[Treatment of obstructive sleep apnea with anterior mandibular positioning device]

The efficacy of the anterior mandibular positioning (AMP) device in obstructive sleep apnea syndrome was assessed. This device advances the mandible anteriorly by approximately 5-7 mm. 29 patients were examined and questioned about temporomandibular (TM) and facial pain before and after treatment with the device. Polysomnographic sleep studies were performed on all before, and 2 weeks after continuous use of the AMP device. 10 of the patients also underwent polysomnographic follow-up after 1 year. The mean apnea index (AI) before treatment was 40.1, which decreased to 24.3 (p < 0.0001) after 14.3 days of treatment with the AMP device. O2 saturation also increased, from 84.2% before, to 89.2% after treatment (p < 0.002). In 10 patients the mean AI after 1 year was 24.9, not different from that after only 2 weeks of treatment, but significantly different from their mean AI before treatment (39.8). Use of the AMP device did not change blood saturation levels; neither did it affect dental status, action of the masticatory muscles, nor did it cause TM joint dysfunction. 21 patients (72.4%) have now been fitted with an AMP device, and the mean follow-up is 13.4 months (range 2-22); 3 have been using the AMP only intermittently for TM joint pain or discomfort. We conclude that the AMP device helps the majority of patients and is an alternative, nonsurgical method for treating obstructive sleep apnea syndrome.