[Intra-oral therapy of borderline sleep-related respiratory disorders with a modified protrusion-fixation of the mandible]

Abstract

Background: Aim of this study was the investigation of the efficacy and acceptance by mechanic-prosthetic mandibular protrusion for patients with mild to moderate OSAS.

Methods and patients: During interdisciplinary teamwork between pneumology (sleep medicine) and dentistry we studied the change in the apnoea-index (AI) of 21 unselected patients treated with a modified oral appliance according to Lyon using less protrusion of the mandible and individual occlusion of the jaws. All patients were asked to rate their complaint-score using the oral appliance.

Results: 21 patients--aged 55.03 +/- 9.71 years; body mass index (BMI) 28.6 +/- 2.4 kg/m2 (mean value +/- SD)--had an improvement of apnoea-index (1/h) high significant (p < 0.0005). (Al before therapy 15.25 +/- 6.6; Al with therapy 6.07 +/- 3.7). Using a validated ambulatory respiratory evaluation device we saw an improvement in the Al of 57% +/- 19% during the estimated sleeptime of 6 h 12 min +/- 30 min. After a wearing-time of about 6 months the low complaint-score of the patients verified the high acceptance and efficacy of the modified oral appliance.

Conclusion: The modified oral appliance of Lyon can improve disease severity, life- and sleep-quality of patients with mild to moderate OSAS. Engaged teamwork of sleep medicine and dentistry is necessary to take care of a very individual and carefully fixation and occlusion of the mandible, resulting a continuing compliance and efficacy for the patients.