Download PDF
Open Access
CC BY-NC-ND 4.0 · Sleep Sci 2018; 11(01): 12-19
DOI: 10.5935/1984-0063.20180004
ORIGINAL ARTICLE

Efficiency of the Ocluch©MAD in the treatment of patients with OSAS and its association with craniofacial morphology

Authors

  • Nilda Becerra

    1   University of Chile, Prosthodontics Deparment - Santiago - RM - Chile.
    2   Hospital de Carabineros (HOSCAR), Neurphysiology Unit - Santiago - RM - Chile.

  • Mónica Firmani

    1   University of Chile, Prosthodontics Deparment - Santiago - RM - Chile.

  • Emilia Valencia

    1   University of Chile, Prosthodontics Deparment - Santiago - RM - Chile.

  • Lissette Cazenave

    1   University of Chile, Prosthodontics Deparment - Santiago - RM - Chile.

  • Claudio Sotomayor

    1   University of Chile, Prosthodontics Deparment - Santiago - RM - Chile.

  • Paula Espinosa

    1   University of Chile, Prosthodontics Deparment - Santiago - RM - Chile.

  • Juan Carlos Salinas

    1   University of Chile, Prosthodontics Deparment - Santiago - RM - Chile.

  • Diana Florea

    2   Hospital de Carabineros (HOSCAR), Neurphysiology Unit - Santiago - RM - Chile.
Further Information
Also available at
  Permissions and Reprints

Objective: This study uses polysomnography and the Epworth sleepiness scale to assess the efficiency of the Ocluch©MAD in patients with Obstructive sleep apnea-hypopnea syndrome (OSAS), on overall respiratory disturbance indices (RDI), supine respiratory disturbance index (SRDI), minimum oxygen saturation, microarousals, CT90 (or ID90), sleep efficacy and snoring. These data are associated with skeletal class and facial biotype in order to establish predictive parameters for its effectiveness according to craniofacial morphology.

Methods: 22 adult patients (between 38 and 60 years of age) of both sexes (7 women, 15 men) diagnosed with OSAS in the Hospital de Carabineros de Chile (HOSCAR) Neurology Unit were recruited and given the Ocluch© MAD in the hospital’s dental clinic, for its use during a three-month period. Patients were assess at the beginning and in the end of this period.

Results: 87.5% of patients with mild OSAS achieved the success criterion and normalization; 71.5% of patients with moderate OSAS achieved the success criterion and 33.3% achieved normalization; 85.7% of patients with severe OSAS achieved the success criterion and 57.1% achieved normalization. All class I and mesofacial patients achieved normalization, but class II patients had the greatest proportional improvement.

Conclusions: The Ocluch MAD is an efficient low-cost alternative that should be considered among the therapeutic arsenal for a multidisciplinary approach to treating this disease.

Sleep Apnea Syndromes - Mandibular Advancement - Dental Devices, Home Care, Craniofacial Morphology

Appendix 1



Publication History

Received: 22 June 2017

Accepted: 18 January 2018

Article published online:
13 October 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • REFERENCES

