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A pilot study of quantitative assessment of mandible advancement using pressure–flow relationship during midazolam sedation
Author(s) -
AYUSE T.,
HOSHINO Y.,
INAZAWA T.,
OI K.,
SCHNEIDER H.,
SCHWARTZ A. R.
Publication year - 2006
Publication title -
journal of oral rehabilitation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.991
H-Index - 93
eISSN - 1365-2842
pISSN - 0305-182X
DOI - 10.1111/j.1365-2842.2006.01627b.x
Subject(s) - midazolam , occlusion , sedation , mandible (arthropod mouthpart) , medicine , airway , anesthesia , continuous positive airway pressure , intravenous sedation , orthodontics , dentistry , surgery , obstructive sleep apnea , botany , biology , genus
summary It has been proposed that a titration of the mandibular positioner would be a promising method for predicting the outcome of nasal continuous positive airway pressure (CPAP) therapy. This study was carried out to test the hypothesis that mandible advancement could be evaluated by analysis of inspiratory flow limitation using a titration procedure. To explore its effect, we examined upper airway pressure–flow relationships using a titrated mandible positioner during midazolam sedation. Non‐flow limited inspiration occurred when the mandible was advanced 7·1 ± 1·2 mm from centric occlusion position. In the centric occlusion position (0 mm advancement), Pcrit was −1·9 ± 2·9 cmH 2 O and Rua was 23·3 ± 4·5 cmH 2 O L −1 s −1 . In the eMAP position, Pcrit was −7·3 ± 1·9 cmH 2 O and Rua was 27·8 ± 3·3 cmH 2 O L −1 s −1 . Essentially no CPAP was required to overcome flow limitation in eMAP position, whereas 3·7 ± 2·2 cmH 2 O CPAP was required in centric occlusion position. We conclude that assessing inspiratory flow limitation using a titrated mandible positioner was effective for estimating individual‐matched mandible positions.