{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T02:26:07Z","timestamp":1779935167075,"version":"3.53.1"},"reference-count":37,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2022,2,18]],"date-time":"2022-02-18T00:00:00Z","timestamp":1645142400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Dent"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objectives\u2003Obstructive sleep apnea is an inflammatory, chronic, and evolutive disease often needing adequate treatment and follow-up. The oral appliance (OA) is an accepted alternative therapy for obstructive sleep apnea (OSA) control. Due to greater adherence, OA with mandibular advancement (OAm) is being recommended treatment for patients who refuse or do not tolerate continuous positive airway pressure. The mode of action of OAm is to promote the advancement of the mandible or tongue with a subsequent increase in the tone of the pharyngeal muscles and the permeability of the upper airway, but most OAm use conventional models as reference, analogic, or digital, dissociating dental arches of the skull structures.<\/jats:p><jats:p>\n          Materials and Methods\u2003A retrospective longitudinal study of 33 OSA patient treated with a different OAm, that use Camper plane as reference with skull structures for dental arches disocclusion, where polysomnographic, cephalometric measures, and subjective data from questionnaires pre- and post-treatment were assessed and correlated. Descriptive analysis, correlated Chi-square tests, and basic statistics were used. Generalized linear mixed model for repeated measure and post hoc Tukey\u2013Kramer test compares the variables pre- and post-treatment. Shapiro\u2013Wilk test and Pearson's correlation coefficients were used. All statistical tests were set in 5% level of significance.<\/jats:p><jats:p>\n          Results\u2003Regarding polysomnography data, there was a significant association between apnea hypopnea index (AHI) with oxygen saturation, arousal index (AI) and the maximum heartbeats, and sleep improvement and health risk reduction. Additionally, from cephalometric data, it was found a significant association between the tongue posture with the soft palate, hioyd-C3 and, lower and posterior airway. When both parameters are correlated, there are a significant dependent association with hyoid bone position with AHI and AI. The limitation of this study was the two-dimensional image used without provide volumetric measurements, but this limitation was reduced with the follow-up polysomnography parameters.<\/jats:p><jats:p>\n          Conclusion\u2003In this pilot study, DIORS OAm as an uniquely designed device using Camper plane as a reference for disocclusion was effective in the control of OSA.<\/jats:p>","DOI":"10.1055\/s-0041-1735933","type":"journal-article","created":{"date-parts":[[2022,2,19]],"date-time":"2022-02-19T01:20:10Z","timestamp":1645233610000},"page":"564-572","source":"Crossref","is-referenced-by-count":4,"title":["Effectiveness of a Uniquely Designed Oral Appliance on Obstructive Sleep Apnea Control: A Pilot Study"],"prefix":"10.1055","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7253-6144","authenticated-orcid":false,"given":"Denise Fernandes","family":"Barbosa","sequence":"additional","affiliation":[{"name":"Division of Surgical Sciences, Department of Otorhinolaryngology, School of Medical Sciences, University of Campinas, UNICAMP, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6076-0878","authenticated-orcid":false,"given":"Miguel","family":"Meira e Cruz","sequence":"additional","affiliation":[{"name":"Sleep Unit, Centro Cardiovascular da Universidade de Lisboa, Lisbon School of Medicine, Lisbon, Portugal"},{"name":"Research Laboratory on the Neuroimmune Interface of Pain S\u00e3o Leopoldo Mandic College, Campinas, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3463-2642","authenticated-orcid":false,"given":"Marcelo Corr\u00eaa","family":"Alves","sequence":"additional","affiliation":[{"name":"ESALQ, University of Sao Paolo, Piracicaba, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1173-2632","authenticated-orcid":false,"given":"Edilson","family":"Zancanella","sequence":"additional","affiliation":[{"name":"Division of Surgical Sciences, Department of Otorhinolaryngology, School of Medical Sciences, University of Campinas, UNICAMP, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9179-1893","authenticated-orcid":false,"given":"Fausto","family":"Berzin","sequence":"additional","affiliation":[{"name":"Department of Odontology, FOP \u2013 UNICAMP, Piracicaba, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1274-8695","authenticated-orcid":false,"given":"Almiro Jos\u00e9 Machado","family":"J\u00fanior","sequence":"additional","affiliation":[{"name":"Division of Surgical Sciences, Department of Otorhinolaryngology, School of Medical Sciences, University of Campinas, UNICAMP, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,2,18]]},"reference":[{"issue":"08","key":"ref1","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1016\/j.amjcard.2009.12.017","article-title":"Characteristics and predictors of obstructive sleep apnea in patients with systemic hypertension","volume":"105","author":"L F Drager","year":"2010","journal-title":"Am J Cardiol"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"459","DOI":"10.3390\/ijms20030459","article-title":"Obstructive sleep apnea and inflammation: proof of concept based on two illustrative cytokines","volume":"20","author":"L Kheirandish-Gozal","year":"2019","journal-title":"Int J Mol Sci"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.smrv.2016.07.002","article-title":"Prevalence of obstructive sleep apnea in the general population: a systematic review","volume":"34","author":"C V Senaratna","year":"2017","journal-title":"Sleep Med Rev"},{"key":"ref4","volume-title":"International Classification of Sleep Disorders","author":"M J Sateia","year":"2014","edition":"3rd edition."