Objective measurement of sleep disordered breathing in mandibular advancement splint and rapid maxillary expansion therapy with the Sonomat™

Abstract

In both adults and children, anatomic factors have increasingly been implicated as a key contributory factor to upper airway obstruction and obstructive sleep apnea (OSA). Craniofacial and dento-morphological abnormalities such as maxillary constriction or mandibular retrusion have also been highly associated with adults and children who snore or have OSA. Dental treatment of these common craniofacial abnormalities often involves the use of rapid maxillary expansion (RME) and mandibular advancement splint (MAS) therapies. This thesis investigates the effects of RME in children and MAS treatment in adults using a novel diagnostic test, the Sonomat™ which has been developed at The University of Sydney for the diagnosis of sleep disordered breathing. The Sonomat™ has been validated against polysomnography. It is able to generate sleep-related indices such as the apnea hypopnea index and also provides an objective measurement of snoring. Overall, both RME and MAS therapies were beneficial for a good majority of adults and children with a subset of patients receiving little benefit from the respective therapies. Further studies are required to identify subjects who do not benefit from RME or MAS therapy and alternative treatment options or combination therapies may be warranted in these patients.