Department of Prosthodontics, Saraswati Dental College & Hospital, Lucknow, Uttar Pradesh, India.
Postgraduate Studies & Research, Saraswati Dental College & Hospital, Lucknow, Uttar Pradesh, India.
J Prosthodont. 2019 Feb;28(2):e837-e842. doi: 10.1111/jopr.12628. Epub 2018 Feb 22.
To record the incidence of cognitive dysfunction in edentulous patients suffering from obstructive sleep apnea (OSA) and establish a plausible hypothesis to explain the correlation of cognitive dysfunction and OSA.
In this study, 315 edentulous patients (aged 60 to 65 years) visiting the outpatient department at Saraswati Dental College, Lucknow were recruited from January 2013 to October 2015. Prosthodontic Diagnostic Index (PDI) classification was used to assess the intraoral condition to relate it with the span of edentulousness. The BERLIN questionnaire and Epworth Sleepiness Scales were used to diagnose sleep-disordered breathing, following which the patients were put through all-night polysomnography. The apnea-hypopnea index (AHI) scores were derived. Mild and moderate OSA patients were classified into mild, moderate, and severe cognitive dysfunction based on SGRQ-C and SCD. Data were tabulated according to a new classification (Cognitive Dysfunction of Dental Sleep Medicine Patients [CDDSMP] Classification) designed specifically for this study. Data were analyzed using SPSS v15.0. Scores were tabulated as mean ± SD and median [IQR] values. Change from baseline was analyzed using Wilcoxon signed rank test.
Mean scores at different time intervals were 3.03 ± 1.76 (3 months), 2.98 ± 1.80 (6 months), and 2.81 ± 1.84 (9 months). The median [IQR] values of scores at all time intervals except 9 months were 3 [1 to 5]. At 9 months, median [IQR] was 2 [1 to 5]. A significant change in scores was observed in the 3-month interval (p ≤ 0.001).
The severity of OSA and neurocognitive dysfunction could be directly related to the PDI classification and the span of edentulousness of the patient and modified mandibular advancement device treatment significantly improved the patients' condition, which was reflective from 3 months post-intervention itself.
记录患有阻塞性睡眠呼吸暂停（OSA）的无牙患者认知功能障碍的发生率，并建立一个合理的假设来解释认知功能障碍与 OSA 的相关性。
本研究纳入了 2013 年 1 月至 2015 年 10 月期间在勒克瑙萨拉斯瓦蒂牙科学院门诊部就诊的 315 名无牙患者（年龄 60-65 岁）。使用修复诊断指数（PDI）分类评估口腔状况，并将其与无牙间隙的长度相关联。使用 BERLIN 问卷和 Epworth 嗜睡量表诊断睡眠呼吸障碍，然后对患者进行整夜多导睡眠图检查。得出呼吸暂停低通气指数（AHI）评分。根据 SGRQ-C 和 SCD 将轻度和中度 OSA 患者分为轻度、中度和重度认知功能障碍。根据本研究专门设计的新分类（牙科睡眠医学患者认知功能障碍[CDDSMP]分类）对数据进行制表。使用 SPSS v15.0 进行数据分析。评分以均值±标准差和中位数[IQR]值表示。使用 Wilcoxon 符号秩检验分析从基线开始的变化。
不同时间间隔的平均评分分别为 3.03±1.76（3 个月）、2.98±1.80（6 个月）和 2.81±1.84（9 个月）。除 9 个月外，所有时间间隔的中位数[IQR]值均为 3[1 至 5]。在 9 个月时，中位数[IQR]为 2[1 至 5]。3 个月间隔的评分有显著变化（p≤0.001）。
OSA 的严重程度和神经认知功能障碍可能与 PDI 分类和患者无牙间隙的长度直接相关，改良的下颌前伸装置治疗可显著改善患者的病情，从干预后 3 个月开始即可反映出这一点。
