Dental side-effects of mandibular advancement splint wear in patients who snore.
OBJECTIVE
(a) To evaluate the longer term orthodontic side-effects of a Herbst mandibular advancement splint (MAS) in subjects with sleep disordered breathing. (b) To determine whether these are related to dental occlusion, degree of mandibular advancement or duration of appliance wear.


METHODS
Retrospective, cohort study.


METHODS
Teaching hospital dental school.


METHODS
Subjects with sleep disordered breathing who had been wearing an MAS regularly (a minimum of 5 h per night, six nights a week) for at least 2 years. Of 192 subjects who were identified, 30 fulfilled the inclusion criteria and were prepared to attend for review.


METHODS
Dental casts were obtained and BMI and Epworth Sleepiness Scale scores recorded. These data were compared with those collected when the subject was first referred. A questionnaire was completed concerning MAS use, side-effects and any problems associated with the device.


METHODS
Changes in incisor tooth position.


RESULTS
Median duration of MAS wear was 3.64 years. Small, statistically significant reductions in both vertical (-0.4 mm) and horizontal (-0.5 mm) overlap of the incisor teeth were found. This correlated with the degree of vertical opening of the MAS but was not related to the amount of mandibular protrusion or the duration of appliance wear.


CONCLUSIONS
Patients who are considered suitable for MAS should be warned that dental changes may occur. Thus referring surgeons should also be aware of this possibility.
Battagel
J M
JM
Department of Orthodontics, St Bartholomew's and the Royal London School of Medicine and Dentistry, London, UK. j.m.battagel@qmul.ac.uk
Kotecha
B
B
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003710:Demography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D019186:Mandibular Advancement / Q000009:adverse effects* / Q000295:instrumentation; D008875:Middle Aged; D010516:Periodontal Splints; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000150:complications; D012913:Snoring / Q000150:complications / Q000628:therapy*; D011795:Surveys and Questionnaires; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D013997:Time Factors