CC BY 4.0 · Eur J Dent
DOI: 10.1055/s-0041-1735933
Original Article

Effectiveness of a Uniquely Designed Oral Appliance on Obstructive Sleep Apnea Control: A Pilot Study

1   Division of Surgical Sciences, Department of Otorhinolaryngology, School of Medical Sciences, University of Campinas, UNICAMP, São Paulo, Brazil
,
2   Sleep Unit, Centro Cardiovascular da Universidade de Lisboa, Lisbon School of Medicine, Lisbon, Portugal
3   Research Laboratory on the Neuroimmune Interface of Pain São Leopoldo Mandic College, Campinas, São Paulo, Brazil
,
4   ESALQ, University of Sao Paolo, Piracicaba, São Paulo, Brazil
,
1   Division of Surgical Sciences, Department of Otorhinolaryngology, School of Medical Sciences, University of Campinas, UNICAMP, São Paulo, Brazil
,
5   Department of Odontology, FOP – UNICAMP, Piracicaba, São Paulo, Brazil
,
1   Division of Surgical Sciences, Department of Otorhinolaryngology, School of Medical Sciences, University of Campinas, UNICAMP, São Paulo, Brazil
› Author Affiliations
Funding None.

Abstract

Objectives Obstructive sleep apnea is an inflammatory, chronic, and evolutive disease often needing adequate treatment and follow-up. The oral appliance (OA) is an accepted alternative therapy for obstructive sleep apnea (OSA) control. Due to greater adherence, OA with mandibular advancement (OAm) is being recommended treatment for patients who refuse or do not tolerate continuous positive airway pressure. The mode of action of OAm is to promote the advancement of the mandible or tongue with a subsequent increase in the tone of the pharyngeal muscles and the permeability of the upper airway, but most OAm use conventional models as reference, analogic, or digital, dissociating dental arches of the skull structures.

Materials and Methods A retrospective longitudinal study of 33 OSA patient treated with a different OAm, that use Camper plane as reference with skull structures for dental arches disocclusion, where polysomnographic, cephalometric measures, and subjective data from questionnaires pre- and post-treatment were assessed and correlated. Descriptive analysis, correlated Chi-square tests, and basic statistics were used. Generalized linear mixed model for repeated measure and post hoc Tukey–Kramer test compares the variables pre- and post-treatment. Shapiro–Wilk test and Pearson's correlation coefficients were used. All statistical tests were set in 5% level of significance.

Results Regarding polysomnography data, there was a significant association between apnea hypopnea index (AHI) with oxygen saturation, arousal index (AI) and the maximum heartbeats, and sleep improvement and health risk reduction. Additionally, from cephalometric data, it was found a significant association between the tongue posture with the soft palate, hioyd-C3 and, lower and posterior airway. When both parameters are correlated, there are a significant dependent association with hyoid bone position with AHI and AI. The limitation of this study was the two-dimensional image used without provide volumetric measurements, but this limitation was reduced with the follow-up polysomnography parameters.

Conclusion In this pilot study, DIORS OAm as an uniquely designed device using Camper plane as a reference for disocclusion was effective in the control of OSA.



Publication History

Article published online:
18 February 2022

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