Cephalometric analysis in patients with obstructive sleep apnea. Part II: Prognostic value in treatment with a mandibular advancement device

• Published in: Journal of orofacial orthopedics Vol. 63; no. 4; pp. 315 - 324
• Main Authors: Rose, Edmund, Lehner, Martin, Staats, Richard, Jonas, Irmtrud E
• Format: Journal Article
• Language: English; German
• Published: Germany 01.07.2002
• Subjects: Adult; Aged; Cephalometry; Dentistry; Equipment Design; Humans; Male; Mandibular Advancement - instrumentation; Middle Aged; Prognosis; Risk Factors; Sleep Apnea Syndromes - etiology; Sleep Apnea Syndromes - therapy; Treatment Outcome
• ISSN: 1434-5293
• DOI: 10.1007/s00056-002-0058-9

The mandibular advancement device (MAD) is accepted as an additional treatment option for snoring and mild obstructive sleep disorders. Its therapeutic efficacy can only be verified through nocturnal polysomnography with the appliance in situ. The relevance of the craniofacial skeletal and soft-tissue structures as an etiological cofactor is controversial. While the lateral cephalogram of the facial skeleton is of no direct diagnostic relevance, it remains unclear to what extent cephalometric assessment can provide prognostic information to better ensure treatment success with an MAD. This study is based on the evaluation of 57 patients diagnosed polysomnographically with obstructive sleep apnea (OSA). The patients were treated primarily with a modified activator; after 6-12 weeks, control polysomnography was carried out in the sleep laboratory. The cephalometric variables were analyzed using a multivariate regression procedure with the response variable of treatment outcome. In addition to a horizontal craniofacial morphology, the downward and forward posture of the hyoid is a prognostic variable for effective therapy with an MAD.