Banca de DEFESA: DANIELA SAMPAIO CARVALHO CLARK

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : DANIELA SAMPAIO CARVALHO CLARK
DATE: 24/03/2025
TIME: 09:00
LOCAL: Sala de Reunião 5 - FS
TITLE:

Effìcacy of Mandibular Advancement Devices: Assessment and Outcome Prediction in the Treatment of Obstructive Sleep Apnea 

KEY WORDS:

Obstructive sleep apnea, mandibular advancement device, efficacy, ultrasound, prediction, oximeter, polysomnography.

PAGES: 100
BIG AREA: Ciências da Saúde
AREA: Odontologia
SUMMARY:

Predictive factors of success in the treatment of obstructive sleep apnea with mandibular advancement devices are still relatively understudied. Most research utilizes imaging exams that involve ionizing radiation or magnetic resonance, which present, respectively, increased biological risk and high cost. This study proposes an innovative approach by employing ultrasonography to analyze the morphology of suprahyoid soft tissues in patients with obstructive sleep apnea treated with mandibular advancement devices. Objective: To evaluate the efficacy of a new custom-made, 3D-printed mandibular advancement device for the treatment of obstructive sleep apnea, as well as to identify possible morphological predictors of therapy success through an innovative methodology based on ultrasonography of the suprahyoid tissues. Methods: Twenty participants with a prior diagnosis of obstructive sleep apnea through type 1 polysomnography, who had already begun CPAP treatment and were either non-compliant or seeking an alternative treatment, were included in the study. Participants were treated with a personalized mandibular advancement device. The effects of the therapy were analyzed using type 4 polysomnography. Measurements were taken at three distinct periods: 1) at the start of the treatment, without the mandibular advancement device (T0); 2) at the end of the titration (T1); 3) six months after the beginning of the treatment (T2). Imaging of anatomical structures of the upper airway and the tongue was conducted. Treatment response was defined as the difference between the values recorded at the end of titration and at the start of treatment for each polysomnographic variable studied. Results: The mandibular advancement device significantly improved all analyzed polysomnographic variables, and efficacy was maintained over the six-month evaluation period. Airway length was the only morphological factor identified by ultrasonography as a predictor of treatment efficacy, both in the reduction of ODI (R= 0.593; R2=0.351; p=0.012), T90 (R=0.561; R2=0.315; p=0.019), and Hypoxic Burden (R=0.61; R2=0.372; p=0.012). The longer the airway, the better the treatment responses observed. Conclusions: The studied mandibular advancement device was effective for the treatment of obstructive sleep apnea. Among the ultrasonographic variables studied, airway length proved to be a statistically significant predictor of therapy success with a mandibular advancement device in reducing ODI, T90, and Hypoxic Burden. A longer airway indicated a better treatment response, suggesting this structural factor may be important for choosing this device as a treatment. Ultrasonography is a promising exam for analyzing patients with obstructive sleep apnea.

COMMITTEE MEMBERS:
Presidente - ***.983.411-** - JORGE DO NASCIMENTO FABER - UnB
Interna - 2867208 - ELIANA MITSUE TAKESHITA NAKAGAWA
Externa ao Programa - 3155042 - JANINE DELLA VALLE ARAKI - UnBExterno à Instituição - ALESSANDRO LOURENÇO JANUÁRIO - ARIA