Dental Side Effects of Long-Term Obstructive Sleep Apnea Therapy: A Comparison of Three Therapeutic Modalities

Venema, Julia A M Uniken; Stellingsma, Cornelis; Doff, Michiel H J; Hoekema, Aarnoud

doi:10.15331/jdsm.7022

Cited by 11 publications

(7 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Device design will also influence the risk of bite changes. One study describes that a device that is attached mainly to the front teeth will produce a faster and larger change in dental occlusion compared with a device that is attached to the whole dentition [83].…”

Section: Bite Changesmentioning

confidence: 99%

Update on oral appliance therapy

2019

View full text Add to dashboard Cite

Oral appliances are increasingly recommended for selected patients with obstructive sleep apnoea (OSA) and those who do not tolerate nor prefer continuous positive airway pressure. The most commonly used oral appliance advances the lower jaw during sleep, the so-called mandibular advancement device (MAD). Patients seek treatment because of disturbing snoring, daytime symptoms, apnoeas that disturb sleep and the longer term consequences with regard to cardiovascular risks. MADs reduce the apnoea–hypopnoea index, although to various degrees among patients. Effects on daytime sleepiness have been observed mainly among the more severe OSA patients. Blood pressure may be reduced in MAD-treated OSA patients. There is, however, uncertainty about which patients will respond to this therapy in terms of apnoea reductions, decreased sleepiness and other symptoms, and reduced risk for future impaired health. The occurrence of side-effects also remains difficult to predict at present. The majority of sleep apnoea patients suffer from various comorbidities in terms of cardiovascular diseases, type 2 diabetes and depression. The most recent findings indicate that phenotyping of patients, considering various aspects of this multifaceted disease, will shed more light on the indications for MADs in patients with nightly sleep breathing disturbances. This review summarises the most recent knowledge about MAD treatment.

show abstract

Section: Bite Changesmentioning

confidence: 99%

Update on oral appliance therapy

2019

View full text Add to dashboard Cite

show abstract

“…The results of the paper agree on a study comparing the dental effects of using a Somnodent TM device and TAPTM (which is a MAD that has the same mechanics as Orthoapnea TM ). In the study, it was shown that the dental modifications are lower in the case of Somnodent TM [60]. According to the authors, the difference depends on the two different mechanics that promote the activation of the three devices.…”

Section: Discussionmentioning

confidence: 98%

“…Since it is not possible to perform an in vivo validation of this study, a comparison of the results with previous studies assessed its reliability. Earlier articles on orthodontic tooth loading and mandibular advancement devices evaluation from both a clinical point [60] of view and an engineering point of view (finite element analysis) [38,[57][58][59] have been taken into account.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Effects Caused by Three Different Mandibular Advancement Devices on the Periodontal Ligaments and Teeth for the Treatment of Osa: A Finite Element Model Study

et al. 2020

View full text Add to dashboard Cite

AIM: The purpose of this study is to compare the stress effects developed on the periodontal ligaments and teeth by three different types of mandibular advancement devices (MADs) using a finite element method (FEM) analysis. Introduction: Obstructive sleep apnea (OSA) is a disease with a high prevalence and, in recent years, the use of MADs as an alternative or support treatment to the continuous positive airway pressure (CPAP) has spread. Their use finds relative contraindications in the case of partial edentulism and severe periodontal disease. Given the widespread of periodontal problems, it is essential to know the effects that these devices cause on the periodontal ligament of the teeth. Materials and methods: Starting from the computed tomography (CT) scan of a patient’s skull, 3D reconstructions of the maxilla and mandible were implemented. Three different MADs were prepared for the patient, then 3D scanned, and lastly, coupled with the 3D models of the jaws. The devices have two different mechanics: One has a front reverse connecting rod (OrthoapneaTM), and two have lateral propulsion (SomnodentTM and HerbstTM). A FEM analysis was performed to calculate the stress applied on periodontal ligaments, on every single tooth and the displacement vectors that are generated by applying an advancement force on the mandible. Results: HerbstTM and SomnodentTM devices present very similar stress values, mainly concentrated on lateral teeth, but in general, the forces are very mild and distributed. The maximum stresses values are 3.27 kPa on periodontal ligaments and 287 kPa on teeth for SomnodentTM and 3.56 kPa on periodontal ligaments and 302 kPa on teeth for HerbstTM. OrthoapneaTM has, instead, higher and concentrated stress values, especially in the anterior maxillary and mandibular area with 4.26 kPa and 600 kPa as maximum stress values, respectively, on periodontal ligaments and teeth. Conclusions: From the results, it is concluded that devices with a bilateral mechanism generate less and more distributed stress than an anterior connecting rod mechanism. Therefore, they may be advisable to patients with compromised periodontal conditions in the anterior area.

show abstract

“…Despite dental changes being unavoidable regardless of the OAT design, it has been suggested that the features of the appliance may be associated with more pronounced occlusal changes. A study investigating occlusal changes following 2 years of therapy has proposed that OAT in which the adjustment mechanism is located anteriorly were associated with more dental changes compared to those in which the mechanism was located posteriorly [ 131 ].…”

Section: Side-effects Of Oatmentioning

confidence: 99%

The role of oral appliance therapy in obstructive sleep apnoea

et al. 2023

View full text Add to dashboard Cite

There is now widespread recognition within the world of sleep medicine of the increasing importance of dental sleep medicine and, in particular, the role of oral appliance therapy (OAT) in the management of adults with obstructive sleep apnoea (OSA). For the purpose of this review, the term OAT refers to a custom-made intra-oral appliance, which acts to posture the mandible in a forward and downward direction, away from its natural resting position. Whilst nasally applied continuous positive airway pressure remains the “gold standard” in nonsurgical OSA management, OAT remains the recognised alternative treatment.This review of OAT aims to provide an evidence-based update on our current understanding of their mode of action, exploring the potential anatomical and physiological impact of their use in preventing collapse of the upper airway; the current clinical practice guidelines, including the recently published National Institute of Clinical Excellence 2021 guidance, in conjunction with the American Academy of Sleep Medicine and American Academy of Dental Sleep Medicine; optimal design features, comparing the role of custom-madeversusnoncustom OAT devices and the importance of titration in achieving a dose-dependent effect; patient predictors, preference and adherence to OAT; its impact on a range of both patient- and clinician-centred health outcomes, with a comparison with CPAP; the limitations and side-effects of providing OAT; and, finally, a look at future considerations to help optimise the delivery and outcomes of OAT.

show abstract

Dental Side Effects of Long-Term Obstructive Sleep Apnea Therapy: A Comparison of Three Therapeutic Modalities

Cited by 11 publications

References 34 publications

Update on oral appliance therapy

Update on oral appliance therapy

Comparison of the Effects Caused by Three Different Mandibular Advancement Devices on the Periodontal Ligaments and Teeth for the Treatment of Osa: A Finite Element Model Study

The role of oral appliance therapy in obstructive sleep apnoea

Contact Info

Product

Resources

About