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Effect of mandibular advancement appliance use on oral and periodontal health in patients with OSA: a systematic review

  • Dentistry • Original Article
  • Published:
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Abstract

Study objectives

Use of a mandibular advancement appliance (MAA) is an effective treatment option for mild-to-moderate obstructive sleep apnea (OSA). MAA is well-tolerated but undesirable effects may be observed over time. The present systematic review aimed to assess the effect of MAA use on oral and periodontal health in patients with OSA.

Methods

MEDLINE (PubMed), Cochrane, and Scopus were searched for randomized and non-randomized controlled trials (RCTs, NRCTs), cohorts, and case–control studies reporting on side effects of MAA treatment in OSA patients during a follow-up of at least 6 months.

Results

From a total of 169 articles screened, 28 were selected. The most frequently reported MAA-related effects on oral health were: hypersalivation (weighted mean prevalence, 33.3%), occlusal changes (30.2%), muscle pain (22.9%), tooth discomfort or pain (20.2%), and xerostomia (18.3%). No MAA-related periodontal effect was reported. The periodontal status prior to MAA treatment was rarely assessed and described, but 5 studies (17.8%) stated that periodontitis was an exclusion criterion for MAA. Only one retrospective study specifically evaluated periodontal parameters and reported no significant changes in periodontally healthy patients with OSA using MAA for over 7 years.

Conclusion

MAA use is associated with a number of clinical consequences on oral health, but there is no evidence to conclude whether or not MAA affects periodontal health in patients with OSA. This aspect appears to be under-evaluated and should be further investigated in relation to the type of MAA, the duration of treatment, and prior history of periodontitis.

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Data availability

Data will be made available on reasonable request.

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Authors and Affiliations

  1. Department of Periodontology, Service of Odontology, Rothschild Hospital (AP-HP), UFR of Odontology, Université Paris Cité, Paris, France

    Nathalie Mansour, Yara Saade, Francis Mora, Philippe Bouchard, Stephane Kerner & Maria Clotilde Carra

  2. URP, 2496, Montrouge, France

    Philippe Bouchard

  3. Laboratory of Molecular Oral Physiopathology, Cordeliers Research Centre, Paris, France

    Stephane Kerner

  4. Department of Periodontology, Loma Linda University School of Dentistry, Loma Linda, CA, USA

    Stephane Kerner

  5. Centre for Research in Epidemiology and Statistics (CRESS) - INSERM, Paris, France

    Maria Clotilde Carra

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Mansour, N., Saade, Y., Mora, F. et al. Effect of mandibular advancement appliance use on oral and periodontal health in patients with OSA: a systematic review. Sleep Breath 28, 1005–1017 (2024). https://doi.org/10.1007/s11325-023-02971-5

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  • DOI: https://doi.org/10.1007/s11325-023-02971-5

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