0340 Non-Surgical Maxillary Expansion Using A Novel Oral Appliance System
Bibliographic record
Abstract
Abstract Introduction Complete Airway Repositioning and Expansion (CARE; Vivos Therapeutics, USA) consists of a series of dental devices that cause gradual expansion of the airway over an 18-month course used to treat mild-to-moderate obstructive sleep apnea. In this retrospective database review we sought to determine whether airway and obstructive sleep apnea (OSA) parameters changed via treatment as measured without the appliance in their mouths. Methods After IRB exemption by the Mount Sinai Health System IRB (STUDY-21-01561) we conducted a retrospective review of the Vivos database. Demographics, pre-, mid-, or post-treatment maxillary dimensions, and pre-, mid-, or post- treatment sleep study parameters were reviewed. CBCT parameters for trans-palatal width (TPW) and total three dimensional (3D) airway volume were analyzed along with available AHI data. Results There were 786 patients with complete radiographic datasets. The median (interquartile range) age was 49 (36-59) years, and half were female. Both the median TPW of 33.5 (31.0-35.3) mm and median 3D volume of 19,752 (15965-25042) mm3 increased, to 35.0(33.0-37.5) mm and 21919 (17484-27711) mm3, respectively. These increases were significantly different (p<0.001 in both measures by related-samples Wilcoxon signed rank test). A subset of patients had complete sleep study data (N=139). For those patients with pre- and post-treatment studies who had also completed at least 18 months of therapy (N=37), the TPW increased by a median of 2.50 (1.00-3.50) mm and the 3D volume by a median of 3092 (1006-6480) mm3. Overall, the number of patients with no OSA went from 4 to 13 and the number of patients with severe OSA went from 10 to 3. Twenty-five patients (65%) had improved AHI, and 15 (41%) had their AHI improve by 50% or more (all of these were decreased to an AHI <20). Conclusion This retrospective database review showed that OSA patients treated with BOAT improved their OSA with concomitant increases in maxillary dimensions. Further analyses of these data, and future prospective clinical trials are warranted to better understand this novel OSA treatment. Support (If Any) Support from Vivos Therapeutics in the form of granting access to their database and compensated clinical advisors.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".