The effects of mandibular advancement appliance therapy on jaw-closing muscle activity time-related to oxygen desaturations: A randomised controlled trial

Boyuan Kuang; Ghizlane Aarab; Frank Lobbezoo; Buu T. Tran; Patrick Arcache; Gilles Lavigne; Nelly Huynh

doi:10.1111/joor.13433

The effects of mandibular advancement appliance therapy on jaw-closing muscle activity time-related to oxygen desaturations: A randomised controlled trial

Boyuan Kuang^*, Ghizlane Aarab, Frank Lobbezoo, Buu T. Tran, Patrick Arcache, Gilles Lavigne, Nelly Huynh

^*Corresponding author for this work

Oral Kinesiology

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Background: Previous study showed that in individuals with obstructive sleep apnea (OSA), the contractions of masseter muscles after respiratory events can be nonspecific motor phenomena, dependent on the duration of respiratory arousals rather than the occurrence of the respiratory events. However, the role of intermittent hypoxia in the occurrence of jaw-closing muscle activities (JCMAs) was not taken into consideration. An exposure to intermittent hypoxia has been shown to initiate a series of activities, including muscular sympathetic activity in patients with OSA. Objective: To determine the effects of mandibular advancement appliance (MAA) therapy on JCMA time-related to oxygen desaturation with and without arousal in individuals with OSA. Methods: Eighteen individuals with OSA (age: 49.4 ± 9.8 years, apnea-hypopnea index (AHI): 10.0|18.4|30.3, JCMA index: 1.7|4.3|5.6), participated in a randomised controlled crossover clinical trial, in which two ambulatory polysomnographic recordings were performed: one with MAA in situ and the other without MAA in situ. JCMAs were recorded bilaterally from both masseter and temporalis muscles. Results: There was no significant effect of the MAA on the overall JCMA index (Z = −1.372, p =.170). With the MAA in situ, JCMA index time-related to oxygen desaturation with arousal significantly decreased (Z = −2.657, p =.008), while there was no significant effect of the MAA on the JCMA index time-related to oxygen desaturation without arousal (Z = −0.680, p =.496). Conclusion: Effective mandibular advancement appliance therapy significantly reduces jaw-closing muscle activities time-related to oxygen desaturation with arousal in individuals with OSA.

Original language	English
Pages (from-to)	460-467
Number of pages	8
Journal	Journal of Oral Rehabilitation
Volume	50
Issue number	6
Early online date	16 Feb 2023
DOIs	https://doi.org/10.1111/joor.13433
Publication status	Published - Jun 2023

Bibliographical note

Funding Information:
Boyuan Kuang reports grants from China Scholarship Council, during the conduct of the study. Ghizlane Aarab reports other from SomnoDent, during the conduct of the study. CSC and SomnoMed had no input in the data analyses and publication of this article. Frank Lobbezoo reports Grants and Other from Sunstar Suisse SA, grants from Vivisol‐Resmed, grants from Somnomed‐Goedegebuure, grants from Health Holland/TKI, grants from NWO, outside the submitted work. The other authors declare no conflict of interest.

Publisher Copyright:
© 2023 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.

Keywords

mandibular advancement appliance
obstructive sleep apnea
oxygen desaturation
randomised clinical trial
sleep arousal
sleep bruxism

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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@article{53e61b1607e54866bfb2f9f8ff8df838,

title = "The effects of mandibular advancement appliance therapy on jaw-closing muscle activity time-related to oxygen desaturations: A randomised controlled trial",

abstract = "Background: Previous study showed that in individuals with obstructive sleep apnea (OSA), the contractions of masseter muscles after respiratory events can be nonspecific motor phenomena, dependent on the duration of respiratory arousals rather than the occurrence of the respiratory events. However, the role of intermittent hypoxia in the occurrence of jaw-closing muscle activities (JCMAs) was not taken into consideration. An exposure to intermittent hypoxia has been shown to initiate a series of activities, including muscular sympathetic activity in patients with OSA. Objective: To determine the effects of mandibular advancement appliance (MAA) therapy on JCMA time-related to oxygen desaturation with and without arousal in individuals with OSA. Methods: Eighteen individuals with OSA (age: 49.4 ± 9.8 years, apnea-hypopnea index (AHI): 10.0|18.4|30.3, JCMA index: 1.7|4.3|5.6), participated in a randomised controlled crossover clinical trial, in which two ambulatory polysomnographic recordings were performed: one with MAA in situ and the other without MAA in situ. JCMAs were recorded bilaterally from both masseter and temporalis muscles. Results: There was no significant effect of the MAA on the overall JCMA index (Z = −1.372, p =.170). With the MAA in situ, JCMA index time-related to oxygen desaturation with arousal significantly decreased (Z = −2.657, p =.008), while there was no significant effect of the MAA on the JCMA index time-related to oxygen desaturation without arousal (Z = −0.680, p =.496). Conclusion: Effective mandibular advancement appliance therapy significantly reduces jaw-closing muscle activities time-related to oxygen desaturation with arousal in individuals with OSA.",

keywords = "mandibular advancement appliance, obstructive sleep apnea, oxygen desaturation, randomised clinical trial, sleep arousal, sleep bruxism",

author = "Boyuan Kuang and Ghizlane Aarab and Frank Lobbezoo and Tran, {Buu T.} and Patrick Arcache and Gilles Lavigne and Nelly Huynh",

