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

开发由人造肌肉驱动的口腔矫治器，仅在出现睡眠呼吸暂停时才会诱导下颌前突

基本信息

批准号：
17592074
负责人：
YOSHIDA Kazuya
金额：
$ 2.24万
依托单位：
Kyoto University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2005
资助国家：
日本
起止时间：
2005 至 2006
项目状态：
已结题

项目摘要

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.

1.测量了金属基人工肌肉的实际载荷和动态变形。我们记录了真实的实际负荷、距离和方向，以便在睡眠时推进下颌骨。2.对161例（平均年龄：54.3岁）诊断为睡眠呼吸暂停综合征（平均呼吸暂停低通气指数：17.9）的患者在插入口腔矫治器前后进行了研究。收缩压、舒张压和平均血压（基线时分别为132.0、82.1、107.1mmHg）在插入器械后显著降低（p<0.001）（分别为127.5、79.2、103.4mmHg）。反应者（平均血压下降>3.7mmHg）和部分反应者（0<血压下降> 3.7mmHg）的AHI下降率（分别为69.6%和65.9%）显著高于无反应者（血压下降> 0 mmHg）（52.5%）（p<0.05）。有效的口腔矫治器治疗可以导致血压的大幅度降低。3.我们用近红外光谱测量了脑血容量，下颌闭合和张开运动，舌头伸出运动，发音时测量，睡眠时脑血容量的变化，在词汇流畅性任务中，我们测量了体感诱发的磁场，通过使用122通道神经磁力计进行抽吸刺激。反应对称地确定在双边parietemporal区域的平均潜伏期约为130 ms。相应的等效电流偶极子估计周围的Sylvian裂。4.中度牙周病患者牙周袋最深处4- 6 mm者占38.4%，重度牙周病患者牙周袋最深处6 mm者占58.9%。牙周袋≤ 3 mm的患者仅占定期牙周治疗患者的2.7%。大多数患者有中、重度牙周病症状，未接受过定期牙周治疗。