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폐쇄성 수면무호흡증 환자에서 장기간 하악전진장치 치료 시 부작용

Long-Term Side Effects of Mandibular Advancement Devices in Patients with Obstructive Sleep Apnea

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To evaluate the side effects of long-term mandibular advancement device (MAD) treatment associated with dental and skeletal changes. The search for clinical trials, retrospective studies and systematic review used PubMed with the following Mesh terms: sleep apnea, mandibular advancement device, and long-term. Patients with obstructive sleep apnea in long-term treatment with MAD may experience side effects due to the protruded jaw position. The side effects reported were reduction in overjet, overbite, development of anterior crossbite, posterior openbite, and deteriorations in apnea-hypopnea index severity and treatment efficacy. Also, the use of MAD may lead to the development of temporomandibular disorders in a small number of patients, but these signs are most likely transient. MAD treatment produces time-related dental and skeletal side effects. Since the side effects are progressive, patients in long-term treatment with MAD must be regularly followed up and the device adjusted.

Abstract

To evaluate the side effects of long-term mandibular advancement device (MAD) treatment associated with dental and skeletal changes. The search for clinical trials, retrospective studies and systematic review used PubMed with the following Mesh terms: sleep apnea, mandibular advancement device, and long-term. Patients with obstructive sleep apnea in long-term treatment with MAD may experience side effects due to the protruded jaw position. The side effects reported were reduction in overjet, overbite, development of anterior crossbite, posterior openbite, and deteriorations in apnea-hypopnea index severity and treatment efficacy. Also, the use of MAD may lead to the development of temporomandibular disorders in a small number of patients, but these signs are most likely transient. MAD treatment produces time-related dental and skeletal side effects. Since the side effects are progressive, patients in long-term treatment with MAD must be regularly followed up and the device adjusted.

참고문헌 (9)

  1. Bartolucci ML, "Dental and skeletal long-term side effects of mandibular advancement devices in obstructive sleep apnea patients : a systematic review with meta-regression analysis", Eur J Orthod, 41, pp.89~100 (2019)
  2. Marklund M, "Non-CPAP therapies in obstructive sleep apnoea : mandibular advancement device therapy", Eur Respir J, 39, pp.1241~1247 (2012)
  3. Knappe SW, "Longterm side effects on the temporomandibular joints and oro-facial function in patients with obstructive sleep apnoea treated with a mandibular advancement device", J Oral Rehabil, 44, pp.354~362 (2017)
  4. Marklund M, "Long-term efficacy of an oral appliance in early treated patients with obstructive sleep apnea", Sleep Breath, 20, pp.689~694 (2016)
  5. Perez CV, "The incidence and prevalence of temporomandibular disorders and posterior open bite in patients receiving mandibular advancement device therapy for obstructive sleep apnea", Sleep Breath, 17, pp.323~332 (2013)
  6. Pliska BT, "Obstructive sleep apnea and mandibular advancement splints : occlusal effects and progression of changes associated with a decade of treatment", J Clin Sleep Med, 10, pp.1285~1291 (2014)
  7. Doff MHJ, "Long-term oral appliance therapy in obstructive sleep apnea syndrome : a controlled study on temporomandibular side effects", Clin Oral Investig, 16, pp.689~697 (2012)
  8. Mehta NR, "Oral appliance therapy and temporomandibular disorders", Sleep Med Clin, 13, pp.513~519 (2018)
  9. Ramar K, "Clinical practice guideline for the treatment of obstructive sleep apnea and snoring with oral appliance therapy : an update for 2015", J Clin Sleep Med, 11, pp.773~827 (2015)

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