Dentoskeletal sequellae after wearing of a mandibular advancement device in an OSAHS setting

Mandibular advancement devices (MAD) are recommended in certain cases for the treatment of obstructive sleep apnea and hypopnea syndrome (OSAHS). The aim of this study was to make a retrospective investigation into the dental and skeletal effects in patients suffering from OSAHS after wearing an MAD, and according to the type of device, rigid or semi-rigid. Cephalometric criteria on lateral cephalograms before and after at least 6 months of treatment were analyzed. Twenty-two patients were included. We observed average labial tipping of the lower incisors (+4.1±5.6 [P=0.0023]) and reduced overbite (-1.6±2.0mm [P=0.0026]) and overjet (-1.4±2.3mm [P=0.0114]). Labial tipping of the mandibular incisors was more pronounced with semi-rigid MAD. Similarly, the decrease in overbite and overjet was more marked with the semi-rigid MAD. Medium-term wearing of MAD gives rise to dentally related occlusal changes, which can only be corrected by orthodontic treatment.