Department of Oral-Facial Disorders, Osaka University Graduate School of Dentistry, Japan.
Department of Oral-Facial Disorders, Osaka University Graduate School of Dentistry, Japan; Department of Geriatric Dentistry, Osaka Dental University, Japan.
Sleep Med Rev. 2018 Oct;41:161-172. doi: 10.1016/j.smrv.2018.02.006. Epub 2018 Mar 1.
An oral appliance (OA) is an effective treatment option for patients with obstructive sleep apnea (OSA), but dental and skeletal changes have been detected by many studies after long-term OA use. Better understanding of the long-term side effects may decrease discontinuation of OA use and assist clinicians to make informed decisions. Accordingly, a systematic review and meta-analysis were performed to evaluate the dental and skeletal changes associated with OAs designed to advance the mandible. The quality of the studies was determined by using the risk of bias assessment tool for non-randomized studies (RoBANS), and 12 studies were included in the meta-analysis. OA use was associated with a significant decrease of overjet (OJ) and overbite (OB), and it was suggested that both parameters decreased along with the duration of treatment. Meta-analysis also demonstrated a significant increase of L1-MP. However, there were no significant changes of skeletal modifications or mandibular rotation. Changes of incisor inclination were suggested to make a contribution to reduction of OJ and OB. In conclusion, long-term OA use was associated with dental changes. The results of this study provide information for clinicians about the long-term effects of OAs.
口腔矫治器 (OA) 是治疗阻塞性睡眠呼吸暂停 (OSA) 患者的有效方法，但许多研究发现，长期使用 OA 后会出现牙齿和骨骼的变化。更好地了解长期的副作用可能会减少 OA 使用的中断，并帮助临床医生做出明智的决策。因此，进行了系统评价和荟萃分析，以评估旨在推进下颌的 OA 相关的牙齿和骨骼变化。使用非随机研究的偏倚风险评估工具 (RoBANS) 确定了研究的质量，共有 12 项研究纳入荟萃分析。OA 的使用与上切牙覆盖（OJ）和上切牙覆盖（OB）的显著减少有关，并且据提示，这两个参数随着治疗时间的延长而减少。荟萃分析还表明 L1-MP 显著增加。然而，骨骼改变或下颌旋转没有明显变化。切牙倾斜的变化被认为对上切牙覆盖（OJ）和上切牙覆盖（OB）的减少有贡献。总之，长期使用口腔矫治器与牙齿变化有关。本研究的结果为临床医生提供了关于口腔矫治器长期效果的信息。
