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PubMedDate not supplied

[Effectiveness of a mandibular advancement prosthesis in the treatment of obstructive sleep apnea syndrome].

OBJECTIVE: To assess the efficacy of a mandibular advancement prosthesis for treating obstructive sleep apnea syndrome (OSAS). METHOD: Mandibular advancement appliances were prescribed for 21 patients (20 men) with OSAS diagnosed by polysomnography. Mean age was 51 (8) years, BMI was 30 (4) kg/m2, and the apnea-hypopnea index (AHI) per hour was 48 (17). If the device was well tolerated, regardless of clinical response, polysomnography was repeated between 1 to 3 months after start of treatment. The device was considered effective if the AHI decreased to < 15/h and symptoms related to OSAS disappeared. RESULTS: Seven patients withdrew from treatment after only a few days. The remaining 14 (66%) tolerated treatment well and the second polysomnogram was performed. In six of the 14 (43%), the device proved effective for correcting OSAS. In six more patients, the AHI decreased but failed to become normal. In the remaining two patients, no improvement was observed. Improvement in the AHI was unrelated to severity of OSAS. CONCLUSION: The mandibular advancement prosthesis is effective for some patients with OSAS, including those in whom the AHI is high. Larger studies are needed to allow us to define the type of patients that might benefit.

Female↗
PubMed2001

Mandibular advancement prosthesis: first-line alternative to surgery in snoring.

Mandibular advancement prosthesis (MAP) is infrequently used in the UK at present for snoring. First-line measures include dietary and weight modification for those that require it. Where such measures are unlikely to be useful or have already failed, surgery is sometimes utilized as a second-line treatment modality. We evaluate the use of MAP as an adjunct to first-line measures, with emphasis on efficacy, side-effects and patient compliance. Case notes of 30 snorers were reviewed and followed up with a questionnaire. Despite being useful in alleviating snoring, the prosthesis was poorly tolerated. Side-effects include increased salivation, temporomandibular joint pain, intra-oral and myofacial discomfort. Patients who persevered with the prosthesis found the early side-effects resolved after a few weeks and snoring reduced. MAP can be used in the initial management of snorers but patients need to be educated and encouraged, especially in the first few weeks.

Humans↗
PubMed1998

An alternative technique for mandibular advancement prosthesis fabrication.

One of the conservative and successful modalities of treatment for obstructive sleep apnea is the mandibular advancement prosthesis. This prosthesis engages teeth on both dental arches for retention and stability. This article describes a technique that allows the fabrication of such a prosthesis in one piece and in a single laboratory step. This may be beneficial in reducing the laboratory time required for fabrication of such a prosthesis.

Dental Prosthesis Design↗
PubMed2005

Analysis of the effects of different materials in a tooth implant-supported fixed prosthesis using finite element method.

In this study, design optimization of a tooth implant-supported fixed prosthesis was investigated theoretically. A three-dimensional finite element analysis was utilized to simulate the stress distribution and deformation, with an emphasis on the material selection for various parts of the prosthesis. This mandibular prosthesis was supported by six implants. The properties of 3 different materials for implants and 4 different materials for framework were incorporated into 12 different models. For the loading conditions used, it was found that the largest displacements occurred at the far ends of the framework and that the resulting deflection was highly dependent on the material properties of the framework. The simulations showed that the stress in the framework was mainly concentrated near the holes in the lower surface and that the highest values of von Mises stresses occurred in the lingual part of the prosthesis. Furthermore, the modeling results revealed that more rigid frameworks led to a corresponding decreased stress in the retaining screws and that high-stress concentration areas moved from the neck of the implant towards the base of it, as the value of Young's modulus increased. It was concluded that the first best model was the Cr-Co alloy for the framework and the Ti alloy for the implant and the second best choice was the Cr-Co alloy for both the framework and the implant.

Computer Simulation↗
PubMed1987

Effect of a maxillary glossectomy prosthesis on articulation and swallowing.

Swallowing was found to be substantially improved with the prosthesis. Less aspiration, less time necessary to complete the swallow, and greater variation in food consistency tolerated were all positive results of the prosthesis. In addition, videofluoroscopic studies of tongue movements during speech revealed that tip-alveolar /t-d/ and back-velar /k-g/ productions were more normal with the prosthesis. With the prosthesis, the understandibility of /t/ and /d/ was improved 20% and that of /k/ and /g/, 33%. It is clear that compromises must be effected in prosthesis design to facilitate improvement in both speech and swallowing. A large prosthetic mass in the oral cavity can also negatively change speech resonance. These issues are being investigated, as are acoustic and perceptual studies of speech articulation. Future research should address whether a combination of maxillary and mandibular prostheses would result in better speech and swallowing function. A mandibular prosthesis could replace missing teeth and alveolar contour that might influence speech and swallowing. A mandibular prosthesis might also allow construction of a smaller maxillary glossectomy prosthesis to interact with the mandibular prosthesis.

