Influencing factors on the effect of mandibular advancement device in obstructive sleep apnea patients: analysis on cephalometric and polysomnographic parameters

The purposes of this study were to evaluate clinical outcome of mandibular advancement device (MAD) for obstructive sleep apnea (OSA) patients and to estimate influencing factors on MAD effect. From the patients who were diagnosed as OSA by polysomnography at Seoul National University Bundang Hospital from January 2007 to February 2009, the patients who chose MAD as initial treatment option were included. All the patients' data were collected by reviewing and analyzing medical record and radiograph retrospectively. Eighty-six patients (76 males and 10 females; mean age of 51.5 +/- 9.8 years) with OSA were included in this study. Total success rate of MAD treatment was 47.7 % (41/86 patients). Among cephalometric parameters, lower facial height (35.61 +/- 4.26 vs. 38.19 +/- 4.89) showed significant difference between success group and non-success group. From the polysomnographic parameters, apnea index (19.79 +/- 17.32 vs. 30.08 +/- 23.28), average oxygen saturation (95.03 +/- 1.42 vs. 94.32 +/- 1.56), lowest oxygen saturation (81.44 +/- 6.64 vs. 76.87 +/- 7.98), oxygen saturation under 90 % (4.47 +/- 5.90 vs. 9.01 +/- 9.29), and oxygen desaturation index (23.58 +/- 17.46 vs. 37.16 +/- 22.35) showed significant difference between groups. From the results, it was proved that MAD was an effective treatment option for the OSA patients. Some cephalometric and polysomnographic parameters including posterior lower facial height, apnea index, average oxygen saturation, lowest oxygen saturation, oxygen saturation under 90 %, and oxygen desaturation index could be influencing factors on MAD effect.