The effect of mandibular advancement on upper airway structure in obstructive sleep apnoea

Abstract

BackgroundThe mechanisms by which mandibular advancement splints (MAS) improve obstructive sleep apnoea (OSA) are not well understood. This study aimed to evaluate the mechanism of action of MAS by assessing their effect on upper airway structure in patients with OSA. Methods Patients were recruited from a sleep disorders clinic for treatment with a custom-made MAS. MRI of the upper airway was performed during wakefulness in the supine position, with and without the MAS.

Efficiency of Mandibular Advancement Device and Bilevel Positive Airway Pressure Treatment for Severe Obstructive Sleep Apnea

“…Treatment success is commonly defined by a reduction in RDI to <5 or <10 in addition to a <50% reduction in baseline RDI. [5][6][7][8]17,18 The patient's RDI decreased from 62.7…”

“…1,3,5 With mandibular advancement device (MAD) treatment, the goal is to prevent the narrowing of the airway during sleep by positioning the mandible in a forward place. 6 When compared with other methods of treatment of OSA, oral appliances have advantages, such as being able to be better tolerated by patients, cheaper, simple, noninvasive, reversible, and reduced clinic hours. 3 Oral appliances are an alternative to CPAP for the treatment of OSA.…”

ETHNOS END OBSTRUCTIVE APNEA/HYPOPNEA SYNDROME (foreign literature review)

“…Несмотря на это, в Гонконге, Китае, Сингапуре, Японии, Таиланде, Филиппинах, Индии и Корее увеличены средства на коррекцию СОАГС [55]. Альтернативным методом умень-шения коллапса верхних дыхательных путей во время сна является применение внутриоральных аппликаторов, размещающихся во время сна в по-лости рта, для поддержания челюсти в переднем положении и механическом изменении структуры верхних дыхательных путей, в частности, за счет увеличения бокового нёбно-глоточного диаметра [56]. Показано, что такой метод улучшает клинику СОАГС у азиатов с краниофациальными аномали-ями до 37% случаев [57].…”

Treatment of sleep apnoea syndrome

“…Normalnim se smatra do 5 respiratornih događaja na sat spavanja (AHI 5). AHI 6-15 je blaga, 16-30 srednje teška, a preko 30 teška sleep apnea [1,[3][4][5][6][7][8][9]. Sleep apnea sindrom dovodi do povećane dnevne pospanosti koja se kvantitativno najbolje izražava preko internacionalne Epfortove skale pospanosti (ESS) [10].…”

“…Neinvazivna ventilacija (NIV) je zlatni standard u terapiji, i nju sprovode dominantno internisti-pulmolozi i pneumoftiziolozi. Stomatolozi-protetičari su uključeni u slučajevima kada specijalno konstruisane oralne aplikacije koje dokazano omogućavaju otvaranje disajnog puta u ždrelu, bivaju predložene na osnovu predhodne kliničke procene i odbijanja NIV tretmana od strane pacijenta [8]. Hirurške metode prevashodno su vezane za ORL intervencije na strukturama mekog nepca i usne duplje uz korekciju nosne prohodnosti [7].…”