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Mandibular Advancement Appliance

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https://www.readbyqxmd.com/read/28738372/advances-in-oral-appliances-for-obstructive-sleep-apnea
#1
Ofer Jacobowitz
Oral appliances that advance the mandible are widely used as alternatives to positive airway pressure (PAP) devices or as primary therapy for obstructive sleep apnea (OSA) in adults. Although PAP is more efficacious at lowering the polysomnographic indices of OSA, the clinical effectiveness of PAP and oral appliances is similar, and patients are more likely to adhere to oral appliance therapy than to PAP treatment. Clinical examination is used to determine the candidacy of oral appliances and to select a particular appliance for a given patient...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738322/pediatric-obstructive-sleep-apnea-where-do-we-stand
#2
Yu-Shu Huang, Christian Guilleminault
Pediatric obstructive sleep apnea (OSA) was initially described in 1976. In 1981, Dr. Guilleminault emphasized that pediatric OSA was different from the clinical presentation reported in adults. It was characterized by more disturbed nocturnal sleep than excessive daytime sleepiness, and presented more behavioral problems, particularly school problems, hyperactivity, nocturnal enuresis, sleep terrors, depression, insomnia, and psychiatric problems. The underlying causes of pediatric OSA are complex. Such factors as adenotonsillar hypertrophy, obesity, anatomical and neuromuscular factors, and hypotonic neuromuscular disease are also involved...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28721528/soft-tissue-profile-changes-after-functional-mandibular-advancer-or-herbst-appliance-treatment-in-class-ii-patients
#3
Jan Hourfar, Jörg Alexander Lisson, Ulrich Gross, Linda Frye, Gero Stefan Michael Kinzinger
OBJECTIVE: The objective of the present study is to compare the effects on soft tissue profile in class II patients after treatment with either "Functional Mandibular Advancer" (FMA) or Herbst appliance. MATERIALS AND METHODS: The study included n = 42 patients treated with either FMA (n = 21) or Herbst appliance (n = 21) by the same experienced orthodontist. The treatment followed a single-step advancement protocol. Lateral cephalograms were analyzed through a set of customized measurements...
July 18, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/28714534/adjustable-thermoplastic-oral-appliance-versus-positive-airway-pressure-for-obstructive-sleep-apnea
#4
Wish Banhiran, Paraya Assanasen, Cherdchai Nopmaneejumrudlers, Nongyoaw Nujchanart, Wimontip Srechareon, Cheerasook Chongkolwatana, Choakchai Metheetrairut
OBJECTIVES/HYPOTHESIS: To compare outcomes of continuous positive airway pressure (CPAP) and the adjustable thermoplastic mandibular advancement splint (AT-MAS) for obstructive sleep apnea treatment. STUDY DESIGN: Randomized crossover, noninferiority, tertiary center setting. METHODS: Fifty patients with a mean age of 49.5 ± 10.6 years were enrolled. Inclusion criteria were age ≥18 years, apnea-hypopnea index (AHI) ≥5 events/hour, and oxygen saturation ≥70%...
July 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28695399/the-long-term-effects-of-mandibular-advancement-splint-on-cardiovascular-fitness-and-psychomotor-performance-in-patients-with-mild-to-moderate-obstructive-sleep-apnea-a-prospective-study
#5
Ashutosh Gupta, Arvind Tripathi, Piyush Sharma
BACKGROUND: Obstructive sleep apnea (OSA) manifests as a reduction or complete cessation of airflow despite an ongoing inspiratory effort, leading to hypoxemia and hypercapnia. The inability to maintain normal breathing reduces the oxygen saturation in blood leading to a cycle of various systemic implications. Hence, a prospective single arm study was planned to evaluate the long-term (2 years) effect of oral appliance on cardiovascular fitness and psychomotor performance in patients with mild to moderate obstructive sleep apnea...
