The effect of a mandibular advancement splint in subjects with sleep-related breathing disorders

Otorhinolaryngological aspects of sleep-related breathing disorders

Snoring and obstructive sleep apnoea (OSA) are disorders within a wide spectrum of sleep-related breathing disorders (SRBD). Given the obesity epidemic, these conditions will become increasingly prevalent and continue to serve as a large economic burden. A thorough clinical evaluation and appropriate investigations will allow stratification of patients into appropriate treatment groups. A multidisciplinary team is required to manage these patients. Patient selection is critical in ensuring successful surgical and non-surgical outcomes. A wide range of options are available and further long term prospective studies, with standardised data capture and outcome goals, are required to evaluate the most appropriate techniques and long term success rates.

Comparative evaluation of the breaking strength of a simple mobile mandibular advancement splint

Mandibular advancement splints (MASs) are used to advance the mandible forward in patients with sleep-disordered breathing. The conventional rigid MAS restricts the movement of the mandible, and this immobility sometimes produces discomfort, including temporomandibular disorders. A simple method for fabricating a mobile MAS was devised, using a connector made from a polyethylene toothed belt, with the intention of making the MAS more comfortable. The experimental connector is easily constructed, inexpensive, and small enough for use as an intraoral MAS. To evaluate durability, the axial and diagonal tensile breaking strengths of the MAS, using high- or low-density polyethylene (HDPE or LDPE) lateral toothed belts, were compared with those of a conventional mobile MAS (Silensor). The values were compared by factorial analysis of variances and post hoc Scheffe's S multiple comparison intervals, with the value of statistical significance set at alpha = 0.05. In addition, the experimental LDPE connectors were clinically tested in 30 patients (23 males and 7 females aged 19-71 years) and evaluated. Compared with the Silensor, the experimental MAS exhibited sufficient breaking strength, especially when a diagonal tensile load was applied to mimic mandibular lateral translation. When examining the clinical evaluation between 3 and 4 months after insertion, no damage or failure was observed. The experimental connecting system may have clinical applications. To make the connector stronger for clinical use, HDPE should be used.