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下颌前移装置对轻中度阻塞性睡眠呼吸暂停低通气综合征患者口颌系统的影响。

Effect of mandibular advancement device on the stomatognathic system in patients with mild-to-moderate obstructive sleep apnoea-hypopnoea syndrome.

机构信息

Department of Stomatology, Kunming Yan'an Hospital, Kunming City, China.

出版信息

J Oral Rehabil. 2020 Jul;47(7):889-901. doi: 10.1111/joor.12982. Epub 2020 Jun 11.

Abstract

OBJECTIVE

This study was conducted to evaluate the changes of temporomandibular joints (TMJs) through magnetic resonance imaging (MRI) scanning and the electrical changes in mandibular movement and masticatory muscle surface of mild-to-moderate obstructive sleep apnoea-hypopnoea syndrome (OSAHS) patients before and after treatment with mandibular advancement device (MAD).

METHODS

This was a single-centre, prospective study recruiting OSAHS patients undergoing treatment with MAD in Department of Stomatology, Yannan Hospital, Kunming, China. Patients were recruited from February 2015 to October 2015, and TMJ changes were observed in MRI scanning before and after 18 months of treatment with MAD in cohort 1. The second cohort of the patients were recruited from January 2014 to September 2015 and electrical changes in mandibular movement and masticatory muscle surface of patients before and after 6 months of treatment with MAD.

RESULTS

In the cohort 1, TMJ changes analysed through MRI scanning, before and after 18-month treatment with MAD, there was no significant deviation in the angle of joint disc position. A minor change in the position relationship between condylar process, articular disc and articular fossa but not significant was observed. There was no significant difference in the shape and magnitude of mandibular incision edge movement, percussion movement, masticatory movement and condylar central trajectory among the recruited OSAHS patients, before and after 6 months of MAD treatment as analysed through electromyography.

CONCLUSION

In this study, from the results it was evident that the effect of MAD on the stomatognathic system of OSAHS patients is minimal.

摘要

目的

本研究旨在通过磁共振成像(MRI)扫描评估中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者使用下颌前伸装置(MAD)治疗前后颞下颌关节(TMJ)的变化以及下颌运动和咀嚼肌表面的电变化。

方法

这是一项在中国昆明延安医院口腔科进行的单中心前瞻性研究,招募了接受 MAD 治疗的 OSAHS 患者。患者于 2015 年 2 月至 2015 年 10 月招募,在队列 1 中观察 18 个月 MAD 治疗前后 TMJ 的 MRI 扫描变化。第二个队列的患者于 2014 年 1 月至 2015 年 9 月招募,观察 MAD 治疗前后 6 个月患者下颌运动和咀嚼肌表面的电变化。

结果

在队列 1 中,通过 MRI 扫描分析 TMJ 变化,在 MAD 治疗 18 个月前后,关节盘位置的角度没有明显偏差。髁突、关节盘和关节窝之间的位置关系有轻微变化,但不显著。招募的 OSAHS 患者在 MAD 治疗前后 6 个月的肌电图分析中,下颌切迹边缘运动、叩诊运动、咀嚼运动和髁突中心轨迹的形状和幅度没有显著差异。

结论

在这项研究中,结果表明 MAD 对 OSAHS 患者的口腔颌面部系统的影响很小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5725/7318685/3604c4c1ed96/JOOR-47-889-g001.jpg

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