Effects of a mandibular advancement device on genioglossus in obstructive sleep apnoea hypopnea syndrome.

Abstract

To investigate effects of mandibular advancement device (MAD) therapy for obstructive sleep apnoea hypopnea syndrome (OSAHS) on the genioglossus contractile properties and fibre-type distribution. Thirty 6-month old male New Zealand white rabbits were randomised into three groups: OSAHS, MAD, and controls. Rabbits in Group OSAHS and Group MAD were established as OSAHS models by injection, at a dose of 2 ml hydrophilic polyacrylamide gel, via the submucous muscular layer of soft palate. Spiral computed tomography (CT) showed a significant reduced retropalatal upper airway, and apnoeas happened with an increase of Apnea Hypopnea Index (AHI) and a decrease of blood oxygen saturation during polysomnography (PSG), which indicated the OSAHS model developed successfully. OSAHS rabbits in Group MAD were fitted with a MAD made from self-curing composite resin, at 30 degrees to the upper incisors, and the mandible was guided forward 3 to 4mm. Further, spiral CT and PSG suggested MAD was effective. Rabbits in 3 groups were induced to sleep for 4-6 hours per day for 8 weeks, after which the genioglossus was removed, mounted in a tissue bath, and stimulated through platinum electrodes; maximal twitch tension, contraction time, half-relaxation time, force-frequency relationship, and fatigability were recorded. The percentage of Type I and Type II fibres was quantified. The fatigability and percentage of Type II fibres of genioglossus increased in Group OSAHS compared with controls; this abnormality was corrected by MAD. MAD therapy for OSAHS could prevent genioglossus fatigue and abnormal fibre-type distribution of genioglossus in OSAHS.