American Journal of Orthodontics and Dentofacial Orthopedics
Original articleA follow-up study of dental and skeletal changes associated with mandibular advancement splint use in obstructive sleep apnea
Section snippets
Material and methods
The sample included 64 patients (50 men, 14 women) recruited from the patient data bank at a multidisciplinary sleep disorders clinic in St George University Hospital. All patients had been assessed by a respiratory physician and an orthodontist associated with the sleep disorders clinic and had been prescribed MAS for their OSA. A selection criterion for this follow-up study was the issue of a MAS at least 6 months before the study. Overnight polysomnography was undertaken before treatment
Results
All 64 patients completed the questionnaire, and 57 patients (89%) underwent a clinical examination. Sufficient records at T1 and T3 were available to complete the dental study model analysis in 45 patients (70%) and radiographic analysis in 46 patients (71%).
The results from the questionnaires are summarized in Fig 4, Fig 5 and Table I. Eight patients (12.5%; 6 men) had no side effects. Bed partners assisted in answering the questionnaire in 46 patients (72%). Nine patients (14%) were not
Discussion
In this study, we found that MAS therapy is subjectively effective and well tolerated despite the side effects reported by many (87.5%) patients. Most patients (97%) found control of OSA symptoms to be satisfactory or better after an average of 25.1 ± 11.8 months. Sleep quality was reported as moderately or very refreshing in 83% of patients, and the subjective improvements in snoring and daytime sleepiness agree with data from other studies.5, 10, 21 Although the questionnaire was not
Conclusions
MAS therapy in the treatment of OSA has been found to provide subjective and objective benefits with minimal dental and skeletal side effects. Compliance levels in this study attest to patients’ satisfaction with MAS therapy in spite of some minor side effects associated with its use by most of the sample. The extent to which this is influenced by design features of the MAS remains to be determined. Management by a multidisciplinary team, consisting of orthodontic, OSA, and prosthetic
References (31)
- et al.
Long-term TMJ effects of Herbst treatment: a clinical and MRI study
Am J Orthod Dentofacial Orthop
(1998) - et al.
Temporomandibular joint remodeling in adolescents and young adults during Herbst treatment: a prospective longitudinal magnetic resonance imaging and cephalometric radiographic investigation
Am J Orthod Dentofacial Orthop
(1999) - et al.
Treatment of snoring and obstructive sleep apnea with a dental orthosis
Chest
(1991) The mechanism of Class II correction in Herbst appliance treatmentA cephalometric investigation
Am J Orthod
(1982)- et al.
Evaluation of variable mandibular advancement appliance for treatment of snoring and sleep apnea
Chest
(1999) - et al.
Risk factors for sleep bruxism in the general population
Chest
(2001) Dentofacial adaptations in adult patients following functional regulator therapy
Am J Orthod
(1984)Does 2 years’ nocturnal treatment with a mandibular advancement splint in adult patients with snoring and OSAS cause a change in the posture of the mandible?
Am J Orthod Dentofacial Orthop
(1999)- et al.
A randomized crossover study of an oral appliance vs nasal-continuous positive airway pressure in the treatment of mild-moderate obstructive sleep apnea
Chest
(1996) - et al.
A randomized, controlled study of a mandibular advancement splint for obstructive sleep apnea
Am J Respir Crit Care Med
(2001)
Oral appliances for the treatment of snoring and obstructive sleep apnea: a review
Sleep
Treatment of sleep apnea with prosthetic mandibular advancement (PMA)
Sleep
Do oral appliances enlarge the airway in patients with obstructive sleep apnoea?A prospective computerized tomographic study
Eur J Orthod
Mandibular advancement splint: an appliance to treat snoring and obstructive sleep apnea
Am J Respir Crit Care Med
Effect of two types of mandibular advancement splints on snoring and obstructive sleep apnoea
Eur J Orthod
Cited by (70)
Mandibular advancement splints for the treatment of obstructive sleep apnea
2023, Encyclopedia of Sleep and Circadian Rhythms: Volume 1-6, Second EditionPATIENT-REPORTED OUTCOMES WHILE MANAGING OBSTRUCTIVE SLEEP APNEA WITH ORAL APPLIANCES: A SCOPING REVIEW
2023, Journal of Evidence-Based Dental PracticeCitation Excerpt :Ten studies have explored patient satisfaction or experience after or during OA usage in adult subjects. Among these studies, 9 have examined satisfaction with the appliance and OA treatment by structured surveys and asking the patients to rate their satisfaction with the appliance,26,32,43,44,52,53,55-57 while 1 study explored the satisfaction and experience of patients with the treatment by focus groups model using a qualitative description methodology.65 Most studies reported that the patients were satisfied with using the OAs and had not perceived the device as a problem in their lives.
Long-term dental and skeletal effects of mandibular advancement devices in adults with obstructive sleep apnoea: A systematic review
2019, International OrthodonticsCitation Excerpt :Eight of the studies used a one piece, non-titratable design [22,25,27,29,34,35]. Eleven used two-piece titratable devices, which could be adjusted, by the clinician or patient, by the use of a screw mechanism or interchangeable rods [19,20,23,24,26,28,32,33,36–38]. Marklund et al., 2001 compared both a rigid and soft variety within the study population.
Dental and skeletal changes associated with long-term oral appliance use for obstructive sleep apnea: A systematic review and meta-analysis
2018, Sleep Medicine ReviewsCitation Excerpt :Therefore, the risk of bias was high with respect to confounding variables. Twelve studies [13,20,21,26,28,29,31–35,37] were judged to have a high risk of bias in relation to measurement of exposure since there was insufficient description of daily OA use and the weekly use rate. In seven studies [21,25,29–31,34,37], adequate blinding of outcome measurements or statistical analysis was not conducted.
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