  • 1 International Classification of Sleep Disorders (ICSD-2) - American Academy of Sleep Medicine (AASM) [Internet].[cited 2016 Nov 7]. Available from: http://www.aasmnet.org/store/product.aspx?pid=101
  • 2 Avdaloff W. Sueño: diagnóstico y tratamiento. Santiago: Editorial Mediterráneo; 2003.
  • 3 Lloberes P, Durán-Cantolla J, Martínez-García MA, Marín JM, Ferrer A, Corral J, et al. Diagnosis and Treatment of Sleep Apnea-Hypopnea Syndrome. Spanish Society of Pulmonology and Thoracic Surgery. Arch Bronconeumol. 2011;47(3):143-56. DOI: http://dx.doi.org/10.1016/j.arbres.2011.01.001
  • 4 Vecchierini MF, Attali V, Collet JM, d'Ortho MP, El Chater P, Kerbrat JB, et al.; ORCADES investigators. A custom-made mandibular repositioning device for obstructive sleep apnoea-hypopnoea syndrome: the ORCADES study. Sleep Med. 2016;19:131-40. DOI: http://dx.doi.org/10.1016/j.sleep.2015.05.020
  • 5 Punjabi NM. The Epidemiology of adult Obstructive sleep Apnea. Proc Am Thorac Soc. 2008; 5:136-143. DOI: http://dx.doi.org/10.1513/pats.200709-155MG
  • 6 Tufik S, Santos-Silva R, Taddei JA, Bittencourt LR. Obstructive sleep apnea syndrome in the Sao Paulo Epidemiologic Sleep Study. Sleep Med. 2010;11(5):441-6. DOI: http://dx.doi.org/10.1016/j.sleep.2009.10.005
  • 7 Eguía VM, Cascante JA. [Sleep apnea-hypopnea syndrome. Concept, diagnosis and medical treatment]. An Sist Sanit Navar. 2007; 30 Suppl 1:53-74. Spanish.
  • 8 Sateia MJ. International classification of sleep disorders-third edition: highlights and modifications. Chest. 2014;146(5):1387-94. DOI: http://dx.doi.org/10.1378/chest.14-0970
  • 9 Epstein LJ, Kristo D, Strollo PJ Jr, Friedman N, Malhotra A, Patil SP, et al.; Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine. Clinical guidelines for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med. 2009;5(3):263-76.
  • 10 Bernstein P, Ebba JH. Snoring versus obstructive sleep apnea: a case report. Perm J. 2006;10(1):21-3. DOI: http://dx.doi.org/10.7812/TPP/05-116
  • 11 Goetting CB, Downey R. Sick, symptomatic & undiagnosed: The failure to diagnose obstructive sleep apnea when the respiratory disturbance index is not used. Sleep. 2010;33(Spec Iss):380. http://www.sleepmeeting.org/docs/default-source/attendee-documents/abstractbook2010.pdf?sfvrsn=2
  • 12 de Oliveira Almeida M, de Britto Teixeira AO, Vieira LS, Quintão CC. Treatment of obstructive sleep apnea and hipoapnea syndrome with oral appliances. Braz J Otorhinolaryngol. 2006;72(5):699-703. PMID: 17221064 DOI: http://dx.doi.org/10.1016/S1808-8694(15)31028-4
  • 13 Okeson JP, Phillips BA, Berry DT, Cook YR, Cabelka JF. Nocturnal bruxing events in subjects with sleep-disordered breathing and control subjects. J Craniomandib Disord. 1991;5(4):258-64.
  • 14 Ahrens A, McGrath C, Hagg U. A systematic review of the efficacy of oral appliance design in the management of obstructive sleep apnoea. Eur J Orthod. 2011;33(3):318-24. DOI: http://dx.doi.org/10.1093/ejo/cjq079
  • 15 Hoffstein V. Review of oral appliances for treatment of sleep-disordered breathing. Sleep Breath. 2007;11(1):1-22. DOI: http://dx.doi.org/10.1007/s11325-006-0084-8
  • 16 Tsai WH, Vazquez JC, Oshima T, Dort L, Roycroft B, Lowe AA, et al. Remotely controlled mandibular positioner predicts efficacy of oral appliances in sleep apnea. Am J Respir Crit Care Med. 2004;170(4):366-70. PMID: 15105166 DOI: http://dx.doi.org/10.1164/rccm.200310-1446OC
  • 17 Deane SA, Cistulli PA, Ng AT, Zeng B, Petocz P, Darendeliler MA. Comparison of mandibular advancement splint and tongue stabilizing device in obstructive sleep apnea: a randomized controlled trial. Sleep. 2009;32(5):648-53. DOI: http://dx.doi.org/10.1093/sleep/32.5.648
  • 18 Mendoza L, Fernández A, Domenzain J, Pérez H. Pacientes con obstrucción de vías aéreas relacionado con la clase esqueletal. Rev Odontol Mex. 2005;9(3):125-130.
  • 19 Gregoret J, Tuber E, Escobar H, da Fonseca AM. Ortodoncia y cirugia ortognática: diagnóstico y planificación. Madrid: NM Ediciones;2008.
  • 20 Levendowski D, Morgan T, Westbrook P. Initial Evaluation of a Titration Appliance for Temporary Treatment of Obstructive Sleep Apnea. J Sleep Disord Ther. 2012;1(1). pii: 101.
  • 21 Martínez-Font J, Soler Segarra I, Arias de Luxán S. Validez de las prótesis de avance mandibular en el tratamiento del síndrome de apnea-hipopnea del sueño]. Rev Esp Ortod. 2011;41(2):90-4.
  • 22 Kato J, Isono S, Tanaka A, Watanabe T, Araki D, Tanzawa H, et al. Dose-dependent effects of mandibular advancement on pharyngeal mechanics and nocturnal oxygenation in patients with sleep-disordered breathing. Chest. 2000;117(4):1065-72. PMID: 10767241 DOI: http://dx.doi.org/10.1378/chest.117.4.1065
  • 23 Walker-Engström M, Ringqvist I, Vestling O, Wilhelmsson B, Tegelberg Å. A prospective randomized study comparing two different degrees of mandibular advancement with a dental appliance in treatment of severe obstructive sleep apnea. Sleep Breath. 2003;7(3):119-30. DOI: http://dx.doi.org/10.1007/s11325-003-0119-3
  • 24 Dacal Quintas R, Tumbeiro Novoa M, Alves Pérez MT, Santalla Martínez ML, Acuña Fernández A, Marcos Velázquez P. Síndrome de apnea-hipopnea del sueño en pacientes normopeso: características y comparación con pacientes con sobrepeso y obesidad. Arch Bronconeumol. 2013;49(12):513-7. DOI: http://dx.doi.org/10.1016/j.arbres.2013.05.005
  • 25 Oksenberg A, Khamaysi I, Silverberg D, Tarasiuk A. Association of body position with severity of apneic events in patients with severe nonpositional obstructive sleep apnea. Chest. 2000;118(4):1018-24. PMID: 11035672 DOI: http://dx.doi.org/10.1378/chest.118.4.1018
  • 26 Kim SJ, Kim YS, Park JH, Kim SW. Cephalometric predictors of therapeutic response to multilevel surgery in patients with obstructive sleep apnea. J Oral Maxillofac Surg. 2012;70(6):1404-12. PMID: 21763049 DOI: http://dx.doi.org/10.1016/j.joms.2011.03.016
  • 27 Kikuchi M, Higurashi N, Miyazaki S, Itasaka Y. Facial patterns of obstructive sleep apnea patients using Ricketts’ method. Psychiatry Clin Neurosci. 2000;54(3):336-7. PMID: 11186102 DOI: http://dx.doi.org/10.1046/j.1440-1819.2000.00703.x
  • 28 Carlos-Villafranca F, Cobo-Plana J, Fernández-Mondragón M, Díaz-Esnal B. Relación entre maloclusión e incremento de la vía aérea utilizando un aparato intraoral en pacientes con síndrome de apnea hipopnea obstructiva del sueño. RCOE. 2002;7(4):359-64. DOI: http://dx.doi.org/10.4321/S1138-123X2002000500002