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Therapeutic Efficacy of Twin‐Block and Fixed Oral Appliances in Patients with Obstructive Sleep Apnea Syndrome
Author(s) -
Umemoto George,
Toyoshima Hideo,
Yamaguchi Yuji,
Aoyagi Naoko,
Yoshimura Chikara,
Funakoshi Kouta
Publication year - 2019
Publication title -
journal of prosthodontics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.902
H-Index - 60
eISSN - 1532-849X
pISSN - 1059-941X
DOI - 10.1111/jopr.12619
Subject(s) - obstructive sleep apnea , overjet , medicine , polysomnography , hypopnea , body mass index , anesthesia , apnea , dentistry , malocclusion
Abstract 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. Results A significant difference ( p < 0.001) was observed in the apnea–hypopnea index before and after MAS treatment in both groups (twin‐block group: 20.6 ± 11.5 vs. 14.7 ± 9.4; fixed group: 21.4 ± 15.2 vs. 11.2 ± 9.7). In the twin‐block group, 5 patients (21.7%) were complete responders, 9 (39.1%) were fair responders, and 9 (39.1%) were nonresponders; the corresponding figures for the fixed group were 14 (48.3%), 9 (31.0%), and 6 (20.7%) patients. A significant between‐group difference was observed in the distribution of responders ( p = 0.046). The fixed group showed a significant improvement in the snoring index ( p = 0.003), arousal index ( p = 0.036), and desaturation rate ( p = 0.012). Finally, the change in incisal overjet was larger in the fixed group than in the twin‐block group ( p < 0.001). Conclusions These results suggest that fixed oral appliances are superior in treating OSA, based on their ability to prevent mouth opening and reduce incisal overjet.