Treatment of obstructive sleep apnea using a custom-made titratable duobloc oral appliance: a prospective clinical study
Identifieur interne : 002F08 ( Main/Exploration ); précédent : 002F07; suivant : 002F09Treatment of obstructive sleep apnea using a custom-made titratable duobloc oral appliance: a prospective clinical study
Auteurs : M. Dieltjens [Belgique] ; O. M. Vanderveken [Belgique] ; E. Hamans [Belgique] ; J. A. Verbraecken [Belgique] ; K. Wouters ; M. Willemen ; W. A. De Backer ; P. H. Van De Heyning [Belgique] ; M. J. Braem [Belgique]Source :
- Sleep & Breathing = Schlaf & Atmung [ 1520-9512 ] ; 2012.
Abstract
This prospective clinical study investigates the efficacy of a specific custom-made titratable mandibular advancement device (MAD) for the treatment of obstructive sleep apnea (OSA). This MAD has attachments in the frontal teeth area that allow for progressive titration of the mandible.
Sixty-one adult OSA patients were included (age, 46.7 ± 9.0 years; male/female ratio, 45/16; apnea–hypopnea index (AHI), 23.2 ± 15.4 events/h sleep; body mass index, 27.9 ± 4.1 kg/m²). After an adaptation period, titration started based on a protocol of symptomatic benefit or upon reaching the physiological limits of protrusion. As a primary outcome, treatment response was defined as an objective reduction in AHI following MAD treatment of ≥50 % compared to baseline, and treatment success as a reduction in AHI with MAD to less than 5 and 10 events/h sleep. Compliance failure was defined as an inability to continue treatment.
A statistically significant decrease was observed in AHI, from 23.4 ± 15.7 at baseline to 8.9 ± 8.6 events/h with MAD (
The present study has evaluated the efficacy of a specific custom-made titratable MAD in terms of sleep apnea reduction.
Url:
DOI: 10.1007/s11325-012-0721-3
PubMed: 22581485
PubMed Central: 3655219
Affiliations:
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Wouters</name><affiliation><nlm:aff id="Aff5">Department of Scientific Coordination and Biostatistics, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation></author><author><name sortKey="Willemen, M" sort="Willemen, M" uniqKey="Willemen M" first="M." last="Willemen">M. Willemen</name><affiliation><nlm:aff id="Aff3">Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation></author><author><name sortKey="De Backer, W A" sort="De Backer, W A" uniqKey="De Backer W" first="W. A." last="De Backer">W. A. De Backer</name><affiliation><nlm:aff id="Aff3">Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff4">Department of Pulmonary Medicine, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation></author><author><name sortKey="Van De Heyning, P H" sort="Van De Heyning, P H" uniqKey="Van De Heyning P" first="P. H." last="Van De Heyning">P. H. Van De Heyning</name><affiliation><nlm:aff id="Aff2">ENT Department and Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff3">Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation><affiliation wicri:level="4"><nlm:aff id="Aff6">Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><orgName type="university">Université d'Anvers</orgName><country>Belgique</country><placeName><settlement type="city">Anvers</settlement><region>Région flamande</region><region type="district" nuts="2">Province d'Anvers</region></placeName></affiliation></author><author><name sortKey="Braem, M J" sort="Braem, M J" uniqKey="Braem M" first="M. 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Braem</name><affiliation><nlm:aff id="Aff1">Department of Special Care Dentistry, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation><affiliation wicri:level="4"><nlm:aff id="Aff6">Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><orgName type="university">Université d'Anvers</orgName><country>Belgique</country><placeName><settlement type="city">Anvers</settlement><region>Région flamande</region><region type="district" nuts="2">Province d'Anvers</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">22581485</idno><idno type="pmc">3655219</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655219</idno><idno type="RBID">PMC:3655219</idno><idno type="doi">10.1007/s11325-012-0721-3</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">000D71</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000D71</idno><idno type="wicri:Area/Pmc/Curation">000D71</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000D71</idno><idno type="wicri:Area/Pmc/Checkpoint">001C17</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001C17</idno><idno