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.

中文翻译：

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长期阻塞性睡眠呼吸暂停治疗的牙科副作用：一项为期10年的随访研究。

目的阻塞性睡眠呼吸暂停（OSA）患者通常采用下颌前移装置（MAD）或持续气道正压通气（CPAP）治疗。这项研究的目的是评估与长期MAD和CPAP治疗相关的牙合变化。材料与方法在基线，2年和10年随访中评估了14位使用MAD的OSA患者和17位使用CPAP疗法的OSA患者的数据。使用数字游标卡尺从牙膏石膏模型分析牙合的变化。结果在2年的随访中，与基线值相比，MAD治疗导致了明显的牙齿变化。在MAD疗法中，过喷射和过咬分别降低了1.1±1.8 mm和1.1±1.2 mm。使用CPAP治疗时，过喷射和超咬显着降低了0.2±0.5 mm和0.3±0。分别为5毫米。两组还显示了磨牙咬合的显着变化。经过10年的随访，发现溢流和咬合发生了显着且更明显的变化。在MAD治疗中，与基线值相比，过喷射和超咬分别降低了3.5±1.5 mm和2.9±1.5 mm。在CPAP治疗中，与基线值相比，溢流和覆牙合分别减少了0.7±1.5 mm和0.8±1.4 mm。结论这项研究表明，MAD和CPAP治疗可导致牙齿咬合发生重大变化。与CPAP治疗相比，MAD的这些变化似乎是进行性的，并且更为明显。临床相关性长期OSA治疗会导致明显的牙科副作用，并可能随着时间的推移而发展。