Reliabilty of recording occlusal contacts by using intraoral scanner and articulating paper - A prospective study.

OBJECTIVE: The recording of occlusal contacts is a pivotal step in many dental procedures, yet the lack of a standardized method could introduce clinical errors. The aim of this study was to compare the occlusal contacts recorded using a intraoral scanner to the contacts recorded using articulating paper. As a secondary outcome, the subjective clinical assessment made using the two methods was compared between different observers. METHODS: Twenty-eight records were analysed for this study. Digital scan and intraoral photos of the coloured marks impressed by articulating paper were taken at the same time point for every patient. Using a standardized occlusal template, two operators recorded the number of occlusal contacts for every tooth provided by the two techniques. Then, 11 clinicians analysed the collected records and answered questions about the quality of the occlusions observed. RESULTS: The statistical analysis showed significant differences between the number of contacts recorded by digital scan and those recorded by the photographed articulation marks, except in the case of the upper central incisors and first premolars. The Kappa Fleiss showed slight and fair agreement between clinicians when judging the occlusions. CONCLUSION: The occlusal contacts recorded using the intraoral scanner and those recorded with the articulating paper did not match, and overall the clinicians showed low agreement when rating the recorded data. CLINICAL SIGNIFICANCE: Despite of the great clinical importance of occlusal contact there is a lack of a precise method for recording and collecting occlusal contacts.

Thermoplastic clear dental aligners under cyclic compression loading: A mechanical performance analysis using acoustic emission technique.

The objective of this work is to analyse the performance of clear aligners made of thermoplastic materials. Within this framework, the damage evolution stages and damage states of the aligners at different cycles of the compressive loading are evaluated using the Acoustic Emission (AE) technique. Three different clear aligner systems were prepared: thermoformed PET-g (polyethylene terephthalate glycol) and PU (polyurethane), and additively manufactured PU. Cyclic compression tests are performed to simulate 22500 swallows. The mechanical results show that the energy absorbed by the thermoformed PET-g aligner remains stable around 4 Nmm throughout the test. Although the PU-based aligners show a higher energy absorption of about 7 Nmm during the initial phase of the cyclic loading, this gradually decreases after 12500 cycles. The time-domain based, and frequency-based parameters of the stress wave acoustic signals generated by the aligners under compression loading are used to identify the damage evolution stages. The machine learning-based AE results reveal the initiation and termination of the different damage states in the aligners and the frequency-based results distinguish the different damage sources. Finally, the microscopy results validated the damage occurrences in the aligners identified by the AE results. The mechanical test results indicate that the thermoformed PET-g has the potential to match the performance and requirements of the dentistry of the popular Invisalign (additively manufactured PU). The AE results have the potential to identify at which cycles the aligners may start losing their functionality.

Skeletal and dental effects of function-generating bite appliance compared to rapid palatal expander and untreated controls.

INTRODUCTION: Maxillary expansion is a fundamental interceptive orthodontic treatment, which can be achieved through either a rapid expansion protocol or functional devices. However, no data exist about the efficacy of functional devices in achieving skeletal expansion. Therefore, the aim of this study was to compare the effects of the rapid palatal expander (RPE) and the function-generating bite type M (FGB-M) on the transversal dimension of the maxilla, and on the maxillary and mandibular dental arch width. METHODS: One hundred eighty-one skeletal Class I patients, aged between 6 and 12 years and with a cervical vertebral maturation stage II or III, with maxillary transversal deficiency were retrospectively enrolled; among these 55 were treated with FGB-M, 73 were treated with RPE and 51 were untreated subjects retrieved from historical databases. The pre-treatment (T0) and post-treatment (T1) frontal cephalograms were retrieved, and the maxillary and mandibular widths, and the distance between upper and lower first molars were measured. T1-T0 interval was of 17.3 months (RPE), 24.6 months (FGB-M) and 18.2 months (controls). RESULTS: The statistical analysis showed that there were no statistically significant differences between the RPE and FGB-M groups regarding skeletal and dental expansion, while the untreated control group differed significantly from the other two groups. CONCLUSION: The comparison between patients treated with RPE and FGB-M showed that there were no statistically significant differences between the RPE and FGB-M groups regarding the amount of skeletal expansion and dental arch width, suggesting that both appliances can be used to achieve similar results.

The Correlation between Mandibular Arch Shape and Vertical Skeletal Pattern.

