Treating obstructive sleep apnea and snoring: Assessment of an anterior mandibular positioning device
Treating obstructive sleep apnea and snoring: Assessment of an anterior mandibular positioning device
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DOI：
10.14219/jada.archive.2000.0275
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发表时间：
2000-06-01
影响因子：
3.9
通讯作者：
Hong, CN
中科院分区：
文献类型：
--
作者：
Clark, GT;Sohn, JW;Hong, CN
背景，牙科设备已被用于帮助管理打鼾和阻塞性睡眠呼吸暂停，或OSA。本文报道了患者的依从性和并发症的长期使用的下颌前定位，或AMP，device.Methods，该设备使用的是一个定制的，两件式，全覆盖，可调丙烯酸类器具，连接Herbst附件。每晚使用该装置，并将下颌骨推进患者最大前伸距离的75%。患者通过电话确定他们是否仍在使用AMP设备。研究样本包括65名轻度至中度阻塞性睡眠呼吸暂停和打鼾的连续患者。结果，这些患者长期使用AMP设备（三年或更长时间）的比例为51%（53名患者中有27名）。在53名回应的患者中，40%的人报告下颌/面部肌肉疼痛，40%的人有咬合变化，38%的人报告牙痛，30%的人报告下颌关节疼痛，30%的人有口干症。在27名长期使用AMP的用户中，22人认为自己非常满意，4人认为自己有些满意;一个人对矫正器既不满意也不不满意。结论，确定使用AMP装置，40%的患者会出现一些轻微的下颌、口腔和/或牙齿疼痛并发症，大约26%的长期使用者可能会经历无痛但不可逆的闭塞变化。临床意义：轻度至中度阻塞性睡眠呼吸暂停（OSA）患者接受两件式可调AMP装置治疗时，应告知50%的患者在三年内会停用该装置，有些患者的咬合会发生变化。
Background, Dental devices have been used to help manage snoring and obstructive sleep apnea, or OSA. This article reports on patients' compliance with and complications of long-term use of an anterior mandibular positioning, or AMP, device.Methods, The device used was a custom-made, two-piece, full-coverage, adjustable acrylic appliance, connected with Herbst attachments. The appliance was used nightly and advanced the mandible by 75 percent of the patient's maximum protrusive distance. Patients were telephoned to determine whether they were still using the AMP device. If not, they were asked when and why they stopped using it. The study sample included 65 consecutive patients with mild-to-moderate obstructive sleep apnea and snoring.Results, Long-term use (three years or more) of the AMP device in these patients was 51 percent (27 of 53 patients). Of the 53 responding patients, 40 percent reported jaw/facial muscle pain, 40 percent had occlusal changes, 38 percent reported tooth pain, 30 percent reported jaw joint pain and 30-percent experienced xerostomia. Of the 27 long-term AMP users, 22 rated themselves as being very satisfied and four as somewhat satisfied; one was neither satisfied nor dissatisfied with the appliance.Conclusions, It was determined that with use of the AMP device, 40 percent of patients will develop some minor complications of jaw, mouth and/or tooth pain, and approximately 26 percent of long-term users might experience a painless but irreversible change in their occlusion. Annual followup office visits with the dentist appear necessary for early detection of these changes.Clinical Implications, Patients with mild-to-moderate OSA who receive a two-piece; adjustable AMP device should be informed that 50 percent of patients quit using the device in a three-year period and some will experience shifts in their occlusion.