Dental changes evaluated with a 3D computer-assisted model analysis after long-term tongue retaining device wear in OSA patients
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Oral appliances (OAs) have been used to treat obstructive sleep apnea (OSA) patients for decades. However, detailed dental side effects in long-term OA cases analyzed with an accurate three-dimensional (3D) measurement tool have seldom been reported. The purpose of this study is to evaluate dental side effects in five OSA patients, who had used a tongue retaining device (TRD) (with occasional other OA wear) for an average of 6 years and 4 months. The baseline and follow-up orthodontic study models were measured with a newly developed MicroScribe-3DX analysis system. High compliance of TRD wear was confirmed in all cases and different patterns and amounts of dental changes were observed. The most common appliance-induced dental changes included anterior and/or unilateral posterior openbites and reduced anterior overjets. It was hypothesized that there might be two possible mechanisms for the TRD side effects—one is the forward pressure of the tongue upon the anterior dental arch and the other is the lateral pressure of the tongue upon the posterior arch. Considerations to correct the TRD dental side effects should be guided by these different mechanisms of the tongue on the dental arch. Possible solutions to minimize occlusal changes and maximize the benefits for OSA patients are also discussed.
KeywordsObstructive sleep apnea Oral appliance Tongue retaining device Study model Computer-assisted Three-dimensional
The authors wish to thank Dr. Alan G. Hannam for his technical support of the MicroScribe-3DX system and Mrs. Ingrid Ellis for her editorial assistance in the final preparation of the manuscript. The study models from Dr. A. Strauss were duplicated by Davis Laboratory, Wyoming, Michigan, USA. The present study was supported by the China Scholarship Council (CSC) to the first author (H.C.) and by royalties paid to the University of British Columbia from Klearway™ sales worldwide.
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