Evaluation of the efficacy of a custom-made monoblock mandibular advancement device in treatment of obstructive sleep apnea hypopnea syndrome

Camille Guichaoua; Sophie Dugast; Anthony Derrien; Pascale Boudaud; Anne Gaelle Chaux; Hélios Bertin; Pierre Corre

doi:10.1016/j.jormas.2023.101743

Evaluation of the efficacy of a custom-made monoblock mandibular advancement device in treatment of obstructive sleep apnea hypopnea syndrome

J Stomatol Oral Maxillofac Surg. 2023 Dec 20;125(4):101743. doi: 10.1016/j.jormas.2023.101743. Online ahead of print.

Authors

Camille Guichaoua¹, Sophie Dugast², Anthony Derrien³, Pascale Boudaud², Anne Gaelle Chaux⁴, Hélios Bertin⁵, Pierre Corre⁶

Affiliations

¹ Nantes Université, CHU Nantes, Service de chirurgie maxillo-faciale et stomatologie, 1, place Alexis Ricordeau, F-44000, Nantes, France; Nantes Université, CHU Nantes, Service de chirurgie orale, 1, place Alexis Ricordeau, F-44000, Nantes, France. Electronic address: camguichaoua@gmail.com.
² Nantes Université, CHU Nantes, Service de chirurgie maxillo-faciale et stomatologie, 1, place Alexis Ricordeau, F-44000, Nantes, France.
³ Cabinet libéral PISB, 6, rue de Gouédic, F-22000, Saint-Brieuc, France.
⁴ Nantes Université, CHU Nantes, Service de chirurgie orale, 1, place Alexis Ricordeau, F-44000, Nantes, France.
⁵ Nantes Université, CHU Nantes, Service de chirurgie maxillo-faciale et stomatologie, 1, place Alexis Ricordeau, F-44000, Nantes, France; Nantes Université, UnivAngers, CHU Nantes, INSERM, CNRS, CRCI2NA, 8, quai Moncousu, F-44000, Nantes, France.
⁶ Nantes Université, CHU Nantes, Service de chirurgie maxillo-faciale et stomatologie, 1, place Alexis Ricordeau, F-44000, Nantes, France; Nantes Université, Oniris, UnivAngers, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, RMeS, UMR 1229, 1, place Alexis Ricordeau, F-44000, Nantes, France.

PMID: 38128880
DOI: 10.1016/j.jormas.2023.101743

Abstract

Introduction: Mandibular advancement devices (MAD) are an alternative to continuous positive airway pressure for the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS). We aimed to evaluate the efficiency of a custom-made monoblock MAD for the treatment of OSAHS.

Materials and methods: We carried out a monocentric retrospective observational study including patients with OSAHS (mild, moderate or severe) or isolated ronchopathy from January 2005 to March 2023. The primary objective was to evaluate the overall efficiency of the MAD assessed by the percentage of patients successfully treated. The secondary objectives included the global efficiency of the device in the treatment of snoring, the report of side effects, and the identification of predictive factors for efficacy or failure.

Results: The medical records of 586 patients were collected, and 293 patients (229 OSAHS and 64 isolated ronchopathy) were included in the analysis. After a mean 2.9 years follow-up, 72.5 % of patients were successfully treated by MAD. We observed a significant improvement in ronchopathy, both in terms of intensity and percentage of time per night. Regarding patients with isolated ronchopathy, 87.5 % reported an improvement in their symptoms and satisfaction with their treatment. Finally, 14.0 % of the patients declared side-effects, the dentoskeletal modifications being the most frequent (6.1 % of the patients).

Conclusion: This study confirmed the long-term efficacy and good tolerance of a custom-made monoblock orthosis in OSAHS.

Keywords: Mandibular advancement device; Mandibular advancement orthosis; Monoblock design; Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS).