Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Department of Oral Radiology & Digital Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Clin Oral Investig. 2023 Sep;27(9):5649-5660. doi: 10.1007/s00784-023-05186-w. Epub 2023 Aug 17.
To compare the effects of mandibular advancement device (MAD) therapy on upper airway dimensions between responders and non-responders with mild to moderate obstructive sleep apnea (OSA).
Thirty-one participants (21 men and 10 women) with a mean ± SD apnea-hypopnea index (AHI) of 16.6 ± 6.7 events/h, and aged 48.5 ± 13.9 years, were included in this study. Polysomnographic recordings and cone beam computed tomography (CBCT) scans in supine position were performed for every participant at baseline and at 3-month follow-up with their MAD in situ. Responders were defined as having ≥ 50% reduction in baseline AHI with a residual AHI < 10 events/h. The primary outcome variable was the minimal cross-sectional area of the upper airway (CSAmin).
No significant differences were found between responders (n = 15) and non-responders (n = 16) in age, gender distribution, body mass index, and neck circumference (P = 0.06-0.93), nor in AHI and CSAmin (P = 0.40 and 0.65, respectively) at baseline. The changes of the CSAmin with MAD in situ in the responder group were not significantly different compared to those in the non-responder group (P = 0.06).
Within the limitations of this study, we conclude that the changes of the upper airway dimensions induced by MADs are not significantly different between responders and non-responders with mild to moderate OSA.
ClinicalTrials.gov Identifier: NCT02724865. https://clinicaltrials.gov/ct2/show/NCT02724865.
比较下颌前移装置（MAD）治疗对轻中度阻塞性睡眠呼吸暂停（OSA）患者中应答者和无应答者的上气道尺寸的影响。
本研究纳入了 31 名参与者（21 名男性和 10 名女性），平均（±SD）呼吸暂停低通气指数（AHI）为 16.6±6.7 次/小时，年龄为 48.5±13.9 岁。每位参与者在基线和使用 MAD 后 3 个月的仰卧位时进行多导睡眠图记录和锥形束计算机断层扫描（CBCT）扫描。应答者定义为 AHI 较基线降低≥50%，残余 AHI<10 次/小时。主要观察变量为上气道最小横截面积（CSAmin）。
应答者（n=15）和无应答者（n=16）在年龄、性别分布、体重指数和颈围方面差异无统计学意义（P=0.06-0.93），基线时 AHI 和 CSAmin 也无差异（P=0.40 和 0.65）。与无应答者组相比，应答者组使用 MAD 时 CSAmin 的变化差异无统计学意义（P=0.06）。
在本研究的限制范围内，我们得出结论，MAD 引起的上气道尺寸变化在轻中度 OSA 的应答者和无应答者之间无显著差异。
ClinicalTrials.gov 标识符：NCT02724865。https://clinicaltrials.gov/ct2/show/NCT02724865。
