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KMID : 0355220130380020203
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Journal of Korean Academy Oral Medicine
2013 Volume.38 No. 2 p.203 ~ p.213
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Treatment Outcome of Mandibular Advancement Device in Obstructive Sleep Apnea Patients- Polysomnographic and Cephalometric analyses
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Kim Sung-Hun
Kim E-Bee
Chung Jin-Woo
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Abstract
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Objecives : The purpose of the study was to evaluate treatment outcome of mandibular advancement device(MAD) in obstructive sleep apnea (OSA) patients using full night polysomnography and cephalometry. Methods : Twenty-seven OSA patients were confirmed by full night, lab-attended polysomnography. Cephalometric examinations were conducted to obtain SNA, ANB, AH⊥MP, AH-C3, SPT, PNS-U, NAS, SOAS, MOAS, and HAS. Mandibular advancement devices (MADs) were fabricated and delivered for all subjects. After acclimation period of MAD, the second polysomnographic examinations were conducted in the same manner. Polysomnographic variables were compared between before and after MAD placement. Also, correlation coefficients were calculated between apnea-hypopnea index (AHI) and each item of cephalometric parameters. Results : There were significant improvements in total AHI, lowest SpO2, and total arousal index after MAD therapy. Also, there were significant improvements in NREM SpO2 and NREM AHI, but not in REM SpO2 and REM AHI with MAD. Stratifying the sleep stage, there were significant decrease in stage I and significant increases in stage II and REM, but change in stage Ⅲ was not significant. SNA and SOAS were significantly correlated with total AHI and NAS was significantly correlated with supine AHI. ANB was significantly associate with the effect of MAD. Conclusions : MAD is an effective treatment in OSA patients comparing polysomnographic variables before and after treatment. Cephalometric examination can be useful to evaluate OSA patients and predict treatment outcome of MAD.
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KEYWORD
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Sleep apnea, Polysomnography, Cephalometry, Sleep stage, Mandibular advancement device
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