway. This syndrome is associated with increased morbidity and mortality in apneic individuals.Objective: It was the objective of this paper to evaluate a removable mandibular advancement device as it provides a noninvasive, straightforward treatment readily accepted by patients.Methods: In this study, 15 patients without temporomandibular disorders (TMD) and with excessive daytime sleepiness or snoring were evaluated. Data were collected by means of: Polysomnography before and after placement of an intraoral appliance, analysis of TMD signs and symptoms using a patient history questionnaire, muscle and TMJ palpation. Results:After treatment, the statistical analysis (t-test, and the "before and after" test) showed a mean reduction of 77.6% (p=0.001) in the apnea-hypopnea index, an increase in lowest oxyhemoglobin saturation (p=0.05), decrease in desaturation (p=0.05), decrease in micro-awakenings or EEG arousals (p=0.05) and highly significant improvement in daytime sleepiness (p=0.005), measured by the Epworth Sleepiness Scale. No TMD appeared during the monitoring period. Conclusion:The oral device developed in this study was considered effective for mild to moderate OSAHS.

Effectiveness of mandibular advancement appliances in treating obstructive sleep apnea syndrome: A systematic review

“…Similar results were obtained by Giannasi et al, 29,30 who also noted that adjustable MADs gave a greater reduction in daytime sleepiness and in snoring than the rigid appliances. Duarte et al 31 also observed the effectiveness of treating patients with adjustable MADs. In this case the device was inserted at a maximum protrusion of 60%, applying 0.5-to 1-mm increments every 2 weeks.…”

Efficacy of Oral Appliance for Mild, Moderate, and Severe Obstructive Sleep Apnea: A Meta‐analysis

“…After a full‐text review, 42 studies with 2265 patients of OA were included for Meta‐analysis. The included studies included 6 TRD, 14‐19 and 35 MAD 20‐54 literature. In addition, Barthlen et al 55 incorporated both TRD and MAD.…”