Long-term sequellae of oral appliance therapy in obstructive sleep apnea patients: Part 1. Cephalometric analysis.
BACKGROUND
Oral appliances (OAs) have been widely used to treat snoring and sleep apnea, but their effects on craniofacial structures in patients after 5 years or more of wear have not yet been quantified.


METHODS
Seventy-one patients who had worn adjustable mandibular repositioners to treat snoring or sleep apnea were evaluated. Upright lateral cephalometric radiographs in centric occlusion taken before treatment and after a mean of 7.3 +/- 2.1 years of OA use were compared. Baseline sleep studies and patient demographic data were included in the analysis.


RESULTS
Cephalometric analyses after long term OA use showed significant (P < .01) changes in many variables, including increases in mandibular plane and ANB angles; decreases in overbite and overjet; retroclined maxillary incisors; proclined mandibular incisors; increased lower facial height; and distally tipped maxillary molars with mesially tipped and erupted mandibular molars. The initial deep overbite group had a significantly greater decrease in overbite. Duration of OA use correlated positively with variables such as decreased overbite and increased mandibular plane angle; changes in the dentition appeared to be progressive over time.


CONCLUSIONS
After long-term use, OAs appear to cause changes in tooth positions that also might affect mandibular posture.
Division of Orthodontics, Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada. falmeida@interchange.ubc.ca
Fernanda Ribeiro de
FR
Almeida
Alan A
AA
Lowe
Jung Ok
JO
Sung
Satoru
S
Tsuiki
Ryo
R
Otsuka
D000704:Analysis of Variance; D002508:Cephalometry / Q000706:statistics & numerical data; D003768:Dental Occlusion, Centric; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000209:etiology* / Q000628:therapy; D019186:Mandibular Advancement / Q000009:adverse effects* / Q000295:instrumentation; D008875:Middle Aged; D017090:Occlusal Splints / Q000009:adverse effects*; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D012913:Snoring / Q000628:therapy; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014716:Vertical Dimension