The influence of a mandibular advancement plate on polysomnography in different grades of obstructive sleep apnea

J Oral Maxillofac Res. 2015 Mar 30;6(1):e4. doi: 10.5037/jomr.2014.6104. eCollection Jan-Mar 2015.


Objectives: The purpose of this study was to investigate the effect of a mandibular advancement device on different grades of obstructive sleep apnea using a relatively simple test for the apnea-hypopnea index to determine if a mandibular device will be effective.

Material and methods: A total of 68 patients with obstructive sleep apnea syndrome (OSAS) including, 31 with mild, 23 with moderate and 14 with severe OSAS were treated with a mandibular advancement device (MAD) and monitored with polysomnography.

Results: 25 of the 31 mild, 15 of the 23 moderate and 2 of the 14 severe OSAS patients were cured of their OSAS if a post treatment apnea-hypopnea index of less than 5 is regarded as cured. The odds ratios for success with MAD therapy are 3 for women over men, 14.9 for mild obstructive sleep apnea, 5.42 for moderate obstructive sleep apnea if severe obstructive sleep apnea is assigned an odds ratio of 1.

Conclusions: The use of the apnea-hypopnea index alone is useful in mild and moderate disease to predict the effectiveness of mandibular advancement device. Treatment with a mandibular advancement device is very effective in treating mild and moderate obstructive sleep apnea. Conservative treatment with a mandibular advancement device can be successful in less severe grades of sleep apnea and may be an alternative for non-surgical patients with severe obstructive sleep apnea intolerant of Continuous Positive Airway Pressure management.

Keywords: appliances; mandible; obstructive sleep apnea; obstructive sleep apnea syndrome.