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Mandibular advancement device in obstructive sleep apnea treatment: what happens to the condyle position and patient response?
Gurgel, Marcela Lima; Pereira, Rowdley Robert Rossi; Pereira, Amanda Barbosa; Fabbro, Cibele Dal; Kurita, Lucio Mitsuo; Ribeiro, Thyciana Rodrigues; Cevidanes, Lucia Helena Soares; Costa, Fabio Wildson Gurgel; Junior, Cauby Maia Chaves.
Afiliação
  • Gurgel ML; Department of Dental Clinic, School of Dentistry, Federal University of Ceará, 1273 Monsenhor Furtado St, Fortaleza, CE, Brazil.
  • Pereira RRR; Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
  • Pereira AB; Department of Pneumology, Division of Sleep Medicine and Biology, Federal University of Sao Paulo, Sao Paulo, Brazil.
  • Fabbro CD; Department of Dental Clinic, School of Dentistry, Federal University of Ceará, 1273 Monsenhor Furtado St, Fortaleza, CE, Brazil.
  • Kurita LM; Faculty of Dental Medicine, Center for Advance Research in Sleep Medicine & Stomatology, Universite de Montreal & CIUSSS Nord Ile de Montreal, CHUM, Montreal, QC, Canada.
  • Ribeiro TR; Department of Dental Clinic, School of Dentistry, Federal University of Ceará, 1273 Monsenhor Furtado St, Fortaleza, CE, Brazil.
  • Cevidanes LHS; Department of Dental Clinic, School of Dentistry, Federal University of Ceará, 1273 Monsenhor Furtado St, Fortaleza, CE, Brazil.
  • Costa FWG; Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
  • Junior CMC; Department of Dental Clinic, School of Dentistry, Federal University of Ceará, 1273 Monsenhor Furtado St, Fortaleza, CE, Brazil. fwildson@yahoo.com.br.
Sleep Breath ; 28(5): 2283-2294, 2024 Oct.
Article em En | MEDLINE | ID: mdl-39046657
ABSTRACT

BACKGROUND:

This study aims primarily to assess the mandibular condyles and patient response to MAD therapy using cone-beam computed tomography (CBCT). Also, the study proposes to analyze whether variations in condylar position, OSA severity and mandibular protrusion influence patient response.

METHODS:

23 patients diagnosed with mild/moderate OSA and treated with MAD comprised the sample. Clinical, CBCT, and PSG assessments were conducted at baseline and with MAD in therapeutic protrusion (4-6 months of MAD use). The condyle position was vertically and horizontally evaluated at baseline and at the therapeutic protrusion.

RESULTS:

The condyle position significantly changed with MAD, showing anterior (7.3 ± 2.8 mm; p < 0.001) and inferior (3.5 ± 1 mm; p < 0.001) displacement. Patients with mild OSA required more protrusion (p = 0.02) for improvement. Responders exhibited a significantly prominent (p = 0.04) anterior baseline condyle position. A negative modest correlation was found between treatment response and baseline condyle anterior position (p = 0.03; r=-0.4), as well as between OSA severity and the percentage of maximum protrusion needed for therapeutic protrusion (p = 0.02; r=-0.4). The patient protrusion amount did not predict condylar positional changes. Neither condyle position, OSA severity, nor therapeutic protrusion were predictors of MAD treatment response.

CONCLUSION:

MAD resulted in anterior and inferior condylar displacement, and the amount of protrusion did not predict condylar positional changes. Responders showed a more anterior baseline condyle position. OSA severity and mandibular protrusion did not predict treatment response.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Avanço Mandibular / Apneia Obstrutiva do Sono / Tomografia Computadorizada de Feixe Cônico / Côndilo Mandibular Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Sleep Breath Assunto da revista: NEUROLOGIA / OTORRINOLARINGOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Avanço Mandibular / Apneia Obstrutiva do Sono / Tomografia Computadorizada de Feixe Cônico / Côndilo Mandibular Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Sleep Breath Assunto da revista: NEUROLOGIA / OTORRINOLARINGOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha