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Long-term effectiveness and side effects of mandibular advancement devices on dental and skeletal parameters
G Vigié du Cayla1, J M Collet1, V Attali2
1Service de stomatologie et chirurgie maxillo-faciale, AP-HP, DHU FAST, GH Pitié - Salpêtrière - Charles-Foix, 75013, Paris, France; Sorbonne Universités, UPMC université Paris 06, UMR 8256 B2A, 75005, Paris, France.
Introduction:
Continuous positive airways pressure, generally used to treat obstructive sleep apnea-hypopnea syndrome (OSAHS), is not tolerated well by many patients. An alternative is to treat OSAHS with mandibular advancement devices (MAD). This research assesses the long term (> 2 years) effectiveness and the side effects on dental and skeletal parameters of these devices.
Material And Methods:
We selected 24 patients with moderate to severe OSAHS. All were treated with MADs for at least 2 years. We gathered cephalometric teleradiographs in centric relation and sleep recordings before and after the patients were treated. We evaluated the patients' apnea-hypopnea indexes (AHI) as well as their Epworth sleepiness scale (ESS) scores. We measured the inclination of the central incisors and the positions of the upper and lower jaws.
Results:
Mandibular advancement devices were used for more than 2 years (3.9 ± 1.9 years). We observed a statistically significant decrease of the patients' AHI and their ESS scores. We also observed a modification of the inclination of the lower central incisors (+0.521; P = 0.047) and of the position of the maxilla (-0.287; P = 0.039).
Discussion:
We demonstrated the clinical effectiveness of mandibular advancement devices for treating OSAHS, with a very low rate of side effects on dental and skeletal positions.
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