Mandibular advancement and obstructive sleep apnoea: a method for determining effective mandibular protrusion

Area of Science:

• Sleep Medicine
• Medical Devices
• Diagnostic Tools

Background:

• Obstructive sleep apnoea (OSA) is a common condition often treated with mandibular repositioning appliances (MRAs).
• Predicting MRA treatment success and optimal device settings prospectively remains a challenge in routine clinical practice.

Purpose of the Study:

• To evaluate the efficacy of a remotely controlled mandibular positioner (RCMP) test during polysomnography (PSG) for identifying suitable candidates for MRA therapy.
• To determine if the RCMP test can accurately estimate the optimal mandibular protrusion for MRA fabrication in OSA patients.

Main Methods:

• A prospective study involving subjects undergoing polysomnography (PSG) with a remotely controlled mandibular positioner (RCMP) test.
• Comparison of RCMP test outcomes (success/failure) with the clinical success of custom-fabricated mandibular repositioning appliances (MRAs).
• Analysis of the correlation between RCMP-determined target protrusion and effective therapeutic protrusion with MRA therapy.

Main Results:

• The RCMP test demonstrated a statistically significant association with the outcome of MRA therapy.
• A successful RCMP test predicted successful MRA therapy in 80% of subjects.
• An unsuccessful RCMP test predicted MRA therapy failure in 78% of subjects.
• The target protrusion identified by the RCMP test corresponded to the effective therapeutic protrusion for successful MRA treatment.

Conclusions:

• The RCMP test is a viable tool for prospectively identifying patients who will respond well to MRA therapy for OSA.
• The RCMP test accurately determines the optimal mandibular protrusion for effective MRA fabrication and treatment.
• Integrating the RCMP test into routine PSG could improve MRA therapy outcomes for OSA patients.