Background and Objectives: The aim of this study was to evaluate the correlation between the mandibular arch shape and the vertical skeletal pattern in growing patients. Materials and Methods: A total of 73 Caucasian patients (33 males and 40 females; mean age 9.4) were retrospectively enrolled from a pool of patients treated in chronological order at the Department of Orthodontics, University of Foggia, Italy, from April 2018 to December 2021. Each patient received a laterolateral radiograph and a digital scan of the dental arch. Eight cephalometric parameters (lower gonial angle, intermaxillary angle, divergence angle, Wits index, Jarabak ratio, OP-MP angle, PP-OP angle, and ANB) and five dental measurements (posterior mandibular arch width, anterior mandibular arch width, mandibular occlusal angle, posterior width on distobuccal molar cusps, and molar angle) were analyzed and then compared. A Spearman's rho correlation test between the cephalometric measurements and the dental measurements was performed. Statistical significance was set at p < 0.05. Results: A negative statistically significant correlation was found between the Jarabak ratio and the intermolar angle; a statistically significant correlation was also observed between the Wits index, the posterior mandibular width, and the occlusal mandibular angle; the ANB angle and the occlusal mandibular angle; the intermaxillary angle (PP-PM) and the mandibular occlusal angle, posterior mandibular width on the disto-vestibular cusp, and the intermolar angle; and the OP-MP angle and mandibular occlusal angle and the posterior mandibular width on the disto-vestibular cusp. Conclusions: The mandibular arch form may be related to certain predisposing features in craniofacial morphology, such as jaw divergence, the Jarabak ratio, and the intermaxillary angle.

Treatment of Mandibular Impacted Canine in a Patient with Class II Division 1 Malocclusion with "Reverse Pin": A Case Report.

This case report presents an orthodontic treatment conducted on a 13-year-old girl with bilateral Class II malocclusion and a mandibular impacted canine. The presence of an impacted tooth necessitates careful consideration of the timing of orthodontic treatment, the appropriate surgical procedure to expose the tooth, the specific orthodontic mechanics involved, and the potential problems that may arise, all of which depend on the type and location of the canine impaction in the jaw. The treatment plan included a surgical procedure to expose the impacted tooth and orthodontic traction to guide it into position. Correction of the Class II Division 1 malocclusion utilized a specialized technique called the "reverse pin", reducing vertical side effects. The revised version maintains clarity and key information about the case report and treatment.

Correction of Class III Malocclusion Treated with Carriere® Motion™.

Class III malocclusion needs complex orthodontic treatment. This case report describes a 16-year-old male patient with skeletal class III malocclusion with a negative overjet and overbite. Upper incisors were proclined with the accentuated curve of Wilson. Treatment has changed the functional curve of Wilson that has improved functional dynamic occlusion. The patient was treated using a Carriere® Motion™ Class III (CM3) and SLX 3D Brackets system. After a 25-month treatment, the patient reached class I molars and canines relationships on both sides with good facial aesthetics and good functional occlusion. The result was also satisfactory for the patient. A one-year follow-up confirmed that the outcome was stable.

The efficacy of a modified mandibular advancement device for OSA treatment in a group of adult patients.

OBJECTIVE: The Mandibular Advancement Device (MAD) is actually recommended for the treatment of Obstructive Sleep Apnea (OSA) with mild or moderate severity. The present study evaluated the effects of a fully customizable MAD-type device (It Makes You Sleep, IMYS), in patients with moderate-to-severe OSA. METHODS: Twenty-nine patients (15 men and 14 women; mean age 62, SD ±10 years) were retrospectively enrolled. Home Sleep Apnea Testing ;(HSAT) was performed for all patients at baseline (T0) and after three months (T1) of IMYS therapy. The analyzed respiratory parameters were: Apnea-Hypopnea Index (AHI), Oxygen Desaturation Index (ODI), Minimum Oxygen Saturation (minSO2) and Medium Oxygen Saturation (medSO2). RESULTS: From T0 to T1, a significant reduction of AHI and ODI was reported, as well as a significant increase of minSO2 and medSO2. CONCLUSION: The IMYS device could be an effective MAD appliance for treating moderate-to-severe OSA.

Evaluation of the relationship between incisor torque and profile aesthetics in patients having orthodontic extractions compared to non-extractions.

