Predicting compliance for mandible advancement splint therapy in 96 obstructive sleep apnea patients

The treatment of choice in obstructive sleep apnea (OSA) is continuous positive airway pressure (CPAP). Mandible advancement splint (MAS) offers an option for patients with mild or moderate OSA, who refuse or are unable to tolerate CPAP. The aim of the study was to find predictive factors in OSA for MAS therapy. The study group comprised 96 consecutive OSA patients who were sent for MAS therapy during 2008. Data were collected on the patients' general and dental condition, diagnosis, and treatment for OSA. Panoramic and cephalometric radiographs were analysed. The treatment compliance rate and problems with the use of the MAS were recorded. This rate was 57% and the significant affecting factors were protrusion of the mandible with MAS during the adaptation to the appliance as well as shorter maxillary and mandible lengths. The compliance of the MAS therapy was best in patients with short maxilla and mandible, which should be taken into consideration when planning MAS therapy for OSA patients. Finally, a sleep study should be part of the follow-up in this patient population.