A comparison of dental changes produced by mandibular advancement splints in the management of obstructive sleep apnoea.

BACKGROUND

Mandibular advancement splints (MAS) are a recognised and popular treatment option for obstructive sleep apnoea (OSA) due to their simplicity, tolerance and non-invasiveness.

OBJECTIVES

To investigate and compare the dental changes associated with the use of monoblock and duoblock appliances.

METHODS

Fifty-two pretreatment and follow-up study models of patients from a public hospital and private dental clinic were assessed. Seventeen subjects used a soft elastomeric monoblock appliance (MB), 29 subjects used a hard acrylic duoblock (DB) and six subjects wore a monoblock followed by a duoblock appliance (MB-DB). Measurements of dental and arch changes were obtained and analysed on study models and standardised bitewing radiographs.

RESULTS

A statistically significant reduction was observed in the maxillary intercanine distance in all splint categories, with DB users showing the greatest decrease (p < 0.05). The change in the mandibular intercanine distances differed according to splint categories (p < 0.05). MB and MB-DB patients demonstrated a decrease in this measurement variable, whereas an increase was seen in DB users. A statistically significant increase in the mandibular intermolar distance was also observed in all splint categories (p < 0.05), with DB users showing the greatest increase.

CONCLUSIONS

Both MB and DB appliance systems produced similar, but mild dental effects. No particular appliance can be recommended and the choice of appliance should be considered on a case-by-case basis.