Antero-Posterior Mandibular Excursion in Obstructive Sleep Apnea Patients Treated with Mandibular Advancement Device: A Retrospective Cohort Study

Chiara Stipa, Serena Incerti-Parenti, Matteo Cameli, Daniela Rita Ippolito, Antonio Gracco and Giulio Alessandri-Bonetti ()
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Chiara Stipa: Unit of Orthodontics and Sleep Dentistry, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via San Vitale 59, 40125 Bologna, Italy
Serena Incerti-Parenti: Unit of Orthodontics and Sleep Dentistry, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via San Vitale 59, 40125 Bologna, Italy
Matteo Cameli: Unit of Orthodontics and Sleep Dentistry, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via San Vitale 59, 40125 Bologna, Italy
Daniela Rita Ippolito: Unit of Orthodontics and Sleep Dentistry, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via San Vitale 59, 40125 Bologna, Italy
Antonio Gracco: Department of Neurosciences, University of Padua, Via Giustiniani 3, 35128 Padua, Italy
Giulio Alessandri-Bonetti: Unit of Orthodontics and Sleep Dentistry, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via San Vitale 59, 40125 Bologna, Italy

IJERPH, 2023, vol. 20, issue 4, 1-9

Abstract: Since obstructive sleep apnea (OSA) management with a mandibular advancement device (MAD) is likely to be life-long, potential changes in mandibular movements during therapy should be investigated. The purpose of this study was to use a method that has already been shown to be reliable in order to determine whether the range of antero-posterior mandibular excursion, the procedure upon which MAD titration is based, varies between baseline (T0) and at least 1 year of treatment (T1). The distance between maximal voluntary protrusion and maximal voluntary retrusion determined using the millimetric scale of the George Gauge was retrospectively collected from the medical records of 59 OSA patients treated with the MAD and compared between T0 and T1. A regression analysis was performed to evaluate the influence of treatment time, MAD therapeutic advancement and the patient’s initial characteristics in excursion range variation. A statistically significant increase of 0.80 ± 1.52 mm (mean ± standard deviation, p < 0.001) was found for antero-posterior mandibular excursion. The longer the treatment time ( p = 0.044) and the smaller the patient’s mandibular excursion at T0 ( p = 0.002), the greater the increase was. These findings could be explained by a muscle–tendon unit adaptation to the forward mandibular repositioning induced by the MAD. During MAD therapy, patients can develop a wider range of antero-posterior mandibular excursion, especially those with a smaller initial excursion capacity.

Keywords: obstructive sleep apnea; mandibular advancement device; sleep dentistry (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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