Initial Evaluation of a Titration Appliance for Temporary Treatment of Obstructive Sleep XXXX .

@entity1 @entity387 @entity27 @entity519 @entity25 @entity386
BACKGROUND: Custom oral appliances that adjustably advance the mandible provide superior outcomes when treating @entity1 with moderate or severe @entity387 . Custom appliances, however, are expensive, must be fitted by a dentist, and the likelihood of successful outcomes are difficult to predict. An inexpensive trial appliance, if proven efficacious, might be used to predict custom appliance outcomes or to provide temporary therapeutic benefit. OBJECTIVE: The aim of this initial study was to assess the treatment efficacy of a novel titration oral appliance with that of an optimized custom appliance. METHODS: Seventeen @entity1 , treated with a custom oral appliance for at least one year, successfully completed a three-night home sleep test. The @entity27 severity was established on Night 1 with seven @entity1 exhibiting severe, six moderate and four mild @entity386 / @entity387 indexes. @entity1 were randomly assigned to wear their custom appliance or the titration appliance on Nights 2 and 3. RESULTS: Significant reductions in the mean overall and supine @entity386 indexes (p < 0.05), and the overall (p < 0.01) and supine (p < 0.05) @entity386 / @entity387 indexes were observed for both the titration and custom appliances. The proportion of @entity1 who exhibited at least a 50% reduction in the overall @entity386 index and supine @entity386 / @entity387 were similar for the titration and custom appliance (~60%). The custom appliance reduced the overall @entity386 / @entity387 index by 50% in a greater proportion of the @entity1 compared to the titration appliance (77% vs. 53%). The titration appliance significantly reduced the degree of @entity519 exposure across @entity25 breathing events overall (p < 0.05) and supine (p < 0.01). @entity1 found their custom appliance was more comfortable than the titration appliance, but preferred the titration appliance to no therapy. CONCLUSION: The titration appliance may be useful in assessing oral appliance treatment efficacy. When set to 70% of maximum protrusion, the titration appliance may provide immediate, temporary therapeutic benefit.
