Am. J. Respir. Crit. Care Med.,
Volume 164, Number 5, September 2001, 813-818
Side Effects of Mandibular Advancement Devices for
Sleep Apnea Treatment
KARSTEN M.
FRITSCH,
ANGELO
ISELI,
ERICH W.
RUSSI,
and
KONRAD E.
BLOCH
Pulmonary Division, Department of Internal Medicine, University Hospital of Zürich, Zürich, Switzerland; and the Department
of Orthodontics and Dentofacial Orthopedics, University of Zürich, Zürich, Switzerland
Our purpose was to investigate side effects of sleep apnea treatment by removable oral appliances (OA) that advance the mandible. In 22 patients suffering from obstructive sleep apnea (OSA), questionnaire evaluations, polysomnographies, cephalographies, and
dental plaster casts were obtained before initiation of treatment
with OA that fully covered both dental arches. Patients were reevaluated after 3 to 12 mo (questionnaires, polysomnographies)
and 12 to 30 mo (questionnaires, cephalographies, plaster casts)
during continuous treatment. Polysomnographies confirmed improved breathing by OA. All patients experienced persistent alleviation of symptoms after 12 to 30 mo and wished to continue treatment. Side effects were common but only mildly disturbing: mucosal
dryness (86% of patients), tooth discomfort (59%), and hypersalivation (55%). Cephalographies revealed a decrease in the mean
(± SE) upper incisors to maxillary plane angle from 102 ± 2° at
baseline, to 101 ± 2° after 12 to 30 mo (p < 0.05). Overbite and
overjet were also slightly (mean reduction < 1 mm) but significantly reduced. None of these side effects required discontinuation of treatment. OA are an effective therapy of obstructive sleep
apnea. Mild side effects are common but rarely require intervention. Nevertheless, close follow-up during long-term therapy by
OA is advisable in order to timely detect potentially relevant orthodontic changes.
Keywords: sleep apnea; snoring; oral appliance; mandibular advancement devices; treatment; side effects
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