Hammond Roger J, Gotsopoulos Helen, Shen Gang, Petocz Peter, Cistulli Peter A, Darendeliler M Ali
Discipline of Orthodontics, Faculty of Dentistry, Sydney Dental Hospital, University of Sydney, Sydney, Australia.
Am J Orthod Dentofacial Orthop. 2007 Dec;132(6):806-14. doi: 10.1016/j.ajodo.2005.08.047.
Mandibular advancement splints (MAS) are a recognized therapeutic option in the treatment of obstructive sleep apnea (OSA). This study aimed to investigate side effects and possible changes in the dentofacial complex associated with long term use of MAS.
The sample included 64 patients with OSA who had been using MAS on average for 25.1 +/- 11.8 months (range, 10.7-64.5 months). A specifically designed questionnaire was used to investigate the patients' self-assessment of the side effects of wearing MAS; cephalometric analyses and dental cast measurements were conducted to identify objectively dental and skeletal changes caused by MAS over time.
The most commonly reported side effects were jaw discomfort, tooth tenderness, excessive salivation, and dry mouth. Subjectively, snoring improved in 56 patients (88%), and daytime sleepiness (Epworth sleepiness scale) scores significantly decreased from pretreatment to follow-up (11.4-7.1, P <.001). Small subjective occlusal changes were experienced by 8 patients (12.5%). Reductions in overbite (-0.3 +/- 0.08 mm, P <.01) and overjet (-0.2 +/- 0.06 mm, P <.05) were found, and cephalometric analysis showed statistically significant but clinically insignificant changes limited to anterior movement of the mandibular incisors (0.5 +/- 0.12 mm, P <.001).
Side effects of MAS use over long periods are common but mild and well tolerated by most patients, and dentofacial changes are negligible.
下颌前移矫治器（MAS）是治疗阻塞性睡眠呼吸暂停（OSA）的一种公认的治疗选择。本研究旨在调查长期使用MAS相关的副作用以及牙颌面复合体可能发生的变化。
样本包括64例OSA患者，他们平均使用MAS达25.1±11.8个月（范围为10.7 - 64.5个月）。使用专门设计的问卷来调查患者对佩戴MAS副作用的自我评估；进行头影测量分析和石膏模型测量，以客观确定MAS随时间引起的牙齿和骨骼变化。
最常报告的副作用是颌部不适、牙齿压痛、唾液过多和口干。主观上，56例患者（88%）的打鼾情况有所改善，并且从治疗前到随访期间，日间嗜睡（爱泼华嗜睡量表）得分显著降低（从11.4降至7.1，P <.001）。8例患者（12.5%）经历了轻微的主观咬合变化。发现覆合（-0.3±0.08 mm，P <.01）和覆盖（-0.2±0.06 mm，P <.05）减小，头影测量分析显示具有统计学意义但临床意义不大的变化，仅限于下颌切牙向前移动（0.5±0.12 mm，P <.001）。
长期使用MAS的副作用常见但轻微，大多数患者耐受性良好，牙颌面变化可忽略不计。
