Masticatory Function and Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan.
Department of General Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan.
Int J Environ Res Public Health. 2022 May 31;19(11):6714. doi: 10.3390/ijerph19116714.
This study aimed to analyze the efficacy of maxillary oral appliance (MOA) designs on respiratory variables during sleep. At baseline, 23 participants underwent a sleep test with a portable device for two nights and were categorized as participants with mild obstructive sleep apnea (mild-OSA) (n = 13) and without OSA (w/o-OSA) (n = 10). Three types of MOAs, standard-OA (S-OA), palatal covering-OA (PC-OA), and vertically increasing-OA (VI-OA), were each worn for three nights, and sleep tests with each MOA were performed with a portable device for two nights. Based on the average of the respiratory event index (REI) values for the two nights for each MOA, w/o-OSA participants with an REI ≥ 5.0 were defined as the exacerbation group and those with an REI < 5.0 as the non-exacerbation group. In mild-OSA participants, an REI ≥ 15.0 or REI ≥ baseline REI × 1.5 were defined as the exacerbation group and those with an REI < 15.0 and REI < baseline REI × 1.5 were defined as the non-exacerbation group. The percentage of the exacerbation and non-exacerbation groups with MOA was evaluated in the w/o-OSA and mild-OSA participants. The maxillary and mandibular dental-arch dimension was compared by dentition model analysis. The exacerbation group in w/o-OSA participants (n = 10) comprised 10.0% participants (n = 1) with S-OA, 40.0% (n = 4) with PC-OA, and 30.0% (n = 3) with VI-OA. The exacerbation group in the mild-OSA participants (n = 13) comprised 15.4% subjects (n = 2) with S-OA, 23.1% (n = 3) with PC-OA, and 23.1% (n = 3) in VI-OA. In the model analysis for w/o-OSA, the posterior dental arch width was significantly greater in the exacerbation group than in the non-exacerbation group wearing S-OA (p < 0.05). In addition, the ratio of the maxillary to mandibular dental arch width (anterior dental arch width) was significantly greater in the exacerbation group than in the non-exacerbation group for both PC-OA and VI-OA (p < 0.05). In mild-OSA, the maxillary and mandibular dental arch lengths and the ratio of maxillary to mandibular dental arch width (posterior dental arch width) were significantly smaller in the exacerbation group than in the non-exacerbation group for S-OA (p < 0.05). This study confirmed that wearing an MOA by w/o-OSA and mild-OSA participants may increase the REI during sleep and that PC-OA and VI-OA may increase the REI more than S-OA. The maxillary and mandibular dental-arch dimensions may affect the REI when using an MOA.
本研究旨在分析上颌口腔矫治器（MOA）设计在睡眠期间对呼吸变量的疗效。在基线时，23 名参与者进行了两次夜间便携式设备睡眠测试，并分为轻度阻塞性睡眠呼吸暂停（mild-OSA）（n=13）和无 OSA（w/o-OSA）（n=10）参与者。三种类型的 MOA，标准-OA（S-OA）、腭覆盖-OA（PC-OA）和垂直增宽-OA（VI-OA），分别佩戴三个晚上，并使用便携式设备进行两次夜间睡眠测试。基于每个 MOA的两个晚上的呼吸事件指数（REI）值的平均值，w/o-OSA 中 REI≥5.0 的参与者被定义为加重组，REI<5.0 的参与者被定义为非加重组。在轻度 OSA 参与者中，REI≥15.0 或 REI≥基线 REI×1.5 被定义为加重组，REI<15.0 和 REI<基线 REI×1.5 的参与者被定义为非加重组。评估 w/o-OSA 和轻度 OSA 参与者中 MOA 的加重和非加重组的比例。通过牙列模型分析比较上颌和下颌牙弓尺寸。w/o-OSA 参与者中的加重组（n=10）包括 10.0%（n=1）的 S-OA 参与者、40.0%（n=4）的 PC-OA 参与者和 30.0%（n=3）的 VI-OA 参与者。轻度 OSA 参与者中的加重组（n=13）包括 15.4%的 S-OA 参与者（n=2）、23.1%的 PC-OA 参与者（n=3）和 23.1%的 VI-OA 参与者（n=3）。在 w/o-OSA 的模型分析中，加重组佩戴 S-OA 时后牙弓宽度明显大于非加重组（p<0.05）。此外，加重组佩戴 PC-OA 和 VI-OA 时上颌与下颌牙弓宽度（前牙弓宽度）的比例明显大于非加重组（p<0.05）。在轻度 OSA 中，加重组的上颌和下颌牙弓长度以及上颌与下颌牙弓宽度（后牙弓宽度）的比例明显小于非加重组的 S-OA（p<0.05）。本研究证实，w/o-OSA 和轻度 OSA 参与者佩戴 MOA 可能会增加睡眠期间的 REI，而 PC-OA 和 VI-OA 可能会比 S-OA 增加更多的 REI。上颌和下颌牙弓尺寸可能会影响使用 MOA 时的 REI。
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