Use of oral appliance to treat sleep apnea tied to minimal negative influence on jaw mobility and occlusion

Oral appliance (OA) therapy in obstructive sleep apnea (OSA) could be a risk factor for normal jaw function, given the prolonged effect of an OA in keeping the mandible in a protruded position away from a normal position. This study aimed to assess changes in symptoms and clinical findings related to jaw function after 1 year of treating obstructive sleep apnea with an Oral appliance.

In this follow-up clinical trial, 302 patients with obstructive sleep apnea were assigned to treatment with either monobloc or bibloc oral appliance. Baseline and 1-year follow-up assessment included using the Jaw Functional Limitation Scale, self-reported symptoms and signs related to jaw function. The clinical examination of jaw function included mandibular mobility, dental occlusion, and tenderness in the temporomandibular joints and masticatory muscles. Descriptive analyses of variables are presented for the per-protocol population. To evaluate differences between the baseline and the 1-year follow-up, paired Student t tests and the McNemar change test was used.

Results

One-hundred and ninety-two patients completed the 1-year follow-up (male 73%, mean aged 55 ± 11 years). There was no change in the Jaw Functional Limitation Scale score at the follow-up (nonsignificant). The patients described no change in symptoms at the follow-up, except for improvements in morning headache (P <0.001) and increased frequency of difficulties in opening the mouth or chewing on awakening (P = 0.002). Subjectively reported changes in dental occlusion during biting/chewing increased significantly at the follow-up (P = 0.009).

No changes in measurements of jaw mobility, dental occlusion, or pain on palpation of the temporomandibular joints or masticatory muscles were seen at the follow-up. Thus, using an Oral appliance in treating obstructive sleep apnea had limited influence on jaw functions and related symptoms. Moreover, the risk of developing pain and functional impairment in the masticatory system was infrequent, indicating that this treatment is safe and can be recommended.

Reference

Åke Tegelberg, Eva Nohlert, Thomas List, Göran Isacsson.Oral appliance influence on jaw function in obstructive sleep apnea. Open AccessPublished:June 15, 2023DOI: https://doi.org/10.1016/j.ajodo.2023.04.018

Keywords:

Use, oral, appliance, treat, obstructive, sleep apnea, minimal, negative, influence, jaw function, including, mobility, occlusion, Åke Tegelberg, Eva Nohlert, Thomas List, Göran Isacsso, American Journal of Orthodontics and Dentofacial Orthopedics