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Mandibular Advancement Appliance

Isil Aras, Aylin Pasaoglu, Sultan Olmez, Idil Unal, Aynur Aras
OBJECTIVES: Purpose of the present study was to determine and compare possible changes in the dimensions of the pharyngeal airway, morphology of the soft palate, and position of the tongue and hyoid bone after single-step or stepwise mandibular advancement using the Functional Mandibular Advancer (FMA). PATIENTS AND METHODS: The sample included 51 peak-pubertal Class II subjects. In all, 34 patients were allocated to two groups using matched randomization: a single-step mandibular advancement group (SSG) and a stepwise mandibular advancement group (SWG)...
October 21, 2016: Journal of Orofacial Orthopedics, Fortschritte der Kieferorthopädie
Simone Schulz, Bernd Koos, Kathrin Duske, Franka Stahl
OBJECTIVES: The purpose of this work was to employ both cephalometric and tensor analysis in characterizing the skeletal changes experienced by patients with Angle Class II/1 malocclusion during functional orthodontic treatment with the functional regulator type II. METHODS: A total of 23 patients with Class II/1 malocclusion based on lateral cephalograms obtained before and after treatment with the functional regulator type II were analyzed. Another 23 patients with Angle Class II/1 malocclusion who had not undergone treatment were included as controls...
October 17, 2016: Journal of Orofacial Orthopedics, Fortschritte der Kieferorthopädie
J Kostrzewa-Janicka, P Śliwiński, M Wojda, D Rolski, E Mierzwińska-Nastalska
A combination of abnormal anatomy and physiology of the upper airway can produce its repetitive narrowing during sleep, resulting in obstructive sleep apnea (OSA). Treatment of sleep-breathing disorder ranges from lifestyle modifications, upper airway surgery, continuous positive airway pressure (CPAP) to the use of oral appliances. A proper treatment selection should be preceded by thorough clinical and instrumental examinations. The type and number of specific oral appliances are still growing. The mandibular advancement appliance (MAA) is the most common type of a dental device in use today...
September 20, 2016: Advances in Experimental Medicine and Biology
Ghassan Idris, Barbara Galland, Christopher J Robertson, Mauro Farella
BACKGROUND: Sleep-Disordered Breathing (SDB) varies from habitual snoring to partial or complete obstruction of the upper airway and can be found in up to 10% of children. SDB can significantly affect children's wellbeing, as it can cause growth disorders, educational and behavioral problems, and even life-threatening conditions, such as cardiorespiratory failure. Adenotonsillectomy represents the primary treatment for pediatric SDB where adeno-tonsillar hypertrophy is indicated. For those with craniofacial anomalies, or for whom adenotonsillectomy or other treatment modalities have failed, or surgery is contra-indicated, mandibular advancement splints (MAS) may represent a viable treatment option...
2016: Frontiers in Physiology
Chloé Kastoer, Marijke Dieltjens, Eline Oorts, Evert Hamans, Marc J Braem, Paul H Van de Heyning, Olivier M Vanderveken
STUDY OBJECTIVES: To perform a review of the current evidence regarding the use of a remotely controlled mandibular positioner (RCMP) and to analyze the efficacy of RCMP as a predictive selection tool in the treatment of obstructive sleep apnea (OSA) with oral appliances that protrude the mandible (OAm), exclusively relying on single-night RCMP titration. METHODS: An extensive literature search is performed through, (CENTRAL only), Embase...
August 22, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
L Ivorra-Carbonell, J-M Montiel-Company, J-M Almerich-Silla, V Paredes-Gallardo, C Bellot-Arcís
BACKGROUND: Although many orthodontists have no doubts about the effectiveness of functional appliances for mandibular advancement, the impact on the temporomandibular joint (TMJ) is still in dispute. The objective of this systematic review is to examine the main effects on the TMJ of using functional appliances, both in healthy patients and in patients with a pre-existing disorder. MATERIAL AND METHODS: A systematic review of the literature was conducted in accordance with the PRISMA guidelines...
2016: Medicina Oral, Patología Oral y Cirugía Bucal
J Kostrzewa-Janicka, P Śliwiński, M Wojda, D Rolski, E Mierzwińska-Nastalska
A combination of abnormal anatomy and physiology of the upper airway can produce its repetitive narrowing during sleep, resulting in obstructive sleep apnea (OSA). Treatment of sleep-breathing disorder ranges from lifestyle modifications, upper airway surgery, continuous positive airway pressure (CPAP) to the use of oral appliances. A proper treatment selection should be preceded by thorough clinical and instrumental examinations. The type and number of specific oral appliances are still growing. The mandibular advancement appliance (MAA) is the most common type of a dental device in use today...