Articulation Disorders↗
PubMedDate not supplied

[Mandibular surgical prosthesis].

The need for prosthesis in patients presenting losses of mandibular substance has been examined, with a subdivision of prostheses into: containment, immediate modelling and reconstructive. Technical difficulties involved in their application are described.

Denture, Complete, Immediate↗
PubMed1993

Evaluation of strain at the terminal abutment site of a fixed mandibular implant prosthesis during cantilever loading.

PURPOSE: Cantilever lengths from 10 mm to 20 mm have been empirically recommended for Brånemark fixed mandibular implant prostheses. However, functional stresses generated within the framework and at the crestal bone associated with various cantilever lengths have not been well researched. The purpose of this investigation was to evaluate the strain generated within an implant-supported prosthesis and on a simulated bone surface during functional cantilever loading. MATERIALS AND METHODS: A symmetrical mandibular fixed-implant framework supported by six Nobelpharma 7.0 x 4.0-mm abutments and 15.0 x 4.0-mm fixtures was fabricated. The fixtures were embedded in a simulated bone matrix of polymethyl methacrylate resin. Fourteen different arrangements of active supporting abutments were tested during 15 lb unilateral static cantilever loading 7 mm, 14 mm and 20 mm distal to the terminal abutments. T-rosette strain gauges were placed immediately distal to the terminal abutment site on the right side of the framework and on the corresponding simulated bone surface. RESULTS: There was no difference in framework microstrain as abutment number and arrangement were varied. Microstrain distal to the terminal abutment increased significantly with increasing cantilever length. Distal abutment microstrain increased 213% (63 mu epsilon to 197 mu epsilon) when cantilever length was increased from 7 mm to 14 mm and an additional 55% (197 mu epsilon to 306 mu epsilon) when cantilever length was increased from 14 mm to 20 mm. Overall, microstrain increased 306% when cantilever length was increased from 7 mm to 20 mm. Microstrain on the framework was always tensile (positive). Microstrain at the simulated bone reached higher maximum levels than on the framework (-588 mu epsilon versus 314 mu epsilon) and was compressive in nature (negative). In contrast to framework microstrain, microstrain at the simulated bone site varied dramatically with changes in abutment arrangement. Strains observed at the simulated bone surface increased dramatically as the distance to the adjacent active abutment increased or as the anterior-posterior span of abutments decreased. Distal abutment microstrain also increased significantly at the bone site as cantilever length increased, however, percent increases were less (7 mm to 14 mm, 55%; 14 mm to 20 mm, 30%; 7 mm to 20 mm, 101%). CONCLUSIONS: The results of this study indicate that an optimum biomechanical environment should exist when cantilever spans exceeding 7 mm are planned regardless of the number of supporting abutments. Strain transmitted to the crestal bone can be decreased by maximizing the number and anterior-posterior spread of supporting fixtures while minimizing the distance between the distal abutment and its adjacent abutment.

Alveolar Process↗
PubMed2004

Impact of oral health on quality of life among the elderly population of Joaçaba, Santa Catarina, Brazil.

The objective of this study was to investigate the impact of oral health conditions on the quality of life of elderly people in Joaçaba - SC, in Southern Brazil. A survey based on systematic sampling of clusters was carried out with 183 elderly people that belong to old age groups. The survey was conducted in order to assess the oral conditions of the participants (use of and need for prosthesis) based on the criteria from the World Health Organization publication "Oral Health Surveys, Basic Methods", 4th edition. The oral health impact profile (OHIP) was used to evaluate the impact of oral condition in the quality of life. ABIPEME (Brazilian Association of Market Research Institutes) criterion was used, together with the level of education and the number of people in the household to determine social inequalities. The participants were mostly women (82%) and the OHIP mean was 10.35. No correlation was observed between the OHIP level and formal education or between OHIP and number of residents per household. There was a correlation of 0.240 (p = 0.001) between ABIPEME and OHIP. The OHIP mean for those not using maxillary prosthesis was 12.48 and the mean for those using it was 9.81 (p = 0.399). The mean OHIP for those in need of maxillary prosthesis for those who did not need it was 13.00 and 8.88, respectively (p = 0.014). The same trend was found for the use and need for mandibular prosthesis. The conclusion was that the need for maxillary and mandibular prosthesis impacted the quality of life among the elderly population of Joaçaba.

Aged↗