Oropharyngeal Dimensions and Mandibular Advancement Outcome in Sleep Apnea Study

Objectives: To investigate the associations between oropharyngeal airway dimensions, dental protrusion with mandibular advancement splint (MAS), sleep characteristics, and treatment response in an obstructive sleep apnea (OSA) sample.
Methods: Thirty-three subjects were assessed retrospectively. Pre-treatment CBCTs were obtained on the NewTom 3G. Dolphin 3D was used to assess the airway. Airway volume, vertical linear dimensions and minimal cross-sectional area (CSA) were identified in each segment, as well as the ratio of transverse and A-P linear dimensions of the minimal CSA. SomnoDent MAS appliances were used and titrated over a 6-8 week period. Pre- and post-treatment polysomnograms (PSGs) assessed OSA severity and treatment response.
Results: Pearson correlation indicated statistically significant associations among most of the variables in this study. A multiple regression analysis indicated that a combination of airway variables, with the inclusion of dental protrusion, initial OSA severity, initial BMI, and initial neck circumference, significantly contributed to the prediction of some variables such as: change in RDI, change in NREM RDI, change in supine NREM RDI, change in non-supine NREM RDI.
Conclusions: Airway dimensions MAS treatment response demonstrated significant correlations, which were affected by sleep position, sleep state, mandibular protrusion, initial OSA severity, BMI, and neck circumference. Future studies with newer CBCT equipment and standardized PSG analyses would be helpful to reassess the relationship between MAS treatment response and airway features.