OBJECTIVE: The aim of the present study was to evaluate the relationship between soft tissues aesthetics and incisor torque, as well as the effect of crowding, anchorage, and extraction pattern, in adult patients treated without extraction or with two or four extractions. MATERIALS AND METHODS: Seventy-seven subjects with permanent dentition were selected retrospectively. Among these, 24 patients were treated with four extractions, 24 with two extractions and 29 without extractions. Lateral cephalograms and photographies taken before (T0) and after (T1) treatment were retrieved. The amount of crowding and the type of anchorage were recorded, and a cephalometric analysis was performed. A one-way ANOVA was used to compare the variables within and between groups. Linear regressions were performed to evaluate the effect of different predictors on soft tissues variables at T1. RESULTS: The statistical analysis showed no differences within and between groups for soft tissue aesthetics. A significant reduction of the angle obtained from the intersection of Frankfurt plane and mandibular plane was observed in the four-extractions group, and a significant proclination of the lower incisors was observed in the two-extraction group. Linear regressions revealed that the change in soft tissue profile aesthetics was affected by the type of anchorage and the two-extractions pattern. CONCLUSIONS: Similar soft tissue aesthetics were observed after treatment in the three groups, despite the presence of some skeletal and dental differences. CLINICAL RELEVANCE: A well-controlled incisor torque helps to preserve soft tissues aesthetics. The type of anchorage could influence soft tissues.

Correlation between dental arch form and OSA severity in adult patients: an observational study.

BACKGROUND: The role of interdental widths and palatal morphology on the development of obstructive sleep apnea (OSA) has not been well investigated in adult patients yet. The aim of this paper was to assess the morphology of maxilla and mandibular dental arches on three-dimensional (3D) casts and to correlate these measurements with the severity of OSA. METHODS: Sixty-four patients (8 women and 56 men, mean age 52.4) with a diagnosis of mild-to-moderate OSA were retrospectively enrolled. On each patient, home sleep apnea test and 3D dental models were collected. Apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) were recorded, as well as the dental measurements including inter-molar distance, anterior and posterior widths of maxillary and mandibular arches, upper and lower arch lengths, palatal height, and palatal surface area. The respiratory and dental variables were then correlated. RESULT: A statistically inverse correlation was found between ODI and anterior width of lower arch, maxillary arch length, palatal height, and palatal area. AHI showed a significant inverse correlation with anterior width of mandibular arch and maxillary length. CONCLUSION: A significant inverse correlation between maxillary and mandibular morphology and respiratory parameters was shown in the present paper.

Correction of Midline Deviation and Unilateral Crossbite Treated with Fixed Appliance.

The following case report describes the treatment of a 20-year-old man with dental and facial asymmetry. Patient presented upper dental midline shifted 3 mm to right side and the lower one 1 mm to left side, skeletal class I, molar class I and canine class III on the right side, molar class I and canine class II on the left side, and upper and lower crowding on teeth #12, #15, #22, #24, #34, and #35 in crossbite. The treatment plan provided four extractions: in the superior arch the right second and the left first premolar and in the lower arch first premolars on the left and right sides. Wire-fixed orthodontic device was used in combinations with coils to correct the midline deviation and to close post-extractive spaces, avoiding miniscrew implants. At the end of the treatment, optimal functional and aesthetic results were obtained: realignment of the midline improved facial symmetry, correction of the crossbite on both sides, and a good occlusal relationship.

Short-term effect of orthodontic clear aligners on muscular activity and occlusal contacts: A cohort study.

INTRODUCTION: The simultaneous presence of maxillary and mandibular clear aligners alters the vertical dimension and the quantity and quality of occlusal contacts. Few data in the literature explain how this occurs and the effects on neuromuscular coordination. This study aimed to evaluate occlusal contacts and muscular balance during treatment with clear aligners over a short follow-up time. METHODS: Twenty-six female adult patients were enrolled in this study. The center of occlusal force (COF) was evaluated using a T-Scan II device, whereas muscular symmetry and balance were determined through surface electromyography using a standardized protocol that reduces anthropometric and electrode variations. Both evaluations were performed in centric occlusion and with aligners worn before treatment, after 3 months, and after 6 months. RESULTS: A statistically significant variation in COF position was reported in the sagittal plane but not in the transverse plane. The shift in the COF position was followed by a change in muscular balance evaluated through surface electromyography. CONCLUSIONS: Treatment with clear aligners resulted in an anterior shift of the COF when biting in centric occlusion and a posterior shift when the aligners were worn in healthy female patients after 6 months of observation. This change in occlusal contact was followed by an improvement in muscular function symmetry in the short term when aligners were worn, compared with the centric occlusion during treatment.