July 10, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28643930/moving-towards-precision-orthodontics-an-evolving-paradigm-shift-in-the-planning-and-delivery-of-customized-orthodontic-therapy
#6
REVIEW
A H Jheon, S Oberoi, R C Solem, S Kapila
Advances in precision medicine portend similar progress in orthodontics and will be increasingly harnessed to achieve customized treatment approaches and enhance treatment efficiencies. Our goal is to provide a background on emerging advances in computer technologies and biomedicine and highlight their current and likely future applications to precision orthodontics. A review of orthodontically relevant technologies and advances in pertinent biological research was undertaken. Innovations in computer hardware and software, and 3D imaging technologies offer the ability for customized treatment and biomechanical planning that will be more fully realized within the next few decades...
June 2017: Orthodontics & Craniofacial Research
https://www.readbyqxmd.com/read/28578372/mandibular-advancement-devices-vs-nasal-continuous-positive-airway-pressure-in-the-treatment-of-obstructive-sleep-apnoea-systematic-review-and-meta-analysis
#7
G Cammaroto, C Galletti, F Galletti, B Galletti, C Galletti, C Gay-Escoda
BACKGROUND: Obstructive sleep apnoea (OSA) is a common disorder that may affect at least 2 to 4% of the adult population. Nasal-Continuous Positive Airway Pressure (N-CPAP) is today considered the gold standard for the treatment of OSA. The development of oral appliances (OAs) represents a new approach for the management of this pathology. The aim of this systematic review is to compare the efficacy of OAs and N-CPAP in the treatment of patients with mild to severe OSA. MATERIAL AND METHODS: A PubMed-MEDLINE and Cochrane databases search of articles published between 1982 and 2016 comparing the effect of N-CPAP and OAs in OSA patients was conducted during July 2016...
July 1, 2017: Medicina Oral, Patología Oral y Cirugía Bucal
https://www.readbyqxmd.com/read/28554462/treatment-of-class-ii-malocclusion-with-mandibular-skeletal-anchorage
#8
Ezgi Cakir, Siddik Malkoç, Mustafa Kirtay
INTRODUCTION: The aim of this case report was to present the dentofacial changes obtained with bone anchorage in a Class II patient with moderate to severe crowding. METHODS: A boy, aged 14.5 years, with a dolichofacial type, convex profile, and skeletal and dental Class II relationships was examined. After evaluation, functional treatment with bone anchorage and 4 first premolar extractions was decided as the treatment approach. Miniplates were placed on the buccal shelves of the mandibular third molars...
June 2017: American Journal of Orthodontics and Dentofacial Orthopedics
https://www.readbyqxmd.com/read/28473927/influence-of-oral-appliances-for-mandibular-advancement-on-dentitions-using-a-strain-gauge-analysis-a-pilot-study
#9
Hiroshi Ueda, Yu Matsumura, Atsushi Horihata, Cynthia Concepcion, Koji Iwai, Kotaro Tanimoto
Introduction. This study aimed to evaluate the influence of oral appliances (OAs) on dentition using a strain gauge analysis. Materials/Methods. Eight volunteers, who were mild snorers, participated in this study. OAs were individually constructed, and advancement was defined as two-thirds of the maximum mandibular advancement. Strain gauges were mounted on the right first molar and central incisor of both the upper and lower arches. After OA use, two measurement sessions (short- and long-term) were performed...
2017: Sleep Disorders
https://www.readbyqxmd.com/read/28457272/three-dimensional-upper-airway-changes-with-mandibular-advancement-device-in-patients-with-obstructive-sleep-apnea
#10
Chandrakant Shivkumar Shete, Wasundhara Ashok Bhad
INTRODUCTION: A mandibular advancement device effectively increases upper airway size in patients with obstructive sleep apnea. Three-dimensional volumetric upper airway changes, exact amounts of change in obstructed upper airways (smallest cross-sectional area), and anteroposterior and transverse changes with mandibular advancement devices are not clear. METHODS: Thirty-seven patients with obstructive sleep apnea diagnosed with polysomnography were evaluated with the subjective Epworth sleepiness scale, percentage of oxygen saturation, and cone-beam computed tomography...
