The Effect of Different Mandibular Advancement Devices on Sleep Parameters in Obstructive Sleep Apnea

BACKGROUND: Obstructive sleep apnea (OSA) is a common sleep disorder that is associated with comorbid diseases if untreated. Mandibular advancement devices (MADs) are a viable treatment option that offers good adherence, although they are not the gold standard. OBJECTIVE: Evaluation and comparison of three different MADs on sleep parameters AHI (apnea-hypopnea index) and ODI (oxygen desaturation index) while adjusting for demographic and clinical parameters. METHODS: In a private dental practice, patients previously diagnosed with OSA received an individually adjusted MAD. For each patient, one of three types of MAD was used, of which one was fabricated conventionally and two were CAD/CAM-fabricated. Polysomnographic parameters before and after treatment with MAD were extracted from patient files. Statistical analysis was conducted assessing the effect of MAD on AHI and ODI and evaluating the impact of clinical and demographic parameters on the reduction of AHI and ODI. RESULTS: A total of 300 patients were included, of which 40 received a conventionally manufactured MAD. Mean AHI and ODI reduction was 16.4 ± 17.9/h and 10.8 ± 15.2/h respectively, while patients with higher baseline AHI and ODI values experienced greater reductions. Female gender and younger age also led to greater reductions. Patients treated with the conventionally manufactured MAD displayed greater reductions. More prominent protrusion did not lead to greater mean reduction of AHI and ODI values. CONCLUSION: Mandibular advancement therapy led to significant reductions in AHI and ODI, with an average improvement of approximately 50%. Baseline severity strongly predicted treatment response, while age and gender also influenced outcomes.