A pilot study of quantitative assessment of mandible advancement using pressure-flow relationship during midazolam sedation

T. Ayuse, Y. Hoshino, T. Inazawa, K. Oi, H. Schneider, A. R. Schwartz

Research output: Contribution to journalArticlepeer-review

Abstract

It has been proposed that a titration of the mandibular positioner would be a promising method for predicting the outcome of nasal continuous positive airway pressure (CPAP) therapy. This study was carried out to test the hypothesis that mandible advancement could be evaluated by analysis of inspiratory flow limitation using a titration procedure. To explore its effect, we examined upper airway pressure-flow relationships using a titrated mandible positioner during midazolam sedation. Non-flow limited Inspiration occurred when the mandible was advanced 7.1 ± 1.2 mm from centric occlusion position. In the centric occlusion position (0 mm advancement), Pcrit was -1.9 ± 2.9 cmH2O and Rua was 23.3 ± 4.5 cmH2O L-1 s-1. In the eMAP position, Pcrit was -7.3 ± 1. 9 cmH2O and Rua was 27.8 ± 3.3 cmH2O L -1 s-1. Essentially no CPAP was required to overcome flow limitation in eMAP position, whereas 3.7 ± 2.2 cmH2O CPAP was required in centric occlusion position. We conclude that assessing inspiratory flow limitation using a titrated mandible positioner was effective for estimating individual-matched mandible positions.

Original languageEnglish (US)
Pages (from-to)813-819
Number of pages7
JournalJournal of Oral Rehabilitation
Volume33
Issue number11
DOIs
StatePublished - Nov 2006

Keywords

  • Critical closing pressure
  • Mandible advancement
  • Obstructive sleep apnoea
  • Sedation
  • Upper airway

ASJC Scopus subject areas

  • Dentistry(all)

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