July 29, 2016: Advances in Experimental Medicine and Biology
Isil Aras, Aylin Pasaoglu, Sultan Olmez, Idil Unal, Ali Vehbi Tuncer, Aynur Aras
OBJECTIVE: To compare two groups of subjects at the peak of the pubertal growth period treated with the Functional Mandibular Advancer (FMA; Forestadent, Pforzheim, Germany) appliance using either single-step or stepwise mandibular advancement. MATERIALS AND METHODS: This study was conducted on 34 Class II Division 1 malocclusion subjects at or just before the peak phase of pubertal growth as assessed by hand-wrist radiographs. Subjects were assigned to two groups of mandibular advancement, using matched randomization...
July 1, 2016: Angle Orthodontist
Peilun Li, Jing Feng, Gang Shen, Ning Zhao
Class II malocclusion is a challenging anomaly in orthodontic practice. Various types of functional appliances are used to correct Class II skeletal and occlusal disharmonies in growing patients, including the Twin-block. We used a modified sagittal-guidance Twin-block appliance combined with a fixed appliance and microimplant anchorage to treat a 13-year-old Chinese boy with a severe skeletal Class II malocclusion and mandibular retrognathia. Normal overjet and a Class I molar relationship were achieved because of the advancement of mandibular development, the restriction of maxillary growth, and dentoalveolar modifications in both the maxilla and the mandible...
July 2016: American Journal of Orthodontics and Dentofacial Orthopedics
De-hong Li, Xiang-hong Yang, Jing Zhou, Ling-peng Zhang, Wen Shu
PURPOSE: To investigate the efficacy and mechanism of mandibular advancement device (MAD) treatment on obstructive sleep apnea syndrome (OSAS) patients. METHODS: Eighty OSAS patients treated with a mandibular protraction appliance were included in the study. Three-dimensional reconstruction technique was used as to measure the changes of upper airway structure and volume before and after MAD treatment. The data was analyzed using SPSS 17.0 software package. RESULTS: The anatomic structure and the reinforcement of soft tissue's collapse in the upper airway changed after application of MAD in OSAS patients; velopharyngeal and laryngopharynx configuration was significantly increased (P<0...
April 2016: Shanghai Kou Qiang Yi Xue, Shanghai Journal of Stomatology
Kaladhar Reddy Aileni, Madhukar Reddy Rachala, Sathu Reddy Dharmender, Vadla Rajesh, Battula Sandeep
Growing skeletal class II malocclusions with mandibular deficiency have been treated for more than a century with different types of functional appliances. Removable or fixed functional appliances are available to advance the mandible. Fixed functional appliances have the advantage of not requiring patient compliance. They can also be used concurrently with brackets. This article presents the case reports of successfully treated mild skeletal class II in late stages of puberty by using a Forsus fatigue resistance appliance along with custom made crimp...
2016: International Journal of Orthodontics
Jeffrey S Rouse
Conventional approaches to sleep dentistry concentrate on apneas/ hypopneas that cause periodic desaturations and fragmentations, a strategy that may be leading healthcare professionals to overlook many patients in dental practices with breathing-disturbed sleep. Recent studies have explored a new chronic "stress" paradigm rather than the apnea/hypopnea model to explain damage from sleep-breathing disorders and the progressive nature of this problem. This article will discuss the shortcomings of traditional approaches for dealing with obstructive sleep apnea and other sleep-breathing conditions and provide a protocol, which involved the autonomic nervous system trial, for improving control and management with mandibular advancement appliances...
May 2016: Compendium of Continuing Education in Dentistry
V Naga Keerthi, S Dhivya Kanya, K Pradeep Babu, Anoop Mathew, A Nanda Kumar
Early screening and diagnosis help in preventing and intercepting the severity of the malocclusion which helps in addressing the esthetic and functional concerns. Growth modulation such as mandibular advancement has been an effective procedure in orthodontics. Mandibular growth advancer (MGA) and PowerScope are gaining popularity recently as these are effective in achieving the mandibular advancement and ease of fabrication, placement, and wear. MGA was fabricated by making the upper and lower splints separately and are placed in the oral cavity by joining the two splints in the new construction bite using cold cure, MGA when worn during growth phase helps in condylar remodeling in the temporomandibular joint thus helps in advancement of the mandible...
