Krishnamurthy Preetha, Maheswari Uma, Mohamed Kasim
Past- Postgraduate, Dept. of Prosthodontics and Crown & Bridge, Sri Ramchandra Institute of Higher Education and Research, Sriher, India.
Dept. of Prosthodontics and Crown & Bridge, Sri Ramchandra Institute of Higher Education & Research, Sriher, India.
J Dent (Shiraz). 2023 Dec 1;24(4):382-388. doi: 10.30476/dentjods.2022.95716.1886. eCollection 2023 Dec.
The common causes of obstructive sleep apnea (OSA) are identified as anatomic and/or functional abnormality in the oral cavity, oropharynx, velopharynx, and hypopharynx leading to compromised airway space and increased collapsibility.
This study was conducted to evaluate the effect of implant-supported mandibular complete denture in improving the airway space among completely edentulous patients with OSA and compare it with conventional complete denture.
In this observational study, completely edentulous individuals were screened with snoring, tiredness, observed apnea, high blood pressure, body mass index, age, neck circumference, and gender (STOP-Bang) questionnaire to evaluate the incidence of OSA. Ten mild-moderate patients were included as study participants. Lateral cephalograms (L1) made at the edentulous state was considered baseline. They were rehabilitated with complete denture prosthesis. One week after denture insertion, two implants were placed in the edentulous mandibular arch. Delayed loading protocol was followed. Lateral cephalogram (L2) was made 6 months after complete denture insertion and 6 months after implant-supported prosthesis (L3). Cephalometric tracings were used to evaluate change in upper airway space (UAS), middle airway space (MAS), and lower airway space (LAS). Repeated measures ANOVA was used to evaluate statistical significance in the airway measurements made at the three intervals. Post hoc Tukey HSD and Bonferroni test were used to assess if the differences obtained were truly significant.
Statistical analysis revealed significant differences in UAS, MAS and LAS between L1, L2 and L3 (< 0.05). Post hoc Tukey HSD indicated that UAS increased significantly at all three intervals followed by LAS and MAS respectively (α=.05). Post hoc Bon-ferroni test indicated that implant-supported mandibular complete dentures had a significant improvement in airway space when compared to conventional complete dentures (α=.05).
Implant-supported mandibular complete denture could be effective in edentulous patients with mild-moderate OSA.
阻塞性睡眠呼吸暂停（OSA）的常见原因被确定为口腔、口咽、腭咽和下咽的解剖和/或功能异常，导致气道空间受损和可塌陷性增加。
本研究旨在评估种植体支持的下颌全口义齿对改善OSA全口无牙患者气道空间的效果，并将其与传统全口义齿进行比较。
在这项观察性研究中，通过打鼾、疲劳、观察到的呼吸暂停、高血压、体重指数、年龄、颈围和性别（STOP-Bang）问卷对全口无牙个体进行筛查，以评估OSA的发生率。纳入10名轻度至中度患者作为研究参与者。无牙状态下拍摄的头颅侧位片（L1）被视为基线。他们用全口义齿修复。义齿插入一周后，在下颌无牙弓植入两颗种植体。采用延迟加载方案。在全口义齿插入后6个月和种植体支持的义齿修复后6个月拍摄头颅侧位片（L3）。使用头影测量描记法评估上气道空间（UAS）、中气道空间（MAS）和下气道空间（LAS）的变化。采用重复测量方差分析评估在三个时间点进行的气道测量的统计学意义。使用事后Tukey HSD和Bonferroni检验评估所获得的差异是否真的具有显著性。
统计分析显示L1、L2和L3之间的UAS、MAS和LAS存在显著差异（<0.05）。事后Tukey HSD表明，UAS在所有三个时间点均显著增加，其次是LAS和MAS（α=0.05）。事后Bonferroni检验表明，与传统全口义齿相比，种植体支持的下颌全口义齿在气道空间方面有显著改善（α=0.05）。
种植体支持的下颌全口义齿对轻度至中度OSA的无牙患者可能有效。
