| [Objective]Obstructive Sleep Apnea Syndrome(OSAS) can cause significant health problems that are associated with a high morbidity and high risk of mortality . For this reason it is not surprising that there are numerous new trends and developments concerning the treatment of Obstructive Sleep Apnea Syndrome .Many years of research have produced significant results in regard to the different therapeutic approaches to OSAS.Nasal ventilation theraps is still the gold standard procedure for OSAS showing a primary success rate of almost 100%. Unfortunately, the long-term acceptance of this treatment modality is not more than 70%. This has prompted the quest for other treatment possibility.Oral appliances offer several advantages over other therapy options.Because they are inexpensive , easy to fabricate , noninvasive, reversible,quiet and well accepted by patients. So,are used increasingly in treatment of OSAS. The previous studies on treating OSAS with dental appliances were published by other scholars , But a further study on the morphological characteristics of OSAS and effect of oral appliances on OSASwould be of a great significance theoretically and practically.The purpose of our study was to research the feature of the craniofacial skeletal struture in OSAS patients, the relationship between effectiveness of oral appliance and craniofaciall skeletal structure, and comparison between the two kinds of oral appliance. [Material and Methods]40 patients of mild and moderate OSAS were divided randomly into two groups. The two group used the different mandibular advancement appliances respectively. A comprehensive cephalometric analysis of the upper airway and craniofacial skeletal structure in patients with OSAS was performed. After treatment with oral appliances about one month, all OSASpatients were re-examined by polysomnography. and evaluated the fixation and comfort of the oral appliances by themselves. Furthermore, this study was designed to evaluate, on the basis of linear correlation analysis ,whether any cephalometric variable could be used as potential predictors of the effectiveness of the oral appliances. [Results]1. The results in upper airway and craniofacial skeletal structure of the patients was observed. SNA 82. 17 3. 12, SPT11.44 2. 50 , There was no significant differences between the OSAS patients and the normal people. SNB77. 39 2. 28, ANB4. 44 1. 97, MP-FH33. 30 4. 30, PNS-R21. 4 3. 55, SPP-SPPW13. 24 2. 04, PAS10. 76 2. 82, SPL40. 56 3. 14, TGL85. 44 5. 91, H-MP15. 04 1. 88, There were significant differences between the OSAS patients and the normal people.2. The clinical effectiveness of the mandibular advancement appliances was obvious:AHI8. 93 4. 11 , AI5. 36 3. 87 , <90%SaO27. 22 6. 94. The objective successful percentage was 88.6%. Most of the patients who did not improvesubstantially belonged to the the patients whose mandibular were not more posteriorly. Furthermore, there existed linear correlation between the improvement of AHI and the morphology of the craniofacial skeletal structure . The larger the mandibular plane angle(r=-0. 529), the longer the height of hyoid (r=-0. 351), the longer the length of soft palate(r=-0.366), the less the improvement of AHI. The larger the angle of ANB(r=0. 536), the more the improvementof AHI. 3. The effectiveness of the two kinds of oral appliance wassimilar ,but the comfort was different. [Conclusion]1. The significant aberration in upper airway and craniofacial skeletal structure of the patients was observed.:the mandibular was more posteriorly positioned , the angle of mandibular plane was higher, the oropharyngeal airway space was significantly narrower , the length of soft palate and tongue were longer, the hyoid bone was located more inferiorly.2. The oral appliances were significantly effective in most of the OSAS patients . the objective successful percentagewas 88.6%. Most of the patients who did not improve substantially belonged to the the patients whose mandibul... |