},{"issue":"05","key":"ref5","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1093\/sleep\/22.5.667","article-title":"Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force","volume":"22","author":"W W Flemons","year":"1999","journal-title":"Sleep"},{"key":"ref6","first-page":"S1","article-title":"Obstructive sleep apnea and primary snoring: diagnosis","volume":"80","author":"E Zancanella","year":"2014","journal-title":"Rev Bras Otorrinolaringol (Engl Ed)"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"991","DOI":"10.5664\/jcsm.8442","article-title":"How much is too much after all? Primary snoring as a remaining unsolved issue","volume":"16","author":"M Meira E Cruz","year":"2020","journal-title":"J Clin Sleep Med"},{"issue":"07","key":"ref8","doi-asserted-by":"crossref","first-page":"773","DOI":"10.5664\/jcsm.4858","article-title":"Clinical practice guideline for the treatment of obstructive sleep apnea and snoring with oral appliance therapy: An update for 2015","volume":"11","author":"K Ramar","year":"2015","journal-title":"J Clin Sleep Med"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1055\/s-0040-1717154","article-title":"The knowledge of sleep medicine among dental interns in Northern Jordan","volume":"15","author":"M Alkhader","year":"2021","journal-title":"Eur J Dent"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1719220","article-title":"Continuous positive airway pressure-mandibular advancement device combination therapy for moderate-to-severe obstructive sleep apnea: a preliminary study","author":"T S Premaraj","year":"2021","journal-title":"Eur J Dent"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1055\/s-0039-1698995","article-title":"Cephalometric comparison of obstructive sleep apnea patients and healthy controls","volume":"7","author":"A Y Gungor","year":"2013","journal-title":"Eur J Dent"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1055\/s-0040-1705243","article-title":"Comparison of the accuracy of three-dimensional printed casts, digital, and conventional casts: an in vitro study","volume":"14","author":"P Aly","year":"2020","journal-title":"Eur J Dent"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1055\/s-0039-1698862","article-title":"Cephalometric comparison of pharyngeal airway in snoring and non-snoring patients","volume":"5","author":"G Kurt","year":"2011","journal-title":"Eur J Dent"},{"issue":"04","key":"ref14","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1093\/sleep\/34.4.469","article-title":"Comparative effects of two oral appliances on upper airway structure in obstructive sleep apnea","volume":"34","author":"K Sutherland","year":"2011","journal-title":"Sleep (Basel)"},{"issue":"01","key":"ref15","first-page":"CD004435","article-title":"Oral appliances for obstructive sleep apnoea","volume":"2006","author":"J Lim","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"issue":"04","key":"ref16","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1111\/adj.12111","article-title":"Clinical guidelines for oral appliance therapy in the treatment of snoring and obstructive sleep apnoea","volume":"58","author":"J Ngiam","year":"2013","journal-title":"Aust Dent J"},{"issue":"02","key":"ref17","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1093\/sleep\/29.2.244","article-title":"Oral appliances for snoring and obstructive sleep apnea: a review","volume":"29","author":"K A Ferguson","year":"2006","journal-title":"Sleep"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"3394","DOI":"10.1038\/s41598-020-60034-1","article-title":"Mandibular advancement devices prevent the adverse cardiac effects of obstructive sleep apnea-hypopnea syndrome (OSAHS)","volume":"10","author":"C Liu","year":"2020","journal-title":"Sci Rep"},{"issue":"01","key":"ref19","first-page":"39","article-title":"Definition of an effective oral appliance for the treatment of obstructive sleep apnea and snoring","volume":"1","author":"S C Scherr","year":"2014","journal-title":"J Dent Sleep Med"},{"issue":"01","key":"ref20","first-page":"17","article-title":"ORal appliance network on global effectiveness (ORANGE): start-up and design description","volume":"1","author":"F R Almeida","year":"2014","journal-title":"J Dent Sleep Med"},{"issue":"03","key":"ref21","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s40675-017-0080-5","article-title":"Update on oral appliance therapy for OSA","volume":"3","author":"M Marklund","year":"2017","journal-title":"Curr Sleep Med Rep"},{"issue":"153","key":"ref22","doi-asserted-by":"crossref","first-page":"190083","DOI":"10.1183\/16000617.0083-2019","article-title":"Update on oral appliance therapy","volume":"28","author":"M Marklund","year":"2019","journal-title":"Eur Respir