Neurosensory Alterations and Interleukins Cascade in SARS-CoV-2 Infection - Results from a Retrospective Cohort of COVID-19 Inpatients.

OBJECTIVES: The aim of this study was to relate IL-6 and IL-1ß serum levels with the severity of olfactory disorders and with the type of unperceived odors. METHODS: 82 inpatients (45 men aged 62.3 ± 14.2 and 37 women aged 57.1 ± 12.8) with only smell dysfunctions were divided into two groups. The evaluation of the smell disorder was carried out with a questionnaire to define which sensitivity is most compromised in COVID-19 patients. Cytokine levels were measured with chemiluminescence and ELISA assay. Statistical analyses were performed with the Wilcoxon Rank test, Welch's T-test, and Mann-Whitney test (p < 0.05). RESULTS: Statistically significant differences in IL-6 and IL-1 ß levels were found in moderate disease patients when there was an impairment of trigeminal sensitivity (p <0.05) and trigeminal and olfactory sensitivity. CONCLUSIONS: The results obtained showed that in COVID-19 patients the impairment of trigeminal sensitivity in association with olfactory sensitivity was more prevalent in moderate than in mild forms.

Evaluation of qualitative and quantitative taste alterations in COVID-19.

A large percentage of coronavirus disease 2019 (COVID-19) patients have taste dysfunction. Interleukin 6 (IL-6) levels in mild and moderate COVID-19 patients with the type (quantitative or qualitative) of taste disorders were compared in this observational study. The 208 COVID-19 patients (118 men and 90 women) revealing only taste dysfunctions as prodromic symptoms were classified as mild and moderate patients. Survey results were used to evaluate the taste disorder. The IL-6 levels were measured using a chemiluminescence assay. Statistical analysis was conducted using the Wilcoxon rank, Welch's, and Mann-Whitney tests. The findings revealed that neither the presence of dysgeusia or phantogeusia nor the perception of sour and salty, differed statistically significantly between moderate and mild patients (P > 0.05). But between moderate and mild patients, there were statistically significant differences in how umami, bitter, sweet, and parageusia were perceived (P < 0.05). There was an impairment of multiple tastes up to ageusia in patients with high IL-6 levels. The findings demonstrated that parageusia and dysfunctions in umami, bitter, and sweet taste perception can be indicators of more severe forms of COVID-19.

Craniofacial morphology in Obstructive Sleep Apnea patients.

Background: To evaluate the correlation between cephalometric skeletal parameters and Obstructive Sleep Apnea syndrome (OSAs) severity, in adult patients with OSAs. Material and Methods: One hundred patients (94 males,6 females mean age 59,3) with diagnosis of OSAs were retrospectively enrolled. Each patient received Home Sleep Apnea Testing (HSAT) and latero-lateral radiograph. Eight cephalometric parameters (cranial deflection angle, saddle angle, articular angle, divergence angle, cranial base angle, skull base length, mandibular length, maxilla length) were analyzed and then related to Apnea/Hypopnea Index (AHI) and to the Oxygen Desaturation Index (ODI), recorded by HSAT. A Spearman's rho correlation test between cephalometric measurements and HSAT indices was performed. Statistical significance was set at p< 0.05. Results: A negative statistically significant correlation was found between mandibular length (Condilion-Gnathion distance) and AHI (rho= -0,2022; p<0,05) and between maxilla length (Ans-Pns) and AHI (rho= -0,2984; p<0,01) and ODI (rho= -0,2443; p<0,05). A statistically significant correlation was also observed between the divergence angle (S-N^Go-Me) and AHI (rho=0,2263; p<0,05) and between cranial deflection angle (Fh^NBa) and AHI (rho=0,2212; p<0,05) and ODI (rho=0,1970; p<0,05). Conclusions: The OSAs severity may be related to certain predisposing features in craniofacial morphology, such as maxillary and mandibular length, divergence and cranial deflection. Key words:OSAs, Home Sleep Apnea Testing, AHI, ODI, Cephalometry, Airway.

OSA Wellness Scale (OWS): A New Health-Related Quality of Life Test in Obstructive Sleep Apnea Patients Treated with Mandibular Advancement Device.

