%0 Journal Article
%T Mandibular advancement device in obstructive sleep apnea treatment: what happens to the condyle position and patient response?
%A Gurgel ML
%A Pereira RRR
%A Pereira AB
%A Fabbro CD
%A Kurita LM
%A Ribeiro TR
%A Cevidanes LHS
%A Costa FWG
%A Junior CMC
%J Sleep Breath
%V 0
%N 0
%D 2024 Jul 24
%M 39046657
%F 2.655
%R 10.1007/s11325-024-03093-2
%X <B>BACKGROUND: </B>This study aims primarily to assess the mandibular condyles and patient response to MAD therapy using cone-beam computed tomography (CBCT). Also, the study proposes to analyze whether variations in condylar position, OSA severity and mandibular protrusion influence patient response.<BR><B>METHODS: </B>23 patients diagnosed with mild/moderate OSA and treated with MAD comprised the sample. Clinical, CBCT, and PSG assessments were conducted at baseline and with MAD in therapeutic protrusion (4-6 months of MAD use). The condyle position was vertically and horizontally evaluated at baseline and at the therapeutic protrusion.<BR><B>RESULTS: </B>The condyle position significantly changed with MAD, showing anterior (7.3 ± 2.8 mm; p < 0.001) and inferior (3.5 ± 1 mm; p < 0.001) displacement. Patients with mild OSA required more protrusion (p = 0.02) for improvement. Responders exhibited a significantly prominent (p = 0.04) anterior baseline condyle position. A negative modest correlation was found between treatment response and baseline condyle anterior position (p = 0.03; r=-0.4), as well as between OSA severity and the percentage of maximum protrusion needed for therapeutic protrusion (p = 0.02; r=-0.4). The patient protrusion amount did not predict condylar positional changes. Neither condyle position, OSA severity, nor therapeutic protrusion were predictors of MAD treatment response.<BR><B>CONCLUSIONS: </B>MAD resulted in anterior and inferior condylar displacement, and the amount of protrusion did not predict condylar positional changes. Responders showed a more anterior baseline condyle position. OSA severity and mandibular protrusion did not predict treatment response.