May 2017: American Journal of Orthodontics and Dentofacial Orthopedics
https://www.readbyqxmd.com/read/28422345/therapeutic-efficacy-of-twin-block-and-fixed-oral-appliances-in-patients-with-obstructive-sleep-apnea-syndrome
#11
George Umemoto, Hideo Toyoshima, Yuji Yamaguchi, Naoko Aoyagi, Chikara Yoshimura, Kouta Funakoshi
PURPOSE: To compare the efficacy of twin-block (i.e., allows mouth opening) and fixed (i.e., maintains mouth closure) mandibular advancement splints (MASs) for the treatment of obstructive sleep apnea-hypopnea syndrome (OSA). MATERIALS AND METHODS: From 2011 to 2013, 23 patients with OSA in the twin-block group, and from 2013 to 2015, 29 patients in the fixed MAS group were included. All patients underwent polysomnography before and after 3 months of treatment. The two sets of polysomnographic and cephalometric variables were compared...
April 19, 2017: Journal of Prosthodontics: Official Journal of the American College of Prosthodontists
https://www.readbyqxmd.com/read/28407779/histologic-effects-of-mandibular-protrusion-splints-in-antigen-induced-tmj-arthritis-in-rabbits
#12
Julia von Bremen, Kernt Köhler, Krystyna Siudak, Daniel Zahner, Sabine Ruf
BACKGROUND: Although it is common clinical practice to treat children with Juvenile Idiopathic Arthritis (JIA) with functional appliances, the scientific evidence for this is limited. The aim of this study was to study the histologic effects of mandibular protrusion splints in temporomandibular joint (TMJ) arthritis in rabbits. METHODS: Twenty-eight ten-week old New Zealand white rabbits were randomly divided into four groups: AO (TMJ arthritis, no splint), AS (TMJ arthritis, mandibular splint advancement), OS (no arthritis, mandibular splint advancement) and OO (no arthritis, no splint)...
April 13, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28365810/a-retrospective-cephalometric-investigation-of-two-fixed-functional-orthodontic-appliances-in-class-ii-treatment-functional-mandibular-advancer-vs-herbst-appliance
#13
Gero Stefan Michael Kinzinger, Jörg Alexander Lisson, Linda Frye, Ulrich Gross, Jan Hourfar
OBJECTIVE: The objective of the study is to compare skeletal and dental changes in class II patients treated with fixed functional appliances (FFA) that pursue different biomechanical concepts: (1) FMA (Functional Mandibular Advancer) from first maxillary molar to first mandibular molar through inclined planes and (2) Herbst appliance from first maxillary molar to lower first bicuspid through a rod-and-tube mechanism. MATERIALS AND METHODS: Forty-two equally distributed patients were treated with FMA (21) and Herbst appliance (21), following a single-step advancement protocol...
April 1, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/28343736/three-dimensional-facial-changes-correlated-with-sagittal-jaw-movements-in-patients-with-class-iii-skeletal-deformities
#14
M Verdenik, N Ihan Hren
The aim of this prospective study was to correlate the postoperative 3-dimensional facial changes in skeletal class III deformity with sagittal jaw movements in 84 patients who had been treated by one piece Le Fort I maxillary advancement only (n=18), mandibular setback only (n=38), or both procedures (n=28). At the times of evaluation before and six months after operation all patients had fixed orthodontic appliances. Soft tissue changes were evaluated on optical 3-dimensional scans, while lateral cephalograms were superimposed to assess sagittal jaw movements...
March 23, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28294380/oral-appliance-therapy-versus-nasal-continuous-positive-airway-pressure-in-obstructive-sleep-apnoea-syndrome-a-randomised-placebo-controlled-trial-on-self-reported-symptoms-of-common-sleep-disorders-and-sleep-related-problems
#15
M Nikolopoulou, A Byraki, J Ahlberg, M W Heymans, H L Hamburger, J De Lange, F Lobbezoo, G Aarab
Obstructive sleep apnoea syndrome (OSAS) is associated with several sleep disorders and sleep-related problems. Therefore, the aim of this study was to compare the effects of a mandibular advancement device (MAD) with those of nasal continuous positive airway pressure (nCPAP) on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. In this randomised placebo-controlled trial, sixty-four OSAS patients (52·0 ± 9·6 years) were randomly assigned to an MAD, nCPAP or an intra-oral placebo appliance in a parallel design...
