Temporomandibular Disorders in Relation to Mandibular Advancement Devices for Treating Obstructive Sleep Apnea

Area of Science:

• Dental sleep medicine
• Orthodontics
• Temporomandibular joint disorders

Background:

• Mandibular advancement devices (MADs) are used to maintain upper airway patency during sleep.
• They function by repositioning the mandible and associated soft tissues anteriorly.
• This repositioning alters the condyles' position relative to the temporal bones.

Purpose of the Study:

• To describe the effects of MAD therapy on the temporomandibular joint (TMJ) and masticatory system.
• To evaluate the potential impact of MADs on pre-existing temporomandibular disorder (TMD) symptoms.

Main Methods:

• The study focuses on the biomechanical effects of MADs on mandibular and condylar positioning.
• Observation of patient-reported symptoms during the initial phase of MAD therapy.
• Assessment of TMD signs and symptoms in patients using MADs.

Main Results:

• Initial pain in the TMJ, masticatory muscles, or teeth is frequently reported during the first weeks of MAD therapy.
• This discomfort typically shows a tendency towards spontaneous resolution.
• Patients with pre-existing TMD symptoms may experience a reduction in their signs and symptoms with MAD use.

Conclusions:

• MAD therapy can cause temporary discomfort, particularly affecting the TMJ and masticatory structures.
• The anterior condylar position induced by MADs may offer therapeutic benefits for individuals with TMD.
• MADs represent a treatment option that requires monitoring for both efficacy and potential side effects.