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对比阻塞性睡眠呼吸暂停伴颞下颌关节紊乱患者使用单体式和分体式下颌前伸装置:对气道容积、多导睡眠图参数和嗜睡量表评分的影响。

Comparison of monoblock and twinblock mandibular advancement devices in patiens with obstructive sleep apnea and temporomandibular disorder: effects on airway volume, polysomnography parameters, and sleepiness scale scores.

机构信息

Antera Dental Clinic, Antalya, Turkey.

Department of Prosthodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey.

出版信息

BMC Oral Health. 2024 Aug 30;24(1):1026. doi: 10.1186/s12903-024-04653-4.

Abstract

PURPOSE

This study aimed to compare the effects of two different mandibular advancement devices on the upper airway volume, polysomnographic parameters, and sleepiness scale scores in patients with obstructive sleep apnea and Temporomandibular disorders (TMD).

MATERIALS AND METHODS

Monoblock and twinblock mandibular advancement devices were applied to patients with obstructive sleep apnea syndrome for 3 months separated by a wash-out period of 2 weeks. Research Diagnostic Criteria for TMD (RDC/TMD), Polysomnographic parameters and cone-beam computed tomography findings were recorded before and after the use of the mandibular advancement devices. A three-dimensional analysis of the airway was then performed.

RESULTS

The use of the monoblock device significantly increased the upper airway volume compared with the use of the twinblock device (p = 0.032). The polysomnographic parameters similarly improved with the use of the twin-block and monoblock devices. The significant reduction in TMD symptoms was observed.

CONCLUSION

The use of the monoblock device increased the retropalatal airway volume. This volume increase may be attributed to the fact that the design of the monoblock device allows less mandibular movement than does that of the twinblock device. Indicates the potential benefits of MAD treatment in alleviating TMD-related issues.

CLINICAL SIGNIFICANCE

Monoblock MADs have improved effects on respiratory parameters and upper airway dimensions in patients with OSA and mild to moderate TMD.

摘要

目的

本研究旨在比较两种不同的下颌前伸装置对上气道容积、多导睡眠图参数和阻塞性睡眠呼吸暂停伴颞下颌关节紊乱病(TMD)患者嗜睡量表评分的影响。

材料和方法

将单块式和双板式下颌前伸装置分别应用于阻塞性睡眠呼吸暂停综合征患者,间隔 2 周洗脱期。使用下颌前伸装置前后记录研究诊断标准为 TMD(RDC/TMD)、多导睡眠图参数和锥形束 CT 发现。然后对上气道进行三维分析。

结果

与使用双板式装置相比,使用单块式装置可显著增加上气道容积(p=0.032)。使用双板式和单块式装置同样改善了多导睡眠图参数。TMD 症状显著减轻。

结论

使用单块式装置增加了腭后气道容积。这种容积的增加可能是由于单块式装置的设计允许下颌运动小于双板式装置。表明 MAD 治疗在缓解 TMD 相关问题方面具有潜在的益处。

临床意义

单块式 MAD 对上气道呼吸参数和尺寸的改善作用优于阻塞性睡眠呼吸暂停伴轻中度 TMD 的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9906/11365127/18ca85e090fd/12903_2024_4653_Fig1_HTML.jpg

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