Long-term sequellae of oral appliance therapy in obstructive sleep apnea patients: Part 2. Study-model analysis.
BACKGROUND
Side effects observed in the occlusion and dental arches of patients using an oral appliance (OA) to treat snoring or sleep apnea for more than 5 years have not yet been investigated.


METHODS
Stone casts trimmed in centric occlusion before appliance placement and after an average of 7.4 +/- 2.2 years of OA use in 70 patients were compared visually by 5 orthodontists.


RESULTS
Of these patients, 14.3% had no occlusal changes, 41.4% had favorable changes, and 44.3% had unfavorable changes. Significant changes in many variables were found. Patients with greater initial overbites and Class II Division 1 and Class II Division 2 malocclusions were more likely to have favorable or no changes. More favorable changes in overbite occurred in subjects with large baseline overbites. A greater baseline overjet and more distal mandibular canine relationship were correlated to favorable changes. A greater initial overjet was correlated to a more favorable change, a decrease in mandibular crowding, a smaller change in anterior crossbite, and a greater change in overjet.


CONCLUSIONS
OA wear after a mean of 7.4 years induces clinically relevant changes in the dental arch and the occlusion.
Almeida
Fernanda Ribeiro de
FR
Division of Orthodontics, Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada. falmeida@interchange.ubc.ca
Lowe
Alan A
AA
Otsuka
Ryo
R
Fastlicht
Sandra
S
Farbood
Maryam
M
Tsuiki
Satoru
S
D000704:Analysis of Variance; D002508:Cephalometry; D003724:Dental Arch; D003766:Dental Occlusion; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007574:Jaw Relation Record; D008297:Male; D008310:Malocclusion / Q000209:etiology* / Q000628:therapy; D019186:Mandibular Advancement / Q000009:adverse effects* / Q000295:instrumentation; D008875:Middle Aged; D003765:Models, Dental; D017090:Occlusal Splints / Q000009:adverse effects*; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D012913:Snoring / Q000628:therapy; D018709:Statistics, Nonparametric; D014085:Tooth Migration / Q000209:etiology*; D016896:Treatment Outcome