ORIGINAL SCIENTIFIC PAPER (IZVORNI ZNANSTVENI ČLANAK)
Tea Galic1,2, Tina Poklepovic Pericic1,3, Ivan Galic4, Zoran Dogas2,5, Frane Mihanovic6
1 Department of Prosthodontics, Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
2 Department of Neuroscience, University of Split School of Medicine, Split, Croatia
3 Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia
4 Private Dental Office, Split, Croatia
5 Sleep Medicine Center, University of Split School of Medicine, Split Croatia
6 Department of Health Sciences University of Split, Split, Croatia
Address for correspondence:
Assoc Professor Tea Galić, DMD, PhD
Department of Prosthodontics
University of Split School of Medicine
Šoltanska 2, 21000 Split, Croatia
Phone: +385 21 557 905
Fax: +385 21 557 955
Study objectives: The main objectives of this study were to assess the effect of mandibular advancement device (MAD) therapy on the upper airway morphology, as well as the occurence of dental and skeletal side effects following 1-year MAD therapy in patients with mild to moderate obstructive sleep apnea (OSA).
Methods: In this study we included 15 patients with mild to moderate OSA treated with MAD therapy. All subjects underwent sleep study and lateral cephalometric radiography at baseline and at 1-year follow-up. Lateral cephalograms were analyzed with respect to relevant variables.
Results: MAD therapy reduced apnea-hypopnea index (AHI) from 22.9±5.9 to 9.7±4.5 events/h (P<0.001) after 1-year of therapy. Oral area enclosure (3697.0±372.4 vs. 3381.5±336.4 mm2, P<0.001), superior airway space width (8.9±2.0 vs. 10.0±2.0 mm2, P=0.039), soft palate width (10.9±1.0 vs. 9.8±1.4, P=0.005) and length (45.4±3.8 vs. 43.9±4.2 mm, P=0.033) were significantly larger with the MAD intra-orally. Additionally, the tongue length decreased (84.1±5.3 vs. 80.7±5.9 mm, P=0.002), while the tongue height increased significantly (27.0±2.4 vs. 29.9±2.5 mm, P=0.003) with the MAD intra-orally. There were no significant changes in skeletal and dental cephalometric variables after 1 year of MAD therapy.
Conclusions: Our results show significant enlargement of the upper airway dimensions with the MAD intra-orally in patients with mild to moderate OSA. Although there were no significant changes in skeletal and dental cephalometric variables after 1 year of MAD therapy, close follow-up during MAD therapy is advisable to prevent potentially relevant occlusal changes.
Keywords: obstructive sleep apnea, mandibular advancement device, lateral cephalometry, side effects, upper airway