Abstract
Objective: 1) Report our experience with custom-made and thermoplastic mandibular advancement devices (MADs). 2) Compare the cost, efficacy, and compliance of thermoplastic mandibular advancement devices vs custom made MADs.
Method: Retrospective review of 287 consecutive adult outpatients treated between July 2009 and August 2010. Compliance was assessed using chart review and phone interviews after 1 and 6 months. Endpoints included: 1. Efficacy measured by post-MAD AHI.
Results: The percentage of patients achieving AHI reduction criteria for efficacy was 70.3% and 72.2% for thermoplastic vs custom-made devices (P = .204). Compliance more than 4 hours a night for 70% of nights within the first month after receiving MAD was 88.2% for thermoplastic vs 64.3% for custom-made (P < .001). At 6 months compliance was 47.4% for thermoplastic devices vs 61.1% for custom devices (P = .01). The average cost for the thermoplastic devices was $150 vs $1450 for the custom-made devices.
Conclusion: Thermoplastic devices resulted in slightly better compliance rate compared with the custom-made devices during the first month after prescription, but reversed at 6 months. Thermoplastic devices have the advantage of significantly lower cost, higher initial acceptance, and comparable efficacy, whereas custom-made devices result in higher long-term compliance.
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