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. 2023 May-Jun;13(3):392-397.
doi: 10.1016/j.jobcr.2023.03.014. Epub 2023 Apr 13.

A computed tomographic evaluation of effect of mandibular advancement device at two different horizontal jaw positions in patients with obstructive sleep apnea

Pooran Chand  1 , Neeti Solanki  1 , Balendra Pratap Singh  1 , Sunit Kumar Jurel  1 , Surya Kant  2 , Pranjali Dutt  1
Affiliations

A computed tomographic evaluation of effect of mandibular advancement device at two different horizontal jaw positions in patients with obstructive sleep apnea

Pooran Chand et al. J Oral Biol Craniofac Res. 2023 May-Jun.

Erratum in

Abstract

Statement of problem: Studies pertaining to the objective assessments of the efficacy of mandibular advancement device in patients with obstructive sleep apnea are scarce.

Purpose: The purpose of this clinical study was to evaluate the effect of MAD at two different horizontal positions of mandible on upper airway dimensions through computed tomography.

Material and methods: Twenty-nine consenting participants satisfying predetermined inclusion and exclusion criteria were enrolled and an adjustable two-piece MAD was fabricated at 50% maximum mandibular protrusion and after 4 weeks was adjusted to 70% protrusion. CT scans were obtained at baseline, 4 weeks after delivering MAD with 50% mandibular protrusion, and then after 4 weeks with 70% mandibular protrusion. Cross sectional area with diameters (lateral and anteroposterior) of upper airway was measured at three specific anatomic levels (retropalatal-RP, retroglossal-RG, and epiglottal-EG). Data were analyzed using the Student t-test for parametric analysis.

Results: Intragroup comparison revealed a statistically significant increase in lateral & anteroposterior dimensions as well as cross sectional area at all three anatomical levels at 4 weeks after MAD with 50% mandibular protrusion compared with baseline and 4 weeks after MAD with 70% mandibular protrusion compared with baseline. However, the difference between lateral and anteroposterior dimensions with MAD at 70% protrusion compared with MAD at 50% protrusion was not statistically significant. The difference between cross-sectional area was found to be statistically significant.

Conclusion: Mandibular advancement device at 70% mandibular protrusion is more effective compared with the device at 50% protrusion in relieving oropharyngeal obstruction seen in OSA.

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Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
Pharyngeal anteroposterior dimensions at retropalatal, retroglossal and epiglottal levels measured at baseline, 4 weeks after MAD at 50% protrusion, and 4 weeks after MAD at 70% protrusion.
Fig. 2
Fig. 2
Pharyngeal lateral dimensions at retropalatal, retroglossal and epiglottal levels measured at baseline, 4 weeks after MAD at 50% protrusion, and 4 weeks after MAD at 70% protrusion.
Fig. 3
Fig. 3
Pharyngeal cross-sectional dimensions at retropalatal, retroglossal and epiglottal levels measured at baseline, 4 weeks after MAD at 50% protrusion, and 4 weeks after MAD at 70% protrusion.
See this image and copyright information in PMC

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