Therapeutic Efficacy of Twin‐Block and Fixed Oral Appliances in Patients with Obstructive Sleep Apnea Syndrome. Issue 2 (19th April 2017)

• Record Type: Journal Article
• Authors: Umemoto, George; Toyoshima, Hideo; Yamaguchi, Yuji; Aoyagi, Naoko; Yoshimura, Chikara; Funakoshi, Kouta
• Is Part Of: Journal of prosthodontics. Volume 28:Issue 2(2019)
• Page Start: e830
• Page End: e836
• Publication Date: 2017-04-19
• Subjects: Cephalometric variables -- fixed mandibular advancement splints -- polysomnographic variables -- twin‐block mandibular advancement splints; Prosthodontics -- Periodicals; Dental implants -- Periodicals; Dentistry -- Periodicals; 617.69
• DOI: 10.1111/jopr.12619
• Languages: English
• ISSNs: 1059-941X

Abstract

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.