title: A prospective 10-year follow-up dental cast study of patients with obstructive sleep apnoea/snoring who use a mandibular protruding device.
abstract: OBJECTIVE
  This 10-year prospective study aimed to measure and evaluate the teeth position and occlusion following 10-year nocturnal use of a mandibular protruding device (MPD) in subjects with obstructive sleep apnoea (OSA) or snoring.
  
  
  METHODS
  Seventy-seven consecutive patients diagnosed with OSA/snoring were treated with an MPD. Fabrication of dental casts with jaw registration indexes in the intercuspal position was carried out at baseline and at follow-up, a construction bite was made, and an MPD was fitted. At the 10-year follow-up, all subjects (n = 74) were invited to participate. The dental casts were analysed in a series of measurements.
  
  
  RESULTS
  Sixty subjects were included in the follow-up examination-41 were still using the device and 19 had ceased using the MPD. The MPD users showed significant changes in all analysed variables-decrease of overjet (-1.8 mm), overbite (-1.5 mm)-except the mandibular intercanine width and the maxillary anteroposterior relationship. Subjects who had ceased using their MPD retained their initial values, with the exception of a decreased overbite. The MPD users also showed an increased number of subjects with mesio-occlusion and posterior infra-occlusion; those who had ceased using their MPD mostly retained their initial status.
  
  
  CONCLUSIONS
  Long-term nocturnal use of an MPD may cause both favourable and unfavourable occlusion changes, such as a decrease of the overjet and overbite or posterior infra-occlusion, and these changes may continue to develop during treatment with an MPD. Subjects with a Class III relationship may not be a suitable group for treatment with an MPD due to the mesial drift of the mandibular teeth.
authors.affiliation: Department of Orthodontics.|Dental Sleep Medicine Clinic, Postgraduate Dental Educaton Center, Örebro, Sweden.
authors.forename: Anette M C
authors.initials: AMC
authors.lastname: Fransson
authors.affiliation: Department of Orthodontics.
authors.forename: Agata
authors.initials: A
authors.lastname: Kowalczyk
authors.affiliation: Department of Orofacial Pain and Jaw Function, Västmanland Hospital Västerås, Sweden.
authors.forename: Göran
authors.initials: G
authors.lastname: Isacsson
mesh_terms: D000328:Adult; D000368:Aged; D003735:Dental Casting Technique; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008310:Malocclusion / Q000209:etiology / Q000473:pathology / Q000628:therapy; D008334:Mandible / Q000473:pathology; D019186:Mandibular Advancement / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D008437:Maxilla / Q000473:pathology; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D012913:Snoring / Q000628:therapy*; D013165:Splints