Objectives: To present a new short self-test, called the OSA wellness scale (OWS), for assessing the health-related quality of life (HRQoL) changes in obstructive apnea syndrome (OSA) patients treated with mandibular advancement device (MAD). Methods: 51 OSA patients (8 women and 43 men, mean age 52.3) treated with a fully customizable MAD device (Protrusor) were retrospectively enrolled. Each patient received a home sleep apnea testing (HSAT) at baseline (T0) and after three months of MAD treatment (T1). Two self-test evaluations, the Epworth sleepiness scale (ESS), and OWS were also submitted at T0 and T1. The OWS was a short self-test of 8 questions for evaluating the daytime HRQoL. Patients gave an assessment from 0 to 3 for each question. At the end of the questionnaire, the patients had a score from 0 to 24, resulting from the sum of all 8 scores. The higher the score, the greater the patient's perceived state of discomfort. Results: At T1, a significant decrease in the oxygen desaturation index (ODI) and apnea-hypopnea index (AHI) was shown (p < 0.0001), while no significant changes in body mass index (BMI) were found. Both the ESS and the OWS records showed a significant reduction in daytime sleepiness and HRQoL (p < 0.0001). Conclusion: The OWS could be a useful method to verify and numerically compare the perceived quality of life in OSA patients, before and after MAD therapy.

Changes in hyoid bone and tongue position in Class I subjects after orthodontic treatment with rapid palatal expander.

OBJECTIVE: To evaluate the effects of the rapid palatal expander (RPE) on the hyoid bone and tongue position in skeletal Class I patients, compared to control groups. METHODS: Eighty-four Class I subjects, aged 6-14, were selected. Among these, 28 patients were treated with RPE, 28 with function-generating bite (FGB) appliance, and 28 were untreated. Lateral cephalograms taken before (T0) and after (T1) treatment were retrieved. Changes in the hyoid bone and tongue position were evaluated, and the area above the tongue was measured. RESULTS: No significant difference in the hyoid and tongue posture was observed across the groups. However, there were significant differences for HC3 (distance from H-point to the third cervical vertebrae), H2H (distance from H-point to SN plane), and TT-Eb (tongue length) between T0 and T1 in all groups. CONCLUSION: The results suggest that hyoid bone and tongue position changes were related to growth rather than treatment.

A full-field DIC analysis of the mechanical-deformation behavior of polyethylene terephthalate glycol (PET-G) aligners.

OBJECTIVES: The aim was to investigate the full-field mechanical-deformation behavior of clear aligners made by polyethylene terephthalate glycol (PET-G) subjected to cyclic compression tests. METHODS: Digital Image Correlation (DIC) (Chu et al., 1985; Schreier et al., 2009), a contactless full-field measurement technique, and Optical Microscope (OM) analysis were applied to study two PET-G aligners thermoformed from discs of a thickness of 0.75 mm and 0.88 mm. The clear aligners were placed on dental shape resin casts and were subjected to cyclic compression up to 13000 load cycles from 0 to 50 N at room temperature. The chosen number of load cycles simulates the average load history to which an aligner is subjected for one week. Local displacements and strains were measured for each test at 2, 6, 10, 20, 1000, 5000 and 13000 loading cycles. RESULTS: Both aligners showed greater displacements in the early stages of loading, more pronounced for the 0.88 mm one. Local displacement and strain maps are derived both along the load direction and to the transverse one (never done from other researchers). Load-displacement cyclic curves allowed to evaluate the evolution of the stored energy and the stiffness during the test. The OM analyses showed significant morphological variations on the aligners' surface, such as wear and tear, high depressions and cracks, especially for the 0.75 mm specimen. SIGNIFICANCE: Full-field analysis allowed to understand the mechanical behavior of device with complex geometry and complex load distribution, like invisible aligners. The knowledge of the stiffness and the direction of the total displacement helps the orthodontist to implement the best strategy to improve the patient's comfort and the treatment time.

Axenfeld-Rieger syndrome: orthopedic and orthodontic management in a pediatric patient: a case report.

Axenfeld-Rieger Syndrome (ARS) is a rare autosomal dominant genetic disease with considerable expressive variability, characterized by ocular and non-ocular manifestations, cardiovascular, mild craniofacial abnormalities and dental malformations. Current data report an incidence of Xenfeld-Rieger syndrome in the population of 1: 200,000.The case described is that of a 14-year-old female patient whose ARS is suspected and investigated following a dental specialist visit for orthodontic reasons, acquired the patient's family and clinical data following a medical approach multidisciplinary, we proceed to the orthodontic involved the use of the Rapid Palatal Expander (RPE) and a fixed orthodontic treatment.The aim of this study is to report the case of the orthopaedic and orthodontic treatment in a patient affected by ARS and with facial dysmorphism and teeth anomalies associated to ocular anomalies.

