title: Can treatment with statins have a negative influence on the tolerance of mandibular advancement devices?
abstract: BACKGROUND
  Statins are considered the most effective drugs used in the treatment of dyslipidemias. Some of their adverse effects are related to muscle problems. Myalgias produced by statins appear more often during exercise. Mandibular advancement devices (MAD) force the propulsory and elevatory musculature of the mandible to exercise by making the jaw move forward. The aim of this study is to evaluate the incidence of muscular side effects (referred, spontaneous, or under palpation pain, myofascial pain, mandibular rigidity and fatigue, tension and sensitivity of the masticatory muscles) in a group of patients with a diagnosis of obstructive sleep apnea being treated with MAD.
  
  
  METHODS
  This was a prospective study, involving consecutively 104 patients with a diagnosis of OSAS, and who had begun treatment with a custom made oral device. Muscular side effects were collected by anamnesis (verbal request and questionnaires), psychological status and clinical assessment (manual muscle palpation in the masticatory and cervical muscle groups), before and during MAD treatment.
  
  
  RESULTS
  Of the total sample, 22.1 % presented muscular side effects with the oral device. However, in patients taking statins, this percentage was 57.1 %, as opposed to 16.7 % of the non-statins patients (p < 0.001). The risk of suffering muscular alterations during oral device treatment is higher in statin patients (odds ratio 6.67, p = 0.002).
  
  
  CONCLUSIONS
  Treatment with statins can give rise to the appearance of undesirable side effects among patients being treated with oral devices.
authors: Sleep and Ventilation Unit, Respiratory Division, Marqués de Valdecilla University Hospital, Santander, Spain.
authors: Mónica
authors: M
authors: González
authors: Department of Surgery and Medical-Surgical Specialties, Area of Orthodontics, Faculty of Medicine, University of Oviedo, Catedrático Serrano s/n, 33006, Oviedo, Spain.
authors: Emilio
authors: E
authors: Macias-Escalada
authors: Department of Surgery and Medical-Surgical Specialties, Area of Orthodontics, Faculty of Medicine, University of Oviedo, Catedrático Serrano s/n, 33006, Oviedo, Spain.
authors: Juan
authors: J
authors: Cobo
authors: Department of Stomatology I, Faculty Of Odontology, Basque Country, Leioa, Vizcaya, Spain.
authors: Maria Pilar
authors: MP
authors: Fernández Mondragón
authors: Department of Special Care in Dentistry, Pharmacological Research in Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain.
authors: Gerardo
authors: G
authors: Gómez-Moreno
authors: Sleep and Ventilation Unit, Respiratory Division, Marqués de Valdecilla University Hospital, Santander, Spain.
authors: Marian
authors: M
authors: Martínez-Martínez
authors: Department of Surgery and Medical-Surgical Specialties, Area of Orthodontics, Faculty of Medicine, University of Oviedo, Catedrático Serrano s/n, 33006, Oviedo, Spain. fcarlos@uniovi.es.
authors: Felix
authors: F
authors: de Carlos
mesh_terms: D000328:Adult; D005157:Facial Pain / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000188:drug therapy*; D015994:Incidence; D008297:Male; D019186:Mandibular Advancement / Q000295:instrumentation*; D008336:Mandibular Diseases / Q000453:epidemiology* / Q000209:etiology*; D008410:Masticatory Muscles / Q000187:drug effects*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D017286:Polysomnography / Q000187:drug effects; D011446:Prospective Studies; D012306:Risk; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D013030:Spain
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Dyslipidemias; Mandibular advancement devices; Myotoxicity; Sleep apnea; Statins