Reasons for failure of mandible advancement splint in the treatment of obstructive sleep apnea
Peltomaa, Anni (2019-02-05)
Reasons for failure of mandible advancement splint in the treatment of obstructive sleep apnea
Peltomaa, Anni
(05.02.2019)
Julkaisu on tekijänoikeussäännösten alainen. Teosta voi lukea ja tulostaa henkilökohtaista käyttöä varten. Käyttö kaupallisiin tarkoituksiin on kielletty.
suljettu
Julkaisun pysyvä osoite on:
https://urn.fi/URN:NBN:fi-fe201903128621
https://urn.fi/URN:NBN:fi-fe201903128621
Tiivistelmä
The aim was to investigate possible association of certain background variables with poor adaption to mandible advancement splint (MAS) treatment. Secondary objective was to evaluate variables related to the length of the dental arch in MAS adaption.
The primary cohort consists of 397 patients diagnosed with obstructive sleep apnea at the Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital during the years 2006-2013 and who had unsuccessful MAS treatment. In total, 44 patients were included in this study. Data were collected on age, body mass index, gender, general and mental diseases, continuous positive airway (CPAP) tryout, usage of occlusal splint, dental overjet, temporomandibular disorders, shortened dental arch, sleep apnea severity, and apnea-hypopnea-index. Fifty-nine randomly selected patients with successful MAS treatment served as controls. The statistical significance between the differences of case and control groups were compared using student’s t-test and chi-square test.
A decreased (p=0.082) probability in adapting to MAS treatment with prior experience with CPAP therapy was found. Molars missing only in the upper dental arch was not a statistically significant (p=0.443) factor but combining both arches showed a tendency of predicting MAS failure (p=0.022). The result also suggests that MAS treatment is more likely to be successful on patients with prior experience with an occlusal splint (p=0.045).
Reasons for MAS failure are individual and no single reason can be pointed out. Our results confirm previous studies that there is no solid predictor of MAS success. Patients with CPAP tryout or occlusal splint usage prior to MAS treatment or missing molars especially in lower dental arch should be paid special attention to avoid failure of the treatment. Further studies including larger patient population are needed to evaluate the risk factors behind poor adaptation to MAS treatment in more detail.
The primary cohort consists of 397 patients diagnosed with obstructive sleep apnea at the Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital during the years 2006-2013 and who had unsuccessful MAS treatment. In total, 44 patients were included in this study. Data were collected on age, body mass index, gender, general and mental diseases, continuous positive airway (CPAP) tryout, usage of occlusal splint, dental overjet, temporomandibular disorders, shortened dental arch, sleep apnea severity, and apnea-hypopnea-index. Fifty-nine randomly selected patients with successful MAS treatment served as controls. The statistical significance between the differences of case and control groups were compared using student’s t-test and chi-square test.
A decreased (p=0.082) probability in adapting to MAS treatment with prior experience with CPAP therapy was found. Molars missing only in the upper dental arch was not a statistically significant (p=0.443) factor but combining both arches showed a tendency of predicting MAS failure (p=0.022). The result also suggests that MAS treatment is more likely to be successful on patients with prior experience with an occlusal splint (p=0.045).
Reasons for MAS failure are individual and no single reason can be pointed out. Our results confirm previous studies that there is no solid predictor of MAS success. Patients with CPAP tryout or occlusal splint usage prior to MAS treatment or missing molars especially in lower dental arch should be paid special attention to avoid failure of the treatment. Further studies including larger patient population are needed to evaluate the risk factors behind poor adaptation to MAS treatment in more detail.