Dental side effects of long-term obstructive sleep apnea therapy: a 10-year follow-up study

Julia Anne Margarethe Uniken Venema*, Michiel H.J. Doff, Dilyana S. Joffe-Sokolova, Peter J. Wijkstra, Johannes H. van der Hoeven, Boudewijn Stegenga, Aarnoud Hoekema

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Objectives: Patients with obstructive sleep apnea (OSA) are usually treated with either mandibular advancement device (MAD) or continuous positive airway pressure (CPAP) therapy. The objective of this study is to evaluate changes in dental occlusion associated with long-term MAD and CPAP therapy. Materials and methods: Data from 14 OSA patients using MAD and 17 OSA patients using CPAP therapy were evaluated at baseline, 2-year and 10-year follow-up. Changes in dental occlusion were analyzed from dental plaster casts with a digital sliding caliper. Results: At 2-year follow-up, MAD therapy resulted in significant dental changes when compared with baseline values. In MAD therapy, overjet and overbite decreased with 1.1 ± 1.8 mm and 1.1 ± 1.2 mm respectively. With CPAP therapy overjet and overbite decreased significantly with 0.2 ± 0.5 mm and 0.3 ± 0.5 mm, respectively. Both groups also showed significant changes in molar occlusion. After a 10-year follow-up, significant and more pronounced changes were seen in overjet and overbite. In MAD therapy, overjet and overbite decreased with 3.5 ± 1.5 mm and 2.9 ± 1.5 mm respectively when compared with baseline values. In CPAP therapy, overjet and overbite decreased with 0.7 ± 1.5 mm and 0.8 ± 1.4 mm respectively when compared with baseline values. Conclusions: This study demonstrates that MAD and CPAP therapy result in significant changes in dental occlusion. These changes appear progressive and more pronounced with MAD compared to CPAP therapy. Clinical relevance: Long-term OSA treatment results in significant dental side effects that may progress over time. Informed consent is fundamental before starting MAD treatment and individualized long-term follow-up is of eminent importance.

Original languageEnglish
Pages (from-to)3069-3076
Number of pages8
JournalClinical Oral Investigations
Volume24
Issue number9
Early online date20 Dec 2019
DOIs
Publication statusPublished - Sep 2020

Bibliographical note

Funding Information:
This is not an industry supported study. Aarnoud Hoekema is a medical advisor for Airway Management Inc., Somnomed and Zephyr Sleep Technologies.

Publisher Copyright:
© 2019, Springer-Verlag GmbH Germany, part of Springer Nature.

Keywords

  • Continuous positive airway pressure
  • Dental side effects
  • Mandibular advancement device
  • Obstructive sleep apnea
  • Treatment outcome

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