A magnetic appliance for treatment of snoring patients with and without obstructive sleep apnea

The aim of this intraindividual study was to investigate the effects of an intraoral magnetic appliance on snoring, daytime sleepiness, and blood oxygen saturation, as well as to analyze the effects on the craniomandibular complex and investigate the response of the device to craniofacial structure. Twenty-five male patients (mean age 54.1 years, SD 11.44) with handicapping snoring or obstructed sleep apnea (OSAS) participated in the study. The appliance consisted of a maxillary and a mandibular occlusal acrylic splint. In each splint, four cylindrical neodymium-iron-boron magnets were embedded and oriented to produce intermaxillary forces that pulled the mandible forward. After a treatment period of 6 months, questionnaires were used for registration of the patients' subjective rating of daytime sleepiness and their close relatives' opinions about the snoring. The treatment effects on the temporomandibular joint were evaluated, according to Helkimos' anamnestic and dysfunctional index, and nightly registration of blood oxygen saturation was performed before and after 6 months of treatment. The effects on craniofacial skeletal and soft tissue profiles were analyzed cephalometrically. All patients easily accepted the magnetic appliance. The main symptoms, snoring and daytime sleepiness, decreased significantly when the magnet appliance was inserted (p = 0.0001 and p = 0.0002, respectively). The blood oxygen saturation during sleep was also improved (p = 0.012). The treatment had no aberrant effects on the temporomandibular joint status. The appliance made the mandible rotate downward and backward, mean 7.8 degrees, and this rotation mostly camouflaged the forward movement of the mandible. There was no significant influence on the hyoid bone position, but the hypopharyngeal airway space increased, the tongue base was lowered, and the contact between the tongue and soft palate was reduced significantly.