There are dento-skeletal changes in long-term treatment of obstructive sleep apnea with mandibular advancement appliance?

Abstract

The obstructive sleep apnea syndrome is a sleep-related breathing disorder characterized by repeated narrowing or collapse of the upper airway during sleep, resulting in severe systemic alterations. There are different approaches to the therapy, depending on the severity of this syndrome. In mild or moderate levels, therapy with mandibular advancement devices, associated or not with continuous positive airway pressure, may be indicated. There are reports in the literature indicating the occurrence of cross-bite in the premolar region and overjet and overbite reductions, due to the lingualization of the upper incisors and vestibularization of the lower incisors. It occur especially if the period of use of the device for mandibular advancement is greater than 3 years. This study reports the dento-skeletal changes promoted by the use during 5 years of an intra-oral appliance for mandibular advancement in an adult patient with nocturnal snoring. For the cephalometric analyzes performed at the beginning of treatment and after the time presented, it is observed that the changes occurred are not clinically relevant. Thus, it can be expected that the use of mandibular advancement devices in the treatment of obstructive sleep apnea does not promote significant dento-skeletal changes.