type="wicri:Area/Ncbi/Merge">003E34</idno><idno type="wicri:Area/Ncbi/Curation">003E34</idno><idno type="wicri:Area/Ncbi/Checkpoint">003E34</idno><idno type="wicri:doubleKey">1520-9512:2012:Dieltjens M:treatment:of:obstructive</idno><idno type="wicri:Area/Main/Merge">002F23</idno><idno type="wicri:Area/Main/Curation">002F08</idno><idno type="wicri:Area/Main/Exploration">002F08</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Treatment of obstructive sleep apnea using a custom-made titratable duobloc oral appliance: a prospective clinical study</title><author><name sortKey="Dieltjens, M" sort="Dieltjens, M" uniqKey="Dieltjens M" first="M." last="Dieltjens">M. Dieltjens</name><affiliation><nlm:aff id="Aff1">Department of Special Care Dentistry, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff2">ENT Department and Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation><affiliation wicri:level="4"><nlm:aff id="Aff6">Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><orgName type="university">Université d'Anvers</orgName><country>Belgique</country><placeName><settlement type="city">Anvers</settlement><region>Région flamande</region><region type="district" nuts="2">Province d'Anvers</region></placeName></affiliation></author><author><name sortKey="Vanderveken, O M" sort="Vanderveken, O M" uniqKey="Vanderveken O" first="O. M." last="Vanderveken">O. M. Vanderveken</name><affiliation><nlm:aff id="Aff2">ENT Department and Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff3">Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation><affiliation wicri:level="4"><nlm:aff id="Aff6">Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><orgName type="university">Université d'Anvers</orgName><country>Belgique</country><placeName><settlement type="city">Anvers</settlement><region>Région flamande</region><region type="district" nuts="2">Province d'Anvers</region></placeName></affiliation></author><author><name sortKey="Hamans, E" sort="Hamans, E" uniqKey="Hamans E" first="E." last="Hamans">E. Hamans</name><affiliation><nlm:aff id="Aff2">ENT Department and Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation><affiliation wicri:level="4"><nlm:aff id="Aff6">Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><orgName type="university">Université d'Anvers</orgName><country>Belgique</country><placeName><settlement type="city">Anvers</settlement><region>Région flamande</region><region type="district" nuts="2">Province d'Anvers</region></placeName></affiliation></author><author><name sortKey="Verbraecken, J A" sort="Verbraecken, J A" uniqKey="Verbraecken J" first="J. A." last="Verbraecken">J. A. Verbraecken</name><affiliation><nlm:aff id="Aff3">Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff4">Department of Pulmonary Medicine, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation><affiliation wicri:level="4"><nlm:aff id="Aff6">Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><orgName type="university">Université d'Anvers</orgName><country>Belgique</country><placeName><settlement type="city">Anvers</settlement><region>Région flamande</region><region type="district" nuts="2">Province d'Anvers</region></placeName></affiliation></author><author><name sortKey="Wouters, K" sort="Wouters, K" uniqKey="Wouters K" first="K." last="Wouters">K. Wouters</name><affiliation><nlm:aff id="Aff5">Department of Scientific Coordination and Biostatistics, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation></author><author><name sortKey="Willemen, M" sort="Willemen, M" uniqKey="Willemen M" first="M." last="Willemen">M. Willemen</name><affiliation><nlm:aff id="Aff3">Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation></author><author><name sortKey="De Backer, W A" sort="De Backer, W A" uniqKey="De Backer W" first="W. A." last="De Backer">W. A. De Backer</name><affiliation><nlm:aff id="Aff3">Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff4">Department of Pulmonary Medicine, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation></author><author><name sortKey="Van De Heyning, P H" sort="Van De Heyning, P H" uniqKey="Van De Heyning P" first="P. H." last="Van De Heyning">P. H. Van De Heyning</name><affiliation><nlm:aff id="Aff2">ENT Department and Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff3">Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation><affiliation wicri:level="4"><nlm:aff id="Aff6">Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><orgName type="university">Université d'Anvers</orgName><country>Belgique</country><placeName><settlement