Influence on the masticatory system in treatment of obstructive sleep apnea and snoring with a mandibular protruding device: A 2-year follow-up

Fransson, Anette M.C.; Tegelberg, Åke; Johansson, Anders; Wenneberg, Bengt

doi:10.1016/j.ajodo.2003.10.040

Cited by 72 publications

(70 citation statements)

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“…MAD reportedly causes symptoms of temporomandibular disorders (TMD), tooth pain, and development of posterior open bite [14][15][16]. This may seriously affect the compliance, thus resulting in discontinuing of treatment.…”

Section: Journal Of Sleep Disorders and Therapymentioning

confidence: 99%

Mandibular Advancement Device Therapy in Obstructive Sleep Apnea and Snoring in Community Dental Care: Two-year Follow-up Study on Self-reported Sleep Quality, Side Effects, and Compliance

Vuorjoki-Ranta¹,

Lobbezoo²,

Tuomilehto³

et al. 2014

J Sleep Disord Ther

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Mandibular advancement device therapy in obstructive sleep apnea and snoring in community dental care: two-year follow-up study on self-reported sleep quality, side effects, and compliance Vuorjoki-Ranta, T.R.; Lobbezoo, F.; Tuomilehto, H.; Könönen, M.; Pihakari, A.; Ahlberg, J. Published in:Journal of Sleep Disorders & Therapy DOI:10.4172/2167-0277.1000180 Link to publication Citation for published version (APA):Vuorjoki-Ranta, T. R., Lobbezoo, F., Tuomilehto, H., Könönen, M., Pihakari, A., & Ahlberg, J. (2014). Mandibular advancement device therapy in obstructive sleep apnea and snoring in community dental care: two-year followup study on self-reported sleep quality, side effects, and compliance. Journal of Sleep Disorders & Therapy, 3(5), 1000180. DOI: 10.4172/2167-0277.1000180 General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. AbstractStudy background: Obesity is constantly increasing health problem worldwide and so are its detrimental consequences, including obstructive sleep apnea (OSA). Mandibular advancement devices (MADs) are proven to be efficient in treating mild to moderate OSA and snoring. We followed for two years 103 patients treated with a titrable MAD in a Community Dental Care setting. Methods:A follow-up questionnaire was mailed in 2012 to 124 patients who had participated in a survey 2010 and given their consent for further study. Results:Of all the 103 respondents 85% (n=88) still used MAD. Subjective tiredness (p<0.05) and the presence of any snoring (p<0.01) were reported more often in the long-term study than in the short-term study. In contrast, difficulty in initiating sleep with the device in situ was seen less often (p<0.05). According to the logistic regression, reduced loud snoring was significantly associated with the compliance of frequent wear of MAD (p<0.05). The majority (82%) of the patients also reported a positive impact of MAD in social (family) life due to reduced loud snoring. Conclusion:Titrable MAD is a noteworthy treatment modality for mild to moderate OSA and especially snoring. Compliance in using MADs and reported subjective health seem to remain at good level. General dentists could probably perform a great part of the care. However, possible worsening of OSA and side effects of MADs should be borne in mind.

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Section: Journal Of Sleep Disorders and Therapymentioning

confidence: 99%

Mandibular Advancement Device Therapy in Obstructive Sleep Apnea and Snoring in Community Dental Care: Two-year Follow-up Study on Self-reported Sleep Quality, Side Effects, and Compliance

Vuorjoki-Ranta¹,

Lobbezoo²,

Tuomilehto³

et al. 2014

J Sleep Disord Ther

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“…Walker-Engströn et al (2002) 4 found a compliance level of 82% after one year and 62% after four years. Fransson et al (2004) 22 found an 84% compliance rate on the two year follow-up. Clark, Sohn & Hong (2000) 3 reported that with the long term use (three or more years), compliance was higher than 51%, whereas Pancer, Al-Faifi & Hoffstein (1999) 20 stated that 350 days after device fitting, 86% of patients still were using it.…”

Section: Discussionmentioning

confidence: 99%

“…For O'Sullivan (1995) 5 , the main effect reported was medium discomfort in the dental arcs when waking up, with reduction of the symptom in three weeks, in most cases. Besides discomfort, joint and masticatory musculature pain was also reported, found in different levels in the works by 2,4,8,9,12,22 . Other frequent clinical symptoms were excessive salivation 8,13 due to the new tongue position and to the presence of the device inside the mouth 2,3,8,9,12,13,14,20 23 , a small overjet is a limiting factor to be considered in the treatment with this type of device.…”

Section: Discussionmentioning

confidence: 99%

“…For Fransson et al (2004) 22 , the treatment with mandibular protruding devices has several advantages and can be considered as first choice treatment for a large group of patients, including patients with severe OSAH, if an optimum advancement quantity could be used. In our sample, more than 80% of patients with OSAH normalized their values of oxygen saturation (with an improvement of 50% or more), and 90% reported a subjective reduction of snoring and apnea (50% reduction or more).…”

Section: Discussionmentioning

confidence: 99%

“…Compliance depends on the comfort level obtained by patient during the use of the devices and their own assessment regarding the result of the therapy. All the studies show a high level of compliance in using the device, and always in a higher level than the use of CPAP when they are compared [2][3][4][5]14,16,20,22 . According to Almeida (2002) 2 and Ferguson et al (1997) 16 patients have a significant preference for the use of mandibular protruding devices rather than the use of CPAP, even those for whom CPAP efficacy was better than intra-oral devices.…”

Section: Discussionmentioning

confidence: 99%

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Tratamento da síndrome da apnéia e hipopnéia obstrutiva do sono com aparelhos intrabucais

Almeida¹,

Teixeira

Vieira

et al. 2006

Rev. Bras. Otorrinolaringol.

