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Systematic assessment of the impact of oral appliance therapy on the temporomandibular joint during treatment of obstructive sleep apnea: long-term evaluation

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Abstract

Objective

The aim of the present study was to evaluate the symptoms of temporomandibular dysfunction (TMD) in patients with obstructive sleep apnea treated with long-term use of an oral appliance (OA) using a questionnaire based on the Helkimo Anamnestic Dysfunction Index. A further aim of the study was to evaluate the presence of daytime sleepiness using the Epworth Sleep Scale (ESS) and otologic symptoms.

Materials and methods

Polysomnograms of 34 patients were performed at baseline and after 6 months of OA use. As follow-up, the patients were contacted by telephone interview to answer the same questionnaires after 36.0 ± 17.0 months.

Results and discussion

The intensity of TMD symptoms decreased significantly throughout treatment (p < 0.01). ESS values improved from 12.2 ± 5.0 to 6.9 ± 2.6 (p ≤ 0.05). Tinnitus was present in nine patients at baseline and decreased in intensity in seven patients by the final assessment while remaining at the same level in two patients.

Conclusions

We conclude that long-term usage of an OA does not cause impairment to the temporomandibular joint. The Helkimo and otologic indexes are simple and useful in long-term patient follow-up. There was a long-term improvement in the ESS values over the years analyzed. A follow-up program could increase compliance by motivating patients to use the device regularly.

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Acknowledgment

We thank Fundaçao de Amparo a Pesquisa do Estado de Sao Paulo (local acronym FAPESP) and Conselho Nacional de Pesquisa (local acronym CNPq) for supporting this research.

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Authors and Affiliations

  1. Institute of Research and Development IP&D, University of Vale do Paraíba, São Paulo, Brazil

    Lílian C. Giannasi, Márcio Magini & Maricília S. Costa

  2. University of Vancouver, Vancouver, Canada

    Fernanda R. Almeida

  3. Sleep Laboratory, Rehabilitation Sciences Master’s Program, Nove de Julho University, São Paulo, Brazil

    Lílian C. Giannasi, Cláudia S. de Oliveira, Júlio César Mendes de Oliveira, Sandra Kalil Bussadori & Luis Vicente F. de Oliveira

  4. Rua Franz de Castro Holzwarth, 103, sala 116, Centro, 12300-000, Jacareí, SP, Brazil

    Lílian C. Giannasi

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  1. Lílian C. Giannasi
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Correspondence to Lílian C. Giannasi.

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Giannasi, L.C., Almeida, F.R., Magini, M. et al. Systematic assessment of the impact of oral appliance therapy on the temporomandibular joint during treatment of obstructive sleep apnea: long-term evaluation. Sleep Breath 13, 375–381 (2009). https://doi.org/10.1007/s11325-009-0257-3

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  • DOI: https://doi.org/10.1007/s11325-009-0257-3

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