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Updated: Sep 12, 2026
Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Frequency and skeletal factors associated with posterior open bite during oral appliance therapy for obstructive
Miho Ezawa1, Chiho Hiraga2, Kei Matsumoto1
1Department of Oral Oncology, Oral and Maxillofacial Surgery, Tokyo Dental College, 5-11-13, Sugano, Ichikawa, Chiba, 272-8513, Japan.
Background:
Posterior open bite (POB) may develop as an occlusal adverse effect of long-term oral appliance (OA) therapy for obstructive sleep apnea (OSA). However, its frequency, time to clinical documentation, and associated skeletal and dental factors remain insufficiently characterized. This study investigated the frequency and clinical characteristics of POB and explored factors associated with its development during OA therapy.
Methods:
This retrospective study included 96 patients with OSA who received OA therapy between August 2015 and May 2025 and had sufficient clinical and cephalometric data for analysis. Patients were categorized into POB and non-POB groups. Patient characteristics, treatment-related factors, dental variables, and cephalometric parameters were compared using unpaired t-tests and Fisher's exact tests, as appropriate. Variables meeting the prespecified screening criterion of p < 0.20 in univariate analyses were entered into a multivariable logistic regression model.
Results:
POB was documented in 16 of 96 patients (16.7%). The mean interval from the initiation of OA therapy to the first documentation of POB was 1,265.3 days (approximately 3.5 years), with considerable variation among patients. Seven of the 16 patients (43.8%) reported awareness of occlusal changes when POB was first documented. Initial apnea-hypopnea index, number of remaining teeth, overjet, SNA, and SNB met the prespecified screening criterion in univariate analyses, with higher SNB showing a statistically significant unadjusted association with POB. However, none of these variables reached statistical significance in the multivariable analysis.
Conclusions:
POB was documented in 16.7% of patients in the final analytical cohort and was first identified at variable times during OA therapy. Although no statistically significant independent predictors were identified, higher SNB may be associated with POB. These exploratory findings require confirmation in larger prospective studies. Careful occlusal monitoring is warranted throughout long-term OA therapy.