Sleep Apnea News and Research

The results of a new study suggests that prefabricated thermoplastic oral devices for mandibular advancement are not effective for treating mild sleep apnea, and clinicians should use custom-made appliances instead.

The devices made of thermoplastic material, also kown as “boil-and-bite” devices, are supposed to provide individualized fit and to be an alternative to devices made by professionals from dental casts.

“To date, there have been no studies comparing the efficacy of such prefabricated devices with custom-made devices,” states lead author Dr. Olivier M. Vanderveken, from the University of Antwerp in Belgium.

The team’s findings suggest that, in addition to being poor treatment for sleep apnea, thermoplastic devices aren’t useful for screening patients for response to mandibular advancement therapy.

This study was conducted using 35 patients with mild sleep apnea during a 4 month cross-over trial. The patients were treated with each type of device separated by a 1-month period.

The custom-made devices were created using a plaster cast of the patient’s mouth and construction bites. These devices significantly reduced the apnea-hypopnea index. However, the prefabricated appliances did not.

Approximately one third of the patients treated with prefabricated appliances failed to consistently retain the device in their mouths at night. The total failure rate with such devices was over 69%. Sixty-three percent of patients who failed with prefabricated devices, succeeded with custom-made devices.

Eighty-two percent of patients reported a preference for custom-made devices and 9% of subjects indicated no preference.

“Our results suggest that the thermoplastic device cannot be recommended as a therapeutic option nor can it be used as a screening tool to find good candidates for mandibular advancement therapy,” the authors conclude.

The study was published in the July 15th edition of the American Journal of Respiratory and Critical Care Medicine.

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