Establishment of Oral Application Criteria

Research Project

Project/Area Number	20K18708
Research Category	Grant-in-Aid for Early-Career Scientists
Allocation Type	Multi-year Fund
Review Section	Basic Section 57060:Surgical dentistry-related
Research Institution	Osaka Medical and Pharmaceutical University
Principal Investigator	Matsumura Mayumi 大阪医科薬科大学, 医学部, 非常勤医師 (60711273)
Project Period (FY)	2020-04-01 – 2022-03-31
Project Status	Completed (Fiscal Year 2021)
Budget Amount *help	¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000) Fiscal Year 2021: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000) Fiscal Year 2020: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000)
Keywords	閉塞性睡眠時無呼吸 / 口腔内装置 / 口腔機能 / AHI / 最大咬合力 / 口唇閉鎖力 / 舌圧 / 睡眠時無呼吸症候群 / 下顎骨 / 顔貌 / 相同モデル / 閉塞性睡眠時無呼吸症候群
Outline of Research at the Start	Dynamic MRIを利用して得られるMRI多組織再構築三次元モデルを作成する。このモデルは軟口蓋と咽頭の筋肉を正確に描出したモデルとして作成し、相同モデルとしたうえで、Free Form Deformation(FFD)法を応用して、筋肉と気道形態の関連性を三次元的に経時的に解析できるようにする。Dynamic MRIは時間分解能の高い情報を得ることが可能であるため、本研究では薬物投与睡眠下での経時的な分析により、睡眠中の気道の狭窄状況とその原因を併せて経時的に解析を行い、閉塞性睡眠時無呼吸症候群(OSAS)発症機序を解明し、口腔内装置(OA)の選択基準に関するエビデンスの創出を目指す。
Outline of Final Research Achievements	To investigate the relationship between oral function and respiratory disturbance index (RDI). This has not been reported previously. Sixty-one patients (41 males, 20 females) who were treated for obstructive sleep apnea with an oral appliance were enrolled in this study. Mean age and body mass index were 55.5±12.7 years and 24.4±4.0 kg/m2, respectively. Patients were classified into groups based on body mass index (non-obese group, < 25.0 kg/m2 and obese group, ≧ 25.0 kg/m2) and severity of RDI (mild group 5≦RDI < 15 and moderate and severe group RDI >15). RDI was measured by portable monitoring and oral function was measured as maximum occlusal force, tongue pressure and labial closure force. A significant negative correlation was found between labial closure force and RDI in the total cohort and in non-obese cases (P<0.05). This study suggests that labial closure force may affect sleep-disordered breathing.
Academic Significance and Societal Importance of the Research Achievements	閉塞性睡眠時無呼吸に罹患する患者は非常に多いが、様々な要因が関与して発症するため、未だ病態など不明な点が多い。本課題で口唇閉鎖力と睡眠時の呼吸障害との関連が明らかになったことから、今後は閉塞性睡眠時無呼吸の新たな治療方法の開発や治療方法の選択基準の確立につながると考えられる。