note = "Funding Information: Boyuan Kuang reports grants from China Scholarship Council, during the conduct of the study. Ghizlane Aarab reports other from SomnoDent, during the conduct of the study. CSC and SomnoMed had no input in the data analyses and publication of this article. Frank Lobbezoo reports Grants and Other from Sunstar Suisse SA, grants from Vivisol‐Resmed, grants from Somnomed‐Goedegebuure, grants from Health Holland/TKI, grants from NWO, outside the submitted work. The other authors declare no conflict of interest. Publisher Copyright: {\textcopyright} 2023 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.",

year = "2023",

month = jun,

doi = "10.1111/joor.13433",

language = "English",

volume = "50",

pages = "460--467",

journal = "Journal of Oral Rehabilitation",

issn = "0305-182X",

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T1 - The effects of mandibular advancement appliance therapy on jaw-closing muscle activity time-related to oxygen desaturations

T2 - A randomised controlled trial

AU - Kuang, Boyuan

AU - Aarab, Ghizlane

AU - Lobbezoo, Frank

AU - Tran, Buu T.

AU - Arcache, Patrick

AU - Lavigne, Gilles

AU - Huynh, Nelly

N1 - Funding Information: Boyuan Kuang reports grants from China Scholarship Council, during the conduct of the study. Ghizlane Aarab reports other from SomnoDent, during the conduct of the study. CSC and SomnoMed had no input in the data analyses and publication of this article. Frank Lobbezoo reports Grants and Other from Sunstar Suisse SA, grants from Vivisol‐Resmed, grants from Somnomed‐Goedegebuure, grants from Health Holland/TKI, grants from NWO, outside the submitted work. The other authors declare no conflict of interest. Publisher Copyright: © 2023 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.

PY - 2023/6

Y1 - 2023/6

N2 - Background: Previous study showed that in individuals with obstructive sleep apnea (OSA), the contractions of masseter muscles after respiratory events can be nonspecific motor phenomena, dependent on the duration of respiratory arousals rather than the occurrence of the respiratory events. However, the role of intermittent hypoxia in the occurrence of jaw-closing muscle activities (JCMAs) was not taken into consideration. An exposure to intermittent hypoxia has been shown to initiate a series of activities, including muscular sympathetic activity in patients with OSA. Objective: To determine the effects of mandibular advancement appliance (MAA) therapy on JCMA time-related to oxygen desaturation with and without arousal in individuals with OSA. Methods: Eighteen individuals with OSA (age: 49.4 ± 9.8 years, apnea-hypopnea index (AHI): 10.0|18.4|30.3, JCMA index: 1.7|4.3|5.6), participated in a randomised controlled crossover clinical trial, in which two ambulatory polysomnographic recordings were performed: one with MAA in situ and the other without MAA in situ. JCMAs were recorded bilaterally from both masseter and temporalis muscles. Results: There was no significant effect of the MAA on the overall JCMA index (Z = −1.372, p =.170). With the MAA in situ, JCMA index time-related to oxygen desaturation with arousal significantly decreased (Z = −2.657, p =.008), while there was no significant effect of the MAA on the JCMA index time-related to oxygen desaturation without arousal (Z = −0.680, p =.496). Conclusion: Effective mandibular advancement appliance therapy significantly reduces jaw-closing muscle activities time-related to oxygen desaturation with arousal in individuals with OSA.

AB - Background: Previous study showed that in individuals with obstructive sleep apnea (OSA), the contractions of masseter muscles after respiratory events can be nonspecific motor phenomena, dependent on the duration of respiratory arousals rather than the occurrence of the respiratory events. However, the role of intermittent hypoxia in the occurrence of jaw-closing muscle activities (JCMAs) was not taken into consideration. An exposure to intermittent hypoxia has been shown to initiate a series of activities, including muscular sympathetic activity in patients with OSA. Objective: To determine the effects of mandibular advancement appliance (MAA) therapy on JCMA time-related to oxygen desaturation with and without arousal in individuals with OSA. Methods: Eighteen individuals with OSA (age: 49.4 ± 9.8 years, apnea-hypopnea index (AHI): 10.0|18.4|30.3, JCMA index: 1.7|4.3|5.6), participated in a randomised controlled crossover clinical trial, in which two ambulatory polysomnographic recordings were performed: one with MAA in situ and the other without MAA in situ. JCMAs were recorded bilaterally from both masseter and temporalis muscles. Results: There was no significant effect of the MAA on the overall JCMA index (Z = −1.372, p =.170). With the MAA in situ, JCMA index time-related to oxygen desaturation with arousal significantly decreased (Z = −2.657, p =.008), while there was no significant effect of the MAA on the JCMA index time-related to oxygen desaturation without arousal (Z = −0.680, p =.496). Conclusion: Effective mandibular advancement appliance therapy significantly reduces jaw-closing muscle activities time-related to oxygen desaturation with arousal in individuals with OSA.

KW - mandibular advancement appliance

KW - obstructive sleep apnea

KW - oxygen desaturation

KW - randomised clinical trial

KW - sleep arousal

KW - sleep bruxism

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JO - Journal of Oral Rehabilitation

JF - Journal of Oral Rehabilitation

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ER -

The effects of mandibular advancement appliance therapy on jaw-closing muscle activity time-related to oxygen desaturations: A randomised controlled trial

Abstract

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Keywords

UN SDGs

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