Effects of a titratable oral appliance on supine airway size in awake non-apneic individuals

• Published in: Sleep (New York, N.Y.) Vol. 24; no. 5; pp. 554 - 560
• Main Authors: TSUIKI, Satoru, HIYAMA, Shigetoshi, ONO, Takashi, IMAMURA, Naoko, ISHIWATA, Yasuo, KURODA, Takayuki, LOWE, Alan A
• Format: Journal Article
• Language: English
• Published: Rochester, MN American Academy of Sleep Medicine 01.08.2001
• Subjects: Adult; Biological and medical sciences; Cephalometry - methods; Cervical Vertebrae - physiology; Diseases of the upper aerodigestive tract; Ent and stomatology; Humans; Male; Mandibular Advancement - methods; Medical sciences; Orthodontic Appliances, Removable; Palate, Soft - physiology; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Sleep Apnea, Obstructive - prevention & control; Supine Position; Wakefulness; Human; Sleep apnea syndrome; Mandible; Upper aerodigestive tract; Healthy subject; Upper respiratory tract; Morphology; Instrumentation therapy; ENT disease; Obstruction; Protrusion
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleep/24.5.554

To define morphological changes in the upper airway and its surrounding structures after the insertion of a titratable mandibular repositioner. Ten non-apneic adult males participated in this study. A set of supine lateral cephalograms was taken for each subject at the end of expiration with a titratable oral appliance in place in four mandibular positions: most retruded (RP), maximum protrusion (MAX), 33% of MAX (MAX33), and 67% of MAX (MAX67). Changes in the anteroposterior width of the upper airway, positions of the hyoid bone and the third cervical vertebra were compared between the four mandibular positions. An ANOVA was used to test for statistical significance. N/A. N/A. N/A. The anteroposterior width of the velopharynx significantly increased when the mandible was advanced from RP to MAX67 and MAX. However, there were no significant changes in the anteroposterior width of the oropharynx. Significant forward displacement of the hyoid bone and third cervical vertebra together with the mandible was found in MAX67 and MAX compared to RP. Especially in MAX67 and MAX, the titratable oral appliance significantly enlarges upper airway size in the velopharynx and results in a forward displacement of the hyoid bone and the third cervical vertebra.