Abstract

Introduction: Although mandibular advancement devices (MADs) are utilized for the management of mild to moderate OSA, there are concerns about temporo-mandibular joint (TMJ) issues. Biomimetic oral appliance therapy (BOAT) differs from MADs as it aims to achieve midfacial redevelopment in combination with mandibular repositioning. In this study, we tested the hypothesis that mild to moderate cases of OSA can be addressed with combined maxillo-mandibular correction using BOAT. Methods: Nineteen adults diagnosed with mild to moderate OSA, following an overnight home sleep test (HST) that had been interpreted by a physician, participated in this study. Each subject was treated by a dentist with advanced training in dental sleep medicine. At each monthly follow-up, the devices were adjusted to optimize their efficacy. The mean apnea-hypopnea index (AHI), respiratory disturbance index (RDI) and oxygen desaturation index (ODI) of the study sample was calculated prior to and after BOAT. The findings were subjected to statistical tests. Results: Prior to treatment the mean AHI of the study subjects was 12.8hr-1 ± 5; the mean RDI was 18.6hr-1 ± 8.2, and the ODI was 6.3% ± 3.5. Follow-up HSTs after approximately 9 mos. indicated the mean AHI decreased significantly to 6.2hr-1 ± 2.9 after BOAT (p < 0.001), which represents a fall in the mean AHI by 51.5% for the study sample. The mean RDI fell to 12.3hr-1 ± 6.9 (p < 0.001), and the ODI was improved to 2.6% ± 1.7 (p < 0.001). Conclusions: This study suggests that combined maxillo-mandibular correction may be a useful method of managing mild to moderate cases of OSA in adults, and represents an alternative to MADs and continuous positive airway pressure therapy. However, further studies are needed to determine the additional advantages of combined maxillo-mandibular correction.

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