0594 PREDICTORS OF SUCCESS FOR ORAL APPLIANCE (OA) THERAPY IN OBSTRUCTIVE SLEEP APNEA (OSA) PATIENTS BASED ON INITIAL CRANIOFACIAL CHARACTERISTICS

Abstract

The aim of this investigation was to explore hard and soft tissue cephalometric predictors for the success of oral appliance therapy, in patients with varying severity of OSA. A review of 108 consecutively treated patients with OSA was performed at the Dental Sleep Medicine Clinic at Tufts University School of Dental Medicine. Fifty-two subjects, all treated with OA therapy were included. Our predictive factors included BMI, age, gender, mandibular plane angle (MP), vertical distance between MP and the most superior point of the hyoid bone (MP-H), ANB angle (ANB), soft tissue ANB angle (S.T. ANB), anterior-posterior upper lip position (UL-VL), anterior-posterior lower lip position (LL-VL), and anterior-posterior soft tissue chin position (C-VL). Treatment success was defined in three ways: 1. At least 50% reduction in initial AHI, 2. Residual AHI ≤ 10 after treatment, and 3. Residual AHI ≤ 5. A multiple regression model was developed to study the effect of various variables on success. The level of statistical significance was set at 0.05. No statistically significant differences were found between subjects with mild, moderate and severe OSA (P>0.05). BMI (median= 28.3, IQR = 5.9) was weakly correlated to AHI (rs = 0.28, P = 0.045). OA therapy resulted in 51.9%, 55.7% and 30.7% successful outcomes, using the first, second and third methods of defining success, respectively. MP and C-VL were positively associated with treatment success (AUCMP= 0.67 and AUCC-VL= 0.71). A weak positive correlation was found between BMI and OSA severity. The MP and C-VL were significantly correlated to the outcome of OA therapy, but showed a weak to moderate predictability for the success of OA therapy. The results should be interpreted with caution and their clinical significance should be investigated in future studies. N/A.