effect of raising the vertical dimension of mandibular advancement prostheses in treatment of obstructive sleep apnea

ABSTRACT

It is well documented that the anterior repositioning of the mandible achieved by mandibular advancement prosthesis has a potent effect on relieving the signs and symptoms of obstructive sleep apnea [OSA]. However, little is known about the degree of vertical opening that has to be made by those appliances to achieve the best possible results. The objective of the present article is to assess the validity of increasing the vertical dimension induced by the mandibular advancement prosthesis in treatment of OSA. Six patients with diagnosed OSA were chosen to carry out this study. Each patient received two forms of the same adjustable mandibular advancement prosthesis. The two forms were designed with the same amount of mandibular protrusion but with different vertical dimensions. A wash out period was allowed between using the two forms to avoid carryover effects. The effect of changing the vertical opening was assessed through both Polysomnographic and cephalometric evaluations. Results obtained seemed to favour the fabrication of mandibular advancement prosthesis at the minimal possible vertical dimension necessary to accommodate this appliance