Harsh Chansoria, Padma Ariga, Shivakshi Chansoria, Mamta Singh


Purpose: To assess the efficacy and compliance of mandibular advancement appliance (MAA) for the treatment of mild to moderate obstructive sleep apnea, under patient-care driven protocol on completely edentulous patients.

Methods: Thirty non denture wearer patients aged between 45-60 years with BMI (Body Mass Index) more than 25 were enrolled for the sleep study based on the sleep questionnaire and pre-operative Epworth sleepiness score (ESS). Out of thirty, twenty three patients who had mild to moderate apnea hypopnea index (AHI) score were chosen to receive a MAA which was fabricated at physiologic rest position. Five patients having severe obstructive sleep apnea (OSA) were referred for continuous positive airway pressure (CPAP). Subjective and objective evaluations of the patient were done using a 4 channel sleep study for continuous six nights and the quality of life questionnaire was assessed before and after the treatment.

Results: Frequency of respiratory events, AHI score, daytime sleepiness, patient’s sleep quality and ESS improved significantly with the MAA. The mean values of pre-operative ESS and AHI were found to be 14.0000 and 17.5728, respectively. However, after insertion of the device for 30 days, the mean values of post-operative ESS and AHI were noted to be 7.2800 and 12.1080, respectively. Side effects and patient complains were minor and transitory. No serious side effects or pathological aggravation were observed.

Conclusion: This study confirms that 4 weeks of MAA therapy along with behaviour modification improved the quality of life (ESS scores) and sleep value parameters (AHI) in completely edentulous patients with mild to moderate OSA. Hence, the MAA treatment under a simple patient driven protocol of care with control of efficacy by the nocturnal 4 channel study is appropriate in dental practice for mild to moderate obstructive sleep apnea patients.


Mandibular device; Epworth sleepiness score; apnea hypopnea index; Obstructive sleep apnea

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