Comparative evaluation of therapeutic efficacy of Thornton adjustable positioner with Karwetzky activator in the management of obstructive sleep apnea syndrome

Mandibular advancement devices (MAD) are recognized as an effective option in the management of obstructive sleep apnea (OSA). Thornton adjustable positioner (TAP) allows gradual forward titration of mandible to optimize treatment outcome. Karwetzky activator is a fixed MAD and titration is not possible. Therefore a study was under taken to compare the therapeutic efficacy of TAP with Karwetzky activator in the management of OSA.

Twenty polysomnography diagnosed OSA patients were prescribed TAP (Group I) and another twenty were prescribed Karwetzky activator (Group II). The therapeutic efficacy was evaluated on Apnea-Hypopnea Index (AHI) and Epworth Sleepiness Scale (ESS).

The percentage improvement in AHI scores in Group I was 52.48% compared to 42.37% in Group II. Statistically significant improvement (P<.001) in AHI and ESS scores was observed in Group I and Group II.75% and 55% positive responders (AHI improvement of >50) in Group I and Group II respectively were observed.

Therapeutic efficacy and clinical acceptance of TAP was superior to Karwetzky activator. Superior performance of TAP can be attributed to gradual titration and optimum mandibular positioning.