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Long-term sequellae of oral appliance therapy in obstructive sleep apnea patients: Part 2. Study-model analysis
Fernanda Ribeiro de Almeida1, Alan A Lowe, Ryo Otsuka
1Division of Orthodontics, Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada. falmeida@interchange.ubc.ca
Introduction:
Side effects observed in the occlusion and dental arches of patients using an oral appliance (OA) to treat snoring or sleep apnea for more than 5 years have not yet been investigated.
Methods:
Stone casts trimmed in centric occlusion before appliance placement and after an average of 7.4 +/- 2.2 years of OA use in 70 patients were compared visually by 5 orthodontists.
Results:
Of these patients, 14.3% had no occlusal changes, 41.4% had favorable changes, and 44.3% had unfavorable changes. Significant changes in many variables were found. Patients with greater initial overbites and Class II Division 1 and Class II Division 2 malocclusions were more likely to have favorable or no changes. More favorable changes in overbite occurred in subjects with large baseline overbites. A greater baseline overjet and more distal mandibular canine relationship were correlated to favorable changes. A greater initial overjet was correlated to a more favorable change, a decrease in mandibular crowding, a smaller change in anterior crossbite, and a greater change in overjet.
Conclusions:
OA wear after a mean of 7.4 years induces clinically relevant changes in the dental arch and the occlusion.