Craniofacial morphology in patients with obstructive sleep apnea: cephalometric evaluation / Morfologia craniofacial em pacientes com apneia obstrutiva do sono: avaliação cefalométrica

Abstract Introduction: Obstructive sleep apnea is characterized by a reduced airflow through the upper airways during sleep. Two forms of obstructive sleep apnea are described: the central form and the obstructive form. The obstructive form is related to many factors, such as the craniofacial morphology. Objective: To evaluate the correlation between the morphology of the cranial base, of the mandible and the maxilla, and obstructive sleep apnea severity. Methods: Eighty-four patients, mean age of 50.4 years old; 73 males and 11 females with obstructive sleep apnea were enrolled in the present study. Patients with high body mass index and comorbidities were excluded. Lateral cephalograms and polysomnography were collected for each patient to evaluate the correlation between craniofacial morphology and obstructive sleep apnea severity. A Spearman's rho correlation test between cephalometric measurements and obstructive sleep apnea indexes was computed. Statistical significance was set at p < 0.05. Results: Patients with a severe obstructive sleep apnea presented a reduction of sagittal growth of both effective mandibular length and cranio-basal length. The mandibular length was the only variable with a statistical correlation with apnea-hypopnea index. Vertical dimension showed a weak correlation with the severity of obstructive sleep apnea. No correlation with maxillary sagittal dimension was shown. Conclusion: Obstructive sleep apnea severity may be correlated to mandibular and cranial base growth. Facial vertical dimension had no correlation with obstructive sleep apnea severity.

Resumo Introdução: A apneia obstrutiva do sono é caracterizada por um fluxo de ar reduzido nas vias aéreas superiores durante o sono. Duas formas de apneia são descritas: a forma central e a forma obstrutiva. A forma obstrutiva tem sido relacionada a vários fatores, como a morfologia craniofacial. Objetivo: Avaliar a correlação entre a morfologia da base do crânio, da mandíbula e da maxila e a gravidade da apneia obstrutiva do sono. Método: Foram incluídos no presente estudo 84 pacientes com apneia obstrutiva do sono, com média de 50,4 anos; 73 homens e 11 mulheres. Pacientes com alto índice de massa corpórea e comorbidades foram excluídos. Foram coletados cefalogramas laterais e polissonografia para cada paciente para avaliar a correlação entre a morfologia craniofacial e a gravidade da apneia. Foi computado o coeficiente de correlação de postos de Spearman (rho) entre medidas cefalométricas e índices de apneia obstrutiva do sono. A significância estatística foi estabelecida em p < 0,05. Resultados: Pacientes com apneia obstrutiva do sono grave apresentaram redução do crescimento sagital do comprimento mandibular efetivo e do comprimento crânio-basal. O comprimento mandibular foi a única variável que apresentou correlação estatística com o índice de apneia-hipopneia. A dimensão vertical mostrou uma fraca correlação com a gravidade da apneia. Não foi demonstrada correlação com a dimensão maxilar sagital. Conclusão: A gravidade da apneia obstrutiva do sono pode estar correlacionada ao crescimento da base mandibular e craniana. A dimensão facial vertical não apresentou correlação com a gravidade da apneia.

A new design of mandibular advancement device (IMYS) in the treatment of obstructive sleep apnea.

OBJECTIVE: The mandibular advancement device (MAD) is currently suggested in patients with mild to moderate obstructive sleep apnea (OSA). This study investigated the effects of a new fully customizable MAD-type device called, "It Makes You Sleep" (IMYS), in patients with mild to moderate OSA. METHODS: Sixteen patients (14 men and 2 women; mean age 62; SD ± 11 years) were retrospectively enrolled. Each patient received home sleep apnea testing (HSAT) at baseline (T0) and after three months (T1) of IMYS treatment. The Apnea-Hypopnea Index (AHI), the Oxygen Desaturation Index (ODI), the Minimum Oxygen Saturation (minSO2) and the Medium Oxygen Saturation (medSO2) were analyzed. RESULTS: From T0 to T1, the IMYS treatment showed a significant reduction of AHI and ODI and a significant increase of minSO2 and medSO2. CONCLUSION: The IMYS appliance is an effective device for treating mild or moderate OSA.