Development of an oral appliance driven by artificial muscles that induce mandibular protrusion only when sleep apnea develops

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1.We measured practical load and kinetic distortion of a metal-based artificial muscle. We recorded real practical load, distance and direction in order to advance the mandible during sleep.2.One hundred sixty-one patients (mean age : 54.3years) diagnosed with sleep apnea syndrome (mean apnea-hypopnea index : 17.9) were studied before and after insertion of an oral appliance. Systolic, diastolic and mean blood pressure (132.0, 82.1, 107.1mmHg, respectively at baseline) decreased significantly (p<0.001) (127.5, 79.2, 103.4mmHg, respectively) after the insertion of the device. The responders (mean blood pressure fall>3.7mmHg) and the partial responders (0<fall≦3.7 mmHg) showed significantly (p<0.05) higher AHI reduction (69.6%, 65.9%, respectively) than that (52.5 %) of nonresponders (fall≦0mmHg). Effective oral appliance therapy can lead to a substantial reduction in blood pressure.3.We measured the brain blood volume with near-infrared spectroscopy, jaw closing and opening movements, tongue protrusion movement, a measurement at the time of pronunciation, brain blood volume changes during sleep, and those in the frontal lobe during a word fluency task.We measured the somatosensory evoked magnetic fields following air-puff stimulation by using a 122-channel neuromagnetometer. Responses were identified symmetrically in the bilateral parietotemporal regions with a mean latency of about 130 ms. Corresponding equivalent current dipoles were estimated around the Sylvian fissures. The responses were derived from the second somatosensory areas.4.The ratio of moderate periodontal disease having pockets of 4-6mm was 38.4%, and 58.9% showed severe periodontal disease presenting 6mm at the deepest pocket. Patients with a periodontal pocket equal to or less than 3mm accounted for only 2.7% of the patients receiving periodical periodontal treatment. Most patients have periodontal disease with medium or severe grade symptom, who had not received periodical periodontal treatment.