PubMed · 3267828
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A H Geis. 1988. [Rediscovered: high labial bow].. https://pubmed.ncbi.nlm.nih.gov/3267828/
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The purpose of this study was to examine the effect of a bionator on masseter and suprahyoid muscle activities during sleep. Ten healthy Japanese males (mean age: 26.3 years) participated in this study. Electromyographic (EMG) activities of the right masseter and bilateral suprahyoid muscles were recorded during sleep with and without a bionator. Although no significant changes were observed in the maximal EMG activities of these muscles, the maximal EMG activity of suprahyoid muscles tended to decrease while wearing the bionator. The number of events over 40% maximal voluntary contraction (MVC) tended to decrease in these muscles with a bionator, but these changes were not statistically significant. These findings indicate that there are no significant changes or there is only a tendency to decrease the activities of the masseter and suprahyoid muscles while wearing a bionator during sleep.
The purpose of this study was to examine and report the effectiveness of early treatment with the headgear/biteplate and the bionator in patients with Class II malocclusion regardless of the mechanism of correction and to compare early-treatment results with changes over a similar time period in an observation group. The role of factors such as compliance was examined to determine their contribution to effective treatment. The experimental design was a prospective, longitudinal, randomized controlled trial. At the end of the early-treatment period, all 3 groups differed significantly (overall, P = .001) in percentage of treatment goal achieved, with median values of 83% for the bionator group, 100% for the headgear group, and 14% for the observation group. In both treated and observation subjects, the percentages of goal achieved varied by initial molar class severity (treated, P =.0205; observation, P = .0040) and race (treated, P = .0314; observation, P = .0416). Significant correlations in the treated subjects were identified between percentage of goal achieved and bone age (13 bones) (r = 0.16; P = .037), bone age (20 bones) (r = 0.16; P = .043), compliance (r = 0.26; P = .0005), and initial overjet (r = -0.26; P = .0095). Significant correlations were not detected in the observation group. Sex, treatment group, age, mandibular plane angle, pretreatment, and retention did not significantly affect percentage of goal achieved among the treated and the observation subjects. Correlation between normalized compliance scores and percentage of goal achieved was high for both bionator (r = 0.50) and headgear subjects (r = 0.49) at the end of treatment. Multivariate analysis suggested that headgear may be superior to bionator/biteplane in achieving a Class II correction during early treatment.
The purpose of this study was to investigate the long-term efficacy of an oral appliance, the Karwetzky activator, on respiratory and sleep parameters in patients with obstructive sleep apnea (OSA). Those selected for this study were 26 patients polysomnographically diagnosed with mild-to-moderate OSA. They were initially treated successfully with this appliance, as documented by a second polysomnographic study after 6 to 12 weeks. Further polysomnographic registrations 6 to 12 months and 18 to 24 months later were performed for each patient wearing the appliance. For 21 patients (81%), therapeutic efficacy was maintained; 5 patients (19%) showed a deterioration in respiratory parameters. We corrected this by adjusting the device in 2 patients. The mean apnea-hypopnea index decreased significantly from 17.8 events per hour at the baseline registration to 4.2 events per hour (P <.001) after 6 to 12 weeks of treatment. After 6 to 12 months, the apnea-hypopnea index was 8.2 events per hour. The index remained at this level 18 to 24 months later, with 8.3 events per hour. Mean oxygen saturation was not improved with the activator, but the number of desaturations had decreased at the 6-to-12 week review. Again, the improvement declined with time, but the number of oxygen desaturations was still significantly decreased at 18 to 24 months (P <.01). Although the respiratory parameters remained statistically improved throughout the study (P <.01), sleep architecture did not change statistically. In most patients, therapeutic efficacy was maintained at the 2-year follow-up, although there was a tendency for effectiveness to fall over time. We concluded that the Karwetzky activator may be an effective treatment alternative for patients with mild-to-moderate OSA, but therapy requires diligent and regular polysomnographic follow-ups. Further long-term studies are needed to assess the continued efficacy of this oral appliance in treating OSA.