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Treatment Outcome of Mandibular Advancement Device in Obstructive Sleep Apnea Patients- Polysomnographic and Cephalometric analyses

수면무호흡증 환자에서 수면다원검사와 두부규격방사선사진을 이용한 하악전방이동장치의 치료효과에 관한 연구

  • Chung, Jin-Woo (Department of Oral Medicine and Oral Diagnosis School of Dentistry, Seoul National University) ;
  • Kim, Ebee (Department of Oral Medicine and Oral Diagnosis School of Dentistry, Seoul National University) ;
  • Kim, Sung-Hun (Department of Oral Medicine and Oral Diagnosis School of Dentistry, Seoul National University)
  • 김성헌 (서울대학교 치의학대학원 구강내과진단학교실) ;
  • 김이비 (서울대학교 치의학대학원 구강내과진단학교실) ;
  • 정진우 (서울대학교 치의학대학원 구강내과진단학교실)
  • Received : 2013.03.18
  • Accepted : 2013.04.15
  • Published : 2013.06.30

Abstract

Objecives : The purpose of the study was to evaluate treatment outcome of mandibular advancement device(MAD) in obstructive sleep apnea (OSA) patients using full night polysomnography and cephalometry. Methods : Twenty-seven OSA patients were confirmed by full night, lab-attended polysomnography. Cephalometric examinations were conducted to obtain SNA, ANB, $AH{\bot}MP$, AH-C3, SPT, PNS-U, NAS, SOAS, MOAS, and HAS. Mandibular advancement devices (MADs) were fabricated and delivered for all subjects. After acclimation period of MAD, the second polysomnographic examinations were conducted in the same manner. Polysomnographic variables were compared between before and after MAD placement. Also, correlation coefficients were calculated between apnea-hypopnea index (AHI) and each item of cephalometric parameters. Results : There were significant improvements in total AHI, lowest $SpO_2$, and total arousal index after MAD therapy. Also, there were significant improvements in NREM $SpO_2$ and NREM AHI, but not in REM $SpO_2$ and REM AHI with MAD. Stratifying the sleep stage, there were significant decrease in stage I and significant increases in stage II and REM, but change in stage III was not significant. SNA and SOAS were significantly correlated with total AHI and NAS was significantly correlated with supine AHI. ANB was significantly associate with the effect of MAD. Conclusions : MAD is an effective treatment in OSA patients comparing polysomnographic variables before and after treatment. Cephalometric examination can be useful to evaluate OSA patients and predict treatment outcome of MAD.

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