June 2017: Journal of Oral Rehabilitation
https://www.readbyqxmd.com/read/28228337/minimizing-the-mandibular-advancement-in-an-oral-appliance-for-the-treatment-of-obstructive-sleep-apnea
#16
Eduardo Anitua, Joaquín Durán-Cantolla, Gabriela Zamora Almeida, Mohammad Hamdan Alkhraisat
OBJECTIVE: In the treatment of obstructive sleep apnea (OSA) with an oral appliance (OA), there is no gold standard method to fine-tune the mandibular advancement. This study aimed to analyze the effect of gradual increment of mandibular advancement on the evolution of the apnea-hypopnea index (AHI). METHODS: OSA patients were recruited from a sleep unit. All treatments started with an oral appliance without mandibular advancement. After two weeks, the AHI was assessed with respiratory polygraphy...
January 29, 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28121165/mode-of-correction-is-related-to-treatment-timing-in-class-ii-patients-treated-with-the-mandibular-advancement-locking-unit-malu-appliance
#17
Muhsin Candir, Heidi Kerosuo
OBJECTIVE: To investigate the proportion of skeletal/dentoalveolar components for correction of Class II malocclusion in relation to the pubertal growth peak (PGP) among patients treated with the mandibular advancement locking unit (MALU) appliance. MATERIALS AND METHODS: We conducted a retrospective study of 27 orthodontic patients (age range: 12-18 years; mean age 14.9 years) with skeletal Class II Division 1 malocclusion who were treated with the MALU appliance until they reached Class I occlusion with overjet and overbite within normal range...
May 2017: Angle Orthodontist
https://www.readbyqxmd.com/read/27932405/dentoskeletal-effects-of-oral-appliance-wear-in-obstructive-sleep-apnoea-and-snoring-patients
#18
Giulio Alessandri-Bonetti, Vincenzo D'Antò, Chiara Stipa, Roberto Rongo, Serena Incerti-Parenti, Ambrosina Michelotti
OBJECTIVES: To evaluate the dentoskeletal changes associated with long-term and continuous mandibular advancement device (MAD) use in sleep-related breathing disorder patients. METHODS: Cephalometric measurements and three-dimensional model analysis were performed at baseline and after 3.5 ± 1.1 years in 20 snoring and obstructive sleep apnoea patients treated with the Silensor® appliance. Intra-group differences were compared using paired t-test or Wilcoxon signed-rank test...
December 8, 2016: European Journal of Orthodontics
https://www.readbyqxmd.com/read/27884081/a-randomized-cross-over-study-comparing-the-efficacy-of-two-mandibular-advancement-appliances-in-the-treatment-of-mild-moderate-obstructive-sleep-apnea
#19
Ayman Al-Dharrab
OBJECTIVE: To compare efficacy, side effects, patient compliance, and preference between two types of custom-made mandibular advancement appliances (MAAs) in the treatment of patients with mild to moderate obstructive sleep apnea (OSA). METHODOLOGY: This prospective, randomized, crossover study of 12 patients with mild to moderate OSA compared a titratable and a non-titratable MAA. Each patient was fitted with both appliances in a random order with a washout period of two weeks...
November 24, 2016: Cranio: the Journal of Craniomandibular Practice
https://www.readbyqxmd.com/read/27871709/cephalometric-study-of-class-ii-division-1-patients-treated-with-an-extended-duration-reinforced-banded-herbst-appliance-followed-by-fixed-appliances
#20
Travis Tomblyn, Michael Rogers, Lee Andrews, Chris Martin, Timothy Tremont, Erdogan Gunel, Peter Ngan
INTRODUCTION: The Herbst appliance has been used in the treatment of Class II malocclusions with deficient mandibles. Various protocols, including different durations of the orthopedic treatment phase and stepwise advancement of the mandible, have been advocated for increasing the orthopedic effects. The objective of this study was to investigate the skeletal and dental changes in patients treated with a reinforced banded Herbst appliance for an extended duration and fixed appliance therapy...
November 2016: American Journal of Orthodontics and Dentofacial Orthopedics
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