Pantin C C, Hillman D R, Tennant M
Department of Pulmonary Physiology, Sir Charles Gairdner Hospital, Nedlands, Western Australia.
Sleep. 1999 Mar 15;22(2):237-40. doi: 10.1093/sleep/22.2.237.
Snoring and obstructive sleep apnea (OSA) are common and related conditions--with major social and health implications--which can be treated successfully with dental devices that reposition the mandible. Despite wide use, side effects of these devices have not yet been systematically evaluated. The purpose of the study was to evaluate side effects of a mandibular advancement splint (MAS) previously described by the authors.
Questionnaire survey and dental examination of a consecutive case series of patients treated with the MAS SETTING: Dental outpatient clinic
Attempts were made to contact all 191 patients treated over a 5-year period. All had snored loudly and habitually with or without OSA prior to treatment.
Of 191 patients treated, 132 agreed to complete the questionnaire. All were scheduled to attend for dental examination and 106 underwent examination. Of the 132 interviewed, patient and partner report indicated that the device was well tolerated and controlled snoring satisfactorily in 100 after 31 +/- 18 (mean +/- SD) months of use. Dental side effects were reported in 107 patients, although these were mostly minor, and only 10 patients ceased using the device because of them. Side effects included excess salivation (in 40), xerostomia (in 30), temporomandibular joint pain (in 35), dental discomfort (in 35), myofacial discomfort (in 33) and bite changes (in 16). Of 106 patients examined, 30 had increased maximal opening and 76 had no change compared with pretreatment records. Temporomandibular joint noises were found in 9 patients, and occlusal changes (12 m mylar strip and wax bite, relative to pretreatment) in 15. None of these effects could be related to degree of opening or protrusion produced by the MAS.
Dental side effects occur in a significant proportion of patients using the MAS. In most cases these are minor and their importance must be balanced against the efficacy of the MAS in treating snoring and OSA.
打鼾和阻塞性睡眠呼吸暂停（OSA）是常见且相关的病症，具有重大的社会和健康影响，可通过重新定位下颌的牙科器械成功治疗。尽管这些器械被广泛使用，但其副作用尚未得到系统评估。本研究的目的是评估作者之前描述的下颌前移矫治器（MAS）的副作用。
对接受MAS治疗的连续病例系列进行问卷调查和牙科检查
牙科门诊
试图联系在5年期间接受治疗的所有191名患者。所有患者在治疗前均有大声且习惯性打鼾，伴有或不伴有OSA。
在接受治疗的191名患者中，132名同意完成问卷调查。所有患者均被安排进行牙科检查，106名接受了检查。在接受访谈的132名患者中，患者及其伴侣的报告表明，在使用31±18（平均±标准差）个月后，该器械耐受性良好，100名患者的打鼾得到了满意控制。107名患者报告了牙科副作用，尽管大多数副作用较小，只有10名患者因这些副作用而停止使用该器械。副作用包括唾液过多（40例）、口干（30例）、颞下颌关节疼痛（35例）、牙齿不适（35例）、肌筋膜不适（33例）和咬合改变（16例）。在接受检查的106名患者中，与治疗前记录相比，30名患者的最大开口度增加，76名患者无变化。9名患者发现颞下颌关节有弹响，15名患者出现咬合改变（相对于治疗前，使用12个月的聚酯薄膜条和蜡咬合）。这些影响均与MAS产生的开口度或前突程度无关。
使用MAS的患者中有相当一部分出现牙科副作用。在大多数情况下，这些副作用较小，其重要性必须与MAS治疗打鼾和OSA的疗效相权衡。