type="city">Anvers</settlement><region>Région flamande</region><region type="district" nuts="2">Province d'Anvers</region></placeName></affiliation></author><author><name sortKey="Braem, M J" sort="Braem, M J" uniqKey="Braem M" first="M. J." last="Braem">M. J. Braem</name><affiliation><nlm:aff id="Aff1">Department of Special Care Dentistry, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><wicri:noCountry code="subfield">Antwerp Belgium</wicri:noCountry></affiliation><affiliation wicri:level="4"><nlm:aff id="Aff6">Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijkstraat 10, 2650 Edegem, Antwerp Belgium</nlm:aff><orgName type="university">Université d'Anvers</orgName><country>Belgique</country><placeName><settlement type="city">Anvers</settlement><region>Région flamande</region><region type="district" nuts="2">Province d'Anvers</region></placeName></affiliation></author></analytic><series><title level="j">Sleep & Breathing = Schlaf & Atmung</title><idno type="ISSN">1520-9512</idno><idno type="eISSN">1522-1709</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>This prospective clinical study investigates the efficacy of a specific custom-made titratable mandibular advancement device (MAD) for the treatment of obstructive sleep apnea (OSA). This MAD has attachments in the frontal teeth area that allow for progressive titration of the mandible.</p></sec><sec><title>Methods</title><p>Sixty-one adult OSA patients were included (age, 46.7 ± 9.0 years; male/female ratio, 45/16; apnea–hypopnea index (AHI), 23.2 ± 15.4 events/h sleep; body mass index, 27.9 ± 4.1 kg/m²). After an adaptation period, titration started based on a protocol of symptomatic benefit or upon reaching the physiological limits of protrusion. As a primary outcome, treatment response was defined as an objective reduction in AHI following MAD treatment of ≥50 % compared to baseline, and treatment success as a reduction in AHI with MAD to less than 5 and 10 events/h sleep. Compliance failure was defined as an inability to continue treatment.</p></sec><sec><title>Results</title><p>A statistically significant decrease was observed in AHI, from 23.4 ± 15.7 at baseline to 8.9 ± 8.6 events/h with MAD (<italic>p</italic> < 0.01). Treatment response was achieved in 42 out of 61 patients (68.8 %), whereas 42.6 % met criteria of AHI < 5 and 63.9 % achieved an AHI < 10 events/h sleep, respectively. Four patients (6.6 %) were considered as “compliance failures.”</p></sec><sec><title>Conclusions</title><p>The present study has evaluated the efficacy of a specific custom-made titratable MAD in terms of sleep apnea reduction.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Young, T" uniqKey="Young T">T Young</name></author><author><name sortKey="Palta, M" uniqKey="Palta M">M Palta</name></author><author><name sortKey="Dempsey, J" uniqKey="Dempsey J">J Dempsey</name></author><author><name sortKey="Skatrud, J" uniqKey="Skatrud J">J Skatrud</name></author><author><name sortKey="Weber, S" uniqKey="Weber S">S Weber</name></author><author><name sortKey="Badr, S" uniqKey="Badr S">S Badr</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Vanderveken, Om" uniqKey="Vanderveken O">OM Vanderveken</name></author><author><name sortKey="Oostveen, E" uniqKey="Oostveen E">E 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A." last="De Backer">W. A. De Backer</name><name sortKey="Willemen, M" sort="Willemen, M" uniqKey="Willemen M" first="M." last="Willemen">M. Willemen</name><name sortKey="Wouters, K" sort="Wouters, K" uniqKey="Wouters K" first="K." last="Wouters">K. Wouters</name></noCountry><country name="Belgique"><region name="Région flamande"><name sortKey="Dieltjens, M" sort="Dieltjens, M" uniqKey="Dieltjens M" first="M." last="Dieltjens">M. Dieltjens</name></region><name sortKey="Braem, M J" sort="Braem, M J" uniqKey="Braem M" first="M. J." last="Braem">M. J. Braem</name><name sortKey="Hamans, E" sort="Hamans, E" uniqKey="Hamans E" first="E." last="Hamans">E. Hamans</name><name sortKey="Van De Heyning, P H" sort="Van De Heyning, P H" uniqKey="Van De Heyning P" first="P. H." last="Van De Heyning">P. H. Van De Heyning</name><name sortKey="Vanderveken, O M" sort="Vanderveken, O M" uniqKey="Vanderveken O" first="O. M." last="Vanderveken">O. M. Vanderveken</name><name sortKey="Verbraecken, J A" sort="Verbraecken, J A" uniqKey="Verbraecken J" first="J. A." last="Verbraecken">J. A. Verbraecken</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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