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Obst ructive sleep apnea and hipoapnea syndrome (OSAHS) is a disorder that affects about 4% of the adult population, and besides the social problems associated to snoring and extreme day time sleepiness, it is preoccupying since it may cause pulmonary hypertension and cardiac failure. Review and discussion -Through a literature review, we discuss the use of oral appliances to treat this condition, in regards of therapy effectiveness and limitations, main clinical symptoms, major occlusal side effects, rate of improvement and patient satisfaction. Conclusions -We concluded that the use of oral appliances should be a first choice treatment for mild to moderate OSAHS, being dental, joint and muscular discomforts, hypersalivation and xerostomia, the most frequent clinical symptoms, with light occlusal side effects that normally do not bother the patients, with a good degree of improvement and high satisfaction index.

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Oral Appliance Therapy in Patients With Daytime Sleepiness and Snoring or Mild to Moderate Sleep Apnea

et al. 2015

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IMPORTANCE Oral appliances that move the mandible forward during sleep are suggested as treatment for mild to moderate obstructive sleep apnea.OBJECTIVE To test whether an adjustable, custom-made oral appliance improves daytime sleepiness and quality of life in patients with daytime sleepiness and snoring or mild to moderate obstructive sleep apnea. DESIGN, SETTING, AND PARTICIPANTS Ninety-six patients with daytime sleepiness and an apnea-hypopnea index (AHI) lower than 30 were included in a randomized, placebo-controlled, parallel trial in Umeå, Sweden, from May 2007 through August 2011.INTERVENTIONS Four months' intervention with an oral appliance or a placebo device. MAIN OUTCOMES AND MEASURES Daytime sleepiness was measured with the EpworthSleepiness Scale, the Karolinska Sleepiness Scale, and the Oxford Sleep Resistance (OSLER) test. Quality of life was assessed with the Short-Form 36-Item Health Survey (SF-36) and the Functional Outcomes of Sleep Questionnaire (FOSQ). Secondary outcomes included the apnea-hypopnea index, headaches, symptoms of restless legs, and insomnia.RESULTS Oral appliance therapy was not associated with improvements in daytime sleepiness from baseline to 4-month follow-up when compared with the placebo device; Epworth score >10: 53% at baseline to 24% at follow-up for the oral appliance group vs 54% at baseline to 40% at follow-up for the placebo device group, P = .11; median (IQR) for Karolinska score Ն7/wk: 10 (8 to 14) at baseline to 7 (4 to 9) at follow-up for the oral appliance group vs 12 (6 to 15) at baseline to 8 (5 to 12) at follow-up for the placebo device group, P = .11; mean between-group difference in OSLER test, −2.4 min (95% CI, −6.3 to 1.4). The mean between-group difference for the total FOSQ score was insignificant (−1.2 [95% CI, −2.5 to 0.1]). No domain of the SF-36 differed significantly between the groups. The AHI was below 5 in 49% of patients using the active appliance and in 11% using placebo, with an odds ratio of 7.8 (95% CI, 2.6-23.5) and a number needed to treat of 3. Snoring (P < .001) and symptoms of restless legs (P = .02) were less frequent when using the oral appliance vs placebo, but this did not apply to headache or insomnia. CONCLUSIONS AND RELEVANCEA custom-made, adjustable oral appliance reduces obstructive sleep apnea, snoring, and possibly restless legs without effects on daytime sleepiness and quality of life among patients with daytime sleepiness and snoring or mild to moderate sleep apnea. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00477009

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Influence on the masticatory system in treatment of obstructive sleep apnea and snoring with a mandibular protruding device: A 2-year follow-up

Cited by 72 publications

References 29 publications

Mandibular Advancement Device Therapy in Obstructive Sleep Apnea and Snoring in Community Dental Care: Two-year Follow-up Study on Self-reported Sleep Quality, Side Effects, and Compliance

Mandibular Advancement Device Therapy in Obstructive Sleep Apnea and Snoring in Community Dental Care: Two-year Follow-up Study on Self-reported Sleep Quality, Side Effects, and Compliance

Tratamento da síndrome da apnéia e hipopnéia obstrutiva do sono com aparelhos intrabucais

Oral Appliance Therapy in Patients With Daytime Sleepiness and Snoring or Mild to Moderate Sleep Apnea

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