Dental side effects of long-term obstructive sleep apnea therapy: a 10-year follow-up study

Abstract

Objectives

Patients with obstructive sleep apnea (OSA) are usually treated with either mandibular advancement device (MAD) or continuous positive airway pressure (CPAP) therapy. The objective of this study is to evaluate changes in dental occlusion associated with long-term MAD and CPAP therapy.

Materials and methods

Data from 14 OSA patients using MAD and 17 OSA patients using CPAP therapy were evaluated at baseline, 2-year and 10-year follow-up. Changes in dental occlusion were analyzed from dental plaster casts with a digital sliding caliper.

Results

At 2-year follow-up, MAD therapy resulted in significant dental changes when compared with baseline values. In MAD therapy, overjet and overbite decreased with 1.1 ± 1.8 mm and 1.1 ± 1.2 mm respectively. With CPAP therapy overjet and overbite decreased significantly with 0.2 ± 0.5 mm and 0.3 ± 0.5 mm, respectively. Both groups also showed significant changes in molar occlusion. After a 10-year follow-up, significant and more pronounced changes were seen in overjet and overbite. In MAD therapy, overjet and overbite decreased with 3.5 ± 1.5 mm and 2.9 ± 1.5 mm respectively when compared with baseline values. In CPAP therapy, overjet and overbite decreased with 0.7 ± 1.5 mm and 0.8 ± 1.4 mm respectively when compared with baseline values.

Conclusions

This study demonstrates that MAD and CPAP therapy result in significant changes in dental occlusion. These changes appear progressive and more pronounced with MAD compared to CPAP therapy.

Clinical relevance

Long-term OSA treatment results in significant dental side effects that may progress over time. Informed consent is fundamental before starting MAD treatment and individualized long-term follow-up is of eminent importance.

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Acknowledgments

This is not an industry supported study. Aarnoud Hoekema is a medical advisor for Airway Management Inc., Somnomed and Zephyr Sleep Technologies.

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Correspondence to Julia Anne Margarethe Uniken Venema.

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Conflict of interest

Aarnoud Hoekema is a medical advisor for Airway Management Inc., Somnomed and Zephyr Sleep Technologies. All other authors do not have any conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Boudewijn Stegenga deceased.

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Uniken Venema, J.A.M., Doff, M.H.J., Joffe-Sokolova, D.S. et al. Dental side effects of long-term obstructive sleep apnea therapy: a 10-year follow-up study. Clin Oral Invest 24, 3069–3076 (2020). https://doi.org/10.1007/s00784-019-03175-6

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Keywords

  • Obstructive sleep apnea
  • Mandibular advancement device
  • Continuous positive airway pressure
  • Treatment outcome
  • Dental side effects