April 2016: Journal of International Society of Preventive & Community Dentistry
G Van Haesendonck, M Dieltjens, E Hamans, M J Braem, O M Vanderveken
PURPOSE: This prospective clinical trial assessed the therapeutic outcomes of patients with obstructive sleep apnea (OSA) treated with a novel duobloc custom-made titratable mandibular advancement device (OAm). MATERIAL AND METHODS: The modular Somnomed G2® OAm (Somnomed Europe AG, Zurich, Switzerland) with 'click-to-fit' adjustability provides instant feedback on the mandibular advancement. 161 consecutive patients with established diagnoses of OSA. Dental impressions were made and a bite registration in 75% of the maximal protrusion being the starting protrusion...
2016: B-ENT
Parul Temani, Pradeep Jain, Pooja Rathee, Ruchira Temani
OBJECTIVE: Recent years have witnessed a renewed interest to determine a quantifiable relationship between mandibular advancement performed with an orthodontic appliance and the resulting airway volume. The study was conducted to evaluate the volumetric changes in pharyngeal airway space using cone-beam computed tomography (CBCT) in Class II division 1 patients with retrognathic mandible treated by Forsus-fixed functional appliance and to compare them with their pretreatment findings...
January 2016: Contemporary Clinical Dentistry
E Nordin, M Stenberg, Å Tegelberg
Over the past few decades, there has been a pronounced increase in the number of patients being treated by general dental practitioners for obstructive sleep apnoea (OSA). The purpose of this study was to survey the care and patient experiences and the self-reported effectiveness of OSA treatment with an oral appliance (OA) incorporating mandibular advancement. The design was a retrospective, cross-sectional study, with follow-up between 6 months to 1 year after commencement of treatment. A survey form was posted to 1150 subjects, identified in the regional register over a 1-year period as having been treated with an OA for OSA...
June 2016: Journal of Oral Rehabilitation
A-J Machado-Júnior, L-G Signorelli, E Zancanella, A-N Crespo
BACKGROUND: The current limited evidence may be suggestive that mandibular advancement appliance (MAAs) result in improvements in AHI scores, but it is not possible to conclude that MAAs are effective to treat paediatric OSA.There are significant weaknesses in the existing evidence due primarily to absence of control groups, small sample sizes, lack of randomization and short-term results. AIM: the objective of the present study was to evaluate MAAs in children with OSA...
2016: Medicina Oral, Patología Oral y Cirugía Bucal
E De Corso, G Bastanza, G Della Marca, C Grippaudo, G Rizzotto, M R Marchese, A Fiorita, B Sergi, D Meucci, W Di Nardo, G Paludetti, E Scarano
Nowadays oral appliance therapy is recognised as an effective therapy for many patients with primary snoring and mild to moderate obstructive sleep apnoea (OSA), as well as those with more severe OSA who cannot tolerate positive airway pressure (PAP) therapies. For this reason, it is important to focus on objective criteria to indicate which subjects may benefit from treatment with a mandibular advancement device (MAD). Various anthropometric and polysomnographic predictors have been described in the literature, whereas there are still controversies about the role of drug-induced sleep endoscopy (DISE) and advancement bimanual manoeuvre as predictor factors of treatment outcome by oral device...
December 2015: Acta Otorhinolaryngologica Italica
Kate Sutherland, Andrew S L Chan, Peter A Cistulli
PURPOSE: Mandibular advancement splints (MAS) are an effective treatment for obstructive sleep apnoea (OSA). However, MAS are not equally efficacious across all patients and the reasons are not well understood. Craniofacial and upper airway structure individually influence MAS response. We aimed to assess anatomical balance, defined as the ratio of upper airway soft tissue (ST) volume to maxillomandibular enclosure volume, between MAS treatment responders and non-responders. METHODS: OSA patients (apnoea-hypopnea index (AHI) >10 h(-1)) were recruited for MAS treatment...
September 2016: Sleep & Breathing, Schlaf & Atmung
K Gjerde, S Lehmann, M E Berge, A-K Johansson, A Johansson
The aim of this retrospective study was to evaluate the effect of individually adjusted custom-made mandibular advancement device/oral appliance (OA) in treatment of patients with moderate and severe obstructive sleep apnoea (OSA), who were non-adherent to continuous positive airway pressure (CPAP) therapy. During 2007-2013, 116 patients with moderate (n = 82) and severe (n = 34) OSA non-adherent to CPAP treatment were referred for dental management with an individually adjusted OA at a specialist sleep clinic...
April 2016: Journal of Oral Rehabilitation
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