Comparative evaluation of craniofacial anthropometric measurements in Indian adult patients with and without obstructive sleep apnea: A pilot study

Comparative evaluation of the efficacy of customized maxillary oral appliance with mandibular advancement appliance as a treatment modality for moderate obstructive sleep apnea patients-a randomized controlled trial

BACKGROUND

Obstructive sleep apnea (OSA) is quite common among the adult population, according to recent epidemiological studies. The most frequently suggested alternate treatment for mild to moderate OSA is oral appliances (OA). The purpose of the present study was to assess as well as compare the effectiveness of custom-made maxillary oral appliances against mandibular advancement appliances in the care of individuals suffering from moderate obstructive sleep apnea.

METHODS

A prospective interventional research was carried out with 40 participants. Polysomnography (PSG) was done and the participants with an apnea-hypopnea index (AHI) >15-30 were involved in the research. Study participants were randomly split up into two test groups: group I was the "Control Group" (group treated with a mandibular advancement device (MAD), n=20), while group II was exposed to a "customized maxillary oral appliance" (CMOA, n=20). Both groups had reference measures for AHI, blood oxygen saturation (SpO2), oro-nasal airflow via respiratory disturbance index (RDI), and the Epworth Sleepiness Scale (ESS). Appliances were fabricated and delivered to the respective study group participants. PSG was again conducted after a period of 1 and 3 months of appliance delivery and re-evaluation was done for all the parameters and was compared with reference measurements. The facts were analyzed using descriptive and analytical statistical methods. The statistical program utilized in the study was "SPSS (Statistical Package for Social Sciences) Version 20.1." After 1 and 3 months, the statistical significance between the two study groups was assessed at P<0.05.

RESULTS

The analysis of mean AHI, SPO2, RDI, and ESS for both test groups manifested statistically significant measures (P<0.001). The study results revealed a statistically significant depletion in mean AHI scores, improvement in mean SPO2 scores, and reduction in mean RDI scores and ESS scores when compared with reference measurements to 1 month, 1 to 3 months, and between reference measurements and 3 months.

CONCLUSION

The CMOA was effective in managing moderate OSA and has great therapeutic potential. It can be an option for the MAD for treating patients suffering from moderate obstructive sleep apnea.

TRIAL REGISTRATION

The study was registered under Clinical Trials Registry-India and the registration number is CTRI/2020/07/026936 . Registered on 31 July 2020.

A spirometric and cephalometric comparative evaluation of mandibular advancement devices and occlusal jig

Aim

Aim of the current study was to evaluate the effect of occlusal jig with increased vertical dimension and mandibular advancement device on the oropharangeal volume in completely edentulous patients using spirometry and cephalometry.

Materials and Methods

The current study included includes 30 completely edentulous patient according to inclusion criteria. They were each subjected to cephalometric and spirometric analysis wearing CCD, OJ & MAD. Results obtained were subjected to following statistical analysis, one-way ANOVA test, unpaired t-test, and Dunnett's test.

Result

Both OJ & MAD brings about significant change in oropharangeal volume hence both the devices are effective treatment of choice for OSA, while greater increase was observed in oropharangealvolume of OJ as compared to MAD. Spirometric analysis shows insignificant changes in the oropharangeal volume caused by MAD while OJ causes small but significant change in oropharangeal volume (PIFR].

Conclusion

Within the limitation of the study, it can be concluded that, on cephalometric & spirometric evaluation, OJ shows greater increase in oropharangeal volume when compared to MAD in completely edentulous patient.

Predictive value of craniofacial and anthropometric measures in obstructive sleep apnea (OSA)

BACKGROUND

Most individuals with OSA remain undiagnosed, mainly due to limited access to effective screening tools and diagnostic facilities. Therefore, the objective of this study was to identify craniofacial and anthropometric measurements that predict OSA in an Indian population.

METHODS AND FINDINGS

Male subjects (n = 76) between 25 and 50 years of age were recruited for the study from the general population. The study measures consisted of home-based type IV polysomnography and a total of 40 anthropometric and craniofacial measurements. Key measures were identified, and a model was developed with these variables, which predicted the presence of OSA with a sensitivity, specificity and overall accuracy of 93.1, 20.0 and 74.4%, respectively.

CONCLUSION

This preliminary study shows the utility of craniofacial and anthropometric variables in the identification of individuals at risk of OSA. These findings need to be further validated against the results of overnight polysomnography in a large independent population.