Mandibular Torus as a New Index of Success for Mandibular Advancement Devices

Teresa Diaz de Teran, Pedro Muñoz, Felix de Carlos, Emilio Macias, Marta Cabello, Olga Cantalejo, Paolo Banfi, Antonello Nicolini, Paolo Solidoro and Monica Gonzalez ()
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Teresa Diaz de Teran: Sleep and Ventilation Unit, Pneumology Department, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain
Pedro Muñoz: Cantabria Primary Health Care Management, Instituto Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
Felix de Carlos: Department of Surgery and Medical-Surgical Specialties, Area of Orthodontics, Faculty of Medicine, University of Oviedo, 33003 Oviedo, Spain
Emilio Macias: Department of Surgery and Medical-Surgical Specialties, Area of Orthodontics, Faculty of Medicine, University of Oviedo, 33003 Oviedo, Spain
Marta Cabello: Sleep and Ventilation Unit, Pneumology Department, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain
Olga Cantalejo: Sleep and Ventilation Unit, Pneumology Department, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain
Paolo Banfi: Don Gnocchi Foundation IRCCS, 20121 Milan, Italy
Antonello Nicolini: Don Gnocchi Foundation IRCCS, 20121 Milan, Italy
Paolo Solidoro: Division of Respiratory Diseases Cardiovascular and Thoracic Department, AOU Città della Salute e della Scienza di Torino, 10126 Torino, Italy
Monica Gonzalez: Sleep and Ventilation Unit, Pneumology Department, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain

IJERPH, 2022, vol. 19, issue 21, 1-13

Abstract: Background: In obstructive sleep apnoea (OSA), treatment with mandibular advancement devices (MADs) reduces patients’ Apnoea–Hypopnoea index (AHI) scores and improves their sleepiness and quality of life. MADs are non-invasive alternatives for patients who cannot tolerate traditional continuous positive airway pressure (CPAP) therapy. The variability of responses to these devices makes it necessary to search for predictors of success. The aim of our study was to evaluate the presence of mandibular torus as a predictor of MAD efficacy in OSA and to identify other potential cephalometric factors that could influence the response to treatment. Methods: This was a retrospective cohort study. The study included 103 patients diagnosed of OSA who met the criteria for initiation of treatment with MAD. Structural variables were collected (cephalometric and the presence or absence of mandibular torus). Statistical analysis was performed to evaluate the existence of predictive factors for the efficacy of MADs. Results: A total of 103 patients who were consecutively referred for treatment with MAD were included (89.3% men); the mean age of the participants was 46.3 years, and the mean AHI before MAD was 31.4 (SD 16.2) and post- MAD 11.3 (SD 9.2). Thirty-three percent of patients had mandibular torus. Torus was associated with a better response (odds ratio (OR) = 2.854 ( p = 0.035)) after adjustment for sex, age, body mass index (BMI; kg/m 2 ), the angle formed by the occlusal plane to the sella–nasion plane (OCC plane to SN), overinjection, and smoking. No cephalometric predictors of efficacy were found that were predictive of MAD treatment success. Conclusions: The presence of a mandibular torus practically triples the probability of MAD success. This is the simplest examination with the greatest benefits in terms of the efficacy of MAD treatment for OSA.

Keywords: obstructive sleep apnoea; mandibular advancement devices; cephalometry; mandibular torus (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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