PubMed · 16468478
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Michel Champagne. 2005. Brainstorming.. https://pubmed.ncbi.nlm.nih.gov/16468478/
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The aim of this study was to examine the dentofacial changes in Class III patients treated with fixed appliances subsequent to rapid maxillary expansion (RME) and facemask therapy. The material consisted of the cephalograms and hand-wrist films of 14 (9 girls, 5 boys) skeletal Class III and 15 (10 girls, 5 boys) untreated subjects obtained at the beginning of treatment/observation T1, immediately after orthopaedic therapy T2, and at the end of the observation period T3. The mean pre-treatment/control ages were approximately 11.5 years and the observation period was 3 years T2-T1: 1 year, T3-T2: 2 years). The cephalometric films were analysed according to the structural superimposition method of Björk. All tracings were double-digitized and the measurements were calculated by a computer program. Intragroup changes and intergroup differences were statistically analysed. Forward movement of the maxilla (P < 0.01), backward movement and rotation of the mandible, an increase in the ANB angle (P < 0.001), lower face height and overjet (P < 0.001), a decrease of overbite, and an improvement in the sagittal lip relationship (P < 0.01) presented significant intergroup differences between T2 and T1. During the second phase of treatment T3-T2, although not statistically significant, forward movement of the maxilla was less than in the control subjects. Overall changes during the observation period T3-T1 revealed that correction was mainly due to favourable changes in the mandibular and dentoalveolar components of the discrepancy, while these in maxillary position were not different from the control group. The soft tissue profile improved significantly (P < 0.001) in the treatment group. Comparison with the Class I controls at the end of the observation period confirmed that some Class III characteristics still remained in the treated patients.
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The objective of the study was to investigate the effects of oral appliance (OA) therapy on ambulatory blood pressure in patients with obstructive sleep apnea (OSA). Eleven OSA patients who received OA therapy were prospectively investigated. Ambulatory blood pressure was measured for 20 h from 4:00 P.M.: to 12:00 noon the next day using an ambulatory blood pressure monitor. The Respiratory Disturbance Index (RDI) was measured in the pretreatment and posttitration periods. The OA was titrated to reach a therapeutic jaw position over 2 to 8 months, and posttitration measurements were repeated. At posttitration, the RDI was significantly decreased from a mean (SD) of 24.7 (20.1) to 6.1 (4.5). Significant reductions in diastolic blood pressure (DBP) and mean arterial pressure (MAP) were found for the 20-h periods, and systolic blood pressure (SBP), DBP, and MAP while asleep. The mean values were 79.5 (5.5) to 74.6 (6.0) for DBP and 95.9 (5.4) to 91.2 (5.9) for MAP, for over a 20-h period, and 118.4 (10.0) to 113.7 (9.1) for SBP, 71.6 (8.0) to 67.2 (7.9) for DBP, and 88.4 (8.0) to 83.9 (7.5) for MAP, while asleep. This study suggests that successful OSA treatment with an OA may also be beneficial to lower blood pressure in OSA patients, as previously suggested for nasal continuous positive airway pressure therapy.