Rev"},{"issue":"06","key":"ref23","doi-asserted-by":"crossref","first-page":"719","DOI":"10.4103\/0970-9290.111246","article-title":"Determination of the relative parallelism of occlusal plane to three ala-tragal lines in various skeletal malocclusions: a cephalometric study","volume":"23","author":"S K Venugopalan","year":"2012","journal-title":"Indian J Dent Res"},{"issue":"06","key":"ref24","first-page":"1","article-title":"Dose-dependent effects of mandibular advancement on upper airway collapsibility and muscle function in obstructive sleep apnea","volume":"42","author":"A A Bamagoos","year":"2019","journal-title":"Sleep (Basel)"},{"issue":"11","key":"ref25","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1111\/j.1365-2842.1995.tb00229.x","article-title":"Electromyographic analysis of the sternohyoid muscle and anterior belly of the digastric muscle in head and tongue movements","volume":"22","author":"F B\u00e9rzin","year":"1995","journal-title":"J Oral Rehabil"},{"issue":"03","key":"ref26","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1093\/ejo\/cjq079","article-title":"A systematic review of the efficacy of oral appliance design in the management of obstructive sleep apnoea","volume":"33","author":"A Ahrens","year":"2011","journal-title":"Eur J Orthod"},{"issue":"03","key":"ref27","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1111\/odi.12291","article-title":"A 2-year mean follow-up of oral appliance therapy for severe obstructive sleep apnea: a cohort study","volume":"21","author":"Y Haviv","year":"2015","journal-title":"Oral Dis"},{"issue":"03","key":"ref28","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1007\/s11325-017-1590-6","article-title":"Effects of CPAP and mandibular advancement device treatment in obstructive sleep apnea patients: a systematic review and meta-analysis","volume":"22","author":"M Schwartz","year":"2018","journal-title":"Sleep Breath"},{"issue":"05","key":"ref29","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1590\/2177-6709.25.5.044-050.oar","article-title":"A singular oral appliance to treat obstructive sleep apnea in CPAP non-adherent patients","volume":"25","author":"D F Barbosa","year":"2020","journal-title":"Dental Press J Orthod"},{"issue":"02","key":"ref30","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1378\/chest.06-2038","article-title":"Dental appliance treatment for obstructive sleep apnea","volume":"132","author":"A SL Chan","year":"2007","journal-title":"Chest"},{"issue":"05","key":"ref31","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1378\/chest.86.5.793","article-title":"Obstructive sleep apnea and abnormal cephalometric measurements. Implications for treatment","volume":"86","author":"C Guilleminault","year":"1984","journal-title":"Chest"},{"issue":"06","key":"ref32","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/S0889-5406(96)80043-6","article-title":"Cephalometric comparisons of craniofacial and upper airway structure by skeletal subtype and gender in patients with obstructive sleep apnea","volume":"110","author":"A A Lowe","year":"1996","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"ref33","first-page":"e37","article-title":"Predictors of success for mandibular repositioning appliance in obstructive sleep apnea syndrome","volume":"31","author":"T CA Cunha","year":"2017","journal-title":"Braz Oral Res"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"8811700","DOI":"10.1155\/2021\/8811700","article-title":"Efficacy of a trial oral appliance in OSAS management: a new protocol to recognize responder\/nonresponder patients","volume":"2021","author":"M Seg\u00f9","year":"2021","journal-title":"Int J Dent"},{"issue":"10","key":"ref35","doi-asserted-by":"publisher","first-page":"1754","DOI":"10.3390\/jcm8101754","article-title":"Obstructive sleep apnea: emerging treatments targeting the genioglossus muscle","volume":"8","author":"O Mediano","year":"2019","journal-title":"J Clin Med"},{"issue":"06","key":"ref36","doi-asserted-by":"crossref","first-page":"563","DOI":"10.3390\/jpm11060563","article-title":"The 6-minute walk test and anthropometric characteristics as assessment tools in patients with obstructive sleep apnea syndrome. a preliminary report during the pandemic","volume":"11","author":"V T Stavrou","year":"2021","journal-title":"J Pers Med"},{"issue":"05","key":"ref37","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1164\/rccm.200208-866OC","article-title":"Identification of upper airway anatomic risk factors for obstructive sleep apnea with volumetric magnetic resonance imaging","volume":"168","author":"R J Schwab","year":"2003","journal-title":"Am J Respir Crit Care Med"}],"container-title":["European Journal of Dentistry"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0041-1735933.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,24]],"date-time":"2022-09-24T00:04:51Z","timestamp":1663977891000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0041-1735933"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,18]]},"references-count":37,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2022,9,23]]},"published-print":{"date-parts":[[2022,7]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0041-1735933","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1305-7456","1305-7464"],"issn-type":[{"value":"1305-7456","type":"print"},{"value":"1305-7464","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,18]]}}}