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Forces created by mandibular advancement devices in OSAS patients

A pilot study during sleep

  • Original Article
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Abstract

Background

The aim of this study was to measure forces created by progressive mandibular advancement with an oral device, during natural sleep, in a sample of adult patients with obstructive sleep apnea syndrome (OSAS).

Methods

A pressure transducer system was placed on the acrylic arms of a two-piece oral appliance (Herbst type) used by nine moderate to severe OSAS patients, in addition to all captors routinely used for polysomnography. Strains on the left and right sides were collected, during stable sleep stages without arousal, for each step of 1 mm advancement.

Results

The mean force in this sample was 1.18 N/mm and showed an almost linear evolution. Measurements showed intra- and inter-individual variability.

Conclusion

The force values recorded in this study may explain the occlusal and skeletal side effects associated with long-term use of these oral appliances. They illustrate the influence of the extent of mandibular advancement, and indicate a possible dose-dependent effect.

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Acknowledgements

We thank Prof. Robert Garcia for his advice. We also thank Prof. Alain Lautrou for his critical comments on the manuscript and his expertise in functional therapy. Special thanks to Prof. Claude Lévy and Dr Max Ganem for their kind assistance with translation. This study was supported by grants from the Programme Hospitalier de Recherche Clinique (Angers, France), ANTADIR and the Etablissement Public, Chancellerie de Paris (both Paris, France).

Conflict of interest

Dr. Boris Pételle and Dr. Bernard Fleury are consultants for Orthosom, a society selling oral appliances in France. All others authors declare no conflict of interest in relation to this article.

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Authors and Affiliations

  1. Post Graduate in Orthodontics, Paris 7, France

    J. Cohen-Levy & E. Limerat

  2. ENT Department, St Antoine Hospital, AP-HP, Paris 6, France

    B. Pételle

  3. Cidelec Laboratory, 49130, St Gemmes Sur Loire, France

    J. Pinguet

  4. Sleep Studies Department, Pneumology Department, St Antoine Hospital, AP HP, Paris 6, France

    B. Fleury

  5. 255, rue St Honoré, 75001, Paris, France

    J. Cohen-Levy

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  1. J. Cohen-Levy
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  2. B. Pételle
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  5. B. Fleury
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Correspondence to J. Cohen-Levy.

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Cohen-Levy, J., Pételle, B., Pinguet, J. et al. Forces created by mandibular advancement devices in OSAS patients. Sleep Breath 17, 781–789 (2013). https://doi.org/10.1007/s11325-012-0765-4

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  • DOI: https://doi.org/10.1007/s11325-012-0765-4

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