Korean J Orthod.  2010 Apr;40(2):115-126. 10.4041/kjod.2010.40.2.115.

Microimplant mandibular advancement (MiMA) therapy for the treatment of snoring and obstructive sleep apnea (OSA)

• Ngiam J
• Kyung HM

• KMID: 2273219
• DOI: http://doi.org/10.4041/kjod.2010.40.2.115

Abstract

This case report describes the treatment of a 66 year old adult patient with a diagnosis of severe obstructive sleep apnea who was intolerant of nasal continuous positive airway pressure (nCPAP) treatment and oral appliance therapy. An alternative treatment of snoring and obstructive sleep apnea (OSA) with 2 orthodontic microimplants anchored to the mandible providing skeletal anchorage for mandibular advancement was implemented. After a 2 week healing period, a custom designed facemask provided extraoral anchorage to which the microimplants were connected to for titratable mandibular advancement. Microimplant Mandibular Advancement (MiMA) therapy resulted in resolution of the symptoms of severe OSA with a reduction of the apnea-hypopnea index (AHI), snoring and OSA symptoms.

Keyword

Severe obstructive sleep apnea; Microimplant; Mandibular advancement

MeSH Terms

Adult
Continuous Positive Airway Pressure
Humans
Mandible
Mandibular Advancement
Sleep Apnea, Obstructive
Snoring

Figure

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  Fig 1. 2 Microimplants (Absoanchor, Dentos Inc. Daegu, Korea) made of titanium Grade 5 alloy fabricated with mushroom head for comfort (1.6 mm diameter, 8 mm or 10 mm length).

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  Fig 2. 2 Microimplants (1.6 x 10 mm long) inserted by hand driver in the mandible distal to both lower canines. The self-tapping method was used under copious irrigation.

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  Fig 3. A, Microimplant attached to titratable connector; B, frontal view of both microimplants attached to a connector.

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  Fig 4. Custom fabricated facemask for mandibular advancement.

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  Fig 5. Panoramic radiograph of patient with 2 microimplants (1.6 mm diameter x 10 mm long) inserted in the mandible (A). Lateral view of 2 microimplants inserted in the mandible (B), and with MiMA therapy (C). An increase in retro-glossal airway size can be seen following mandibular advancement with MiMA therapy.

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