Private Practice, Vancouver, British Columbia, Canada.
College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
J Clin Sleep Med. 2021 Oct 1;17(10):2067-2074. doi: 10.5664/jcsm.9358.
To characterize the mandibular anterior teeth crown height as a marker of periodontal changes and bone loss as a side effect of an oral appliance worn for a minimum of 4.5 years.
This retrospective study conducted in patients with healthy baseline periodontium recruited participants among consecutive sleep apnea patients treated with an oral appliance between 2004 to 2014. Eligible participants were recalled for a follow-up visit at which a periodontal examination was performed and a lateral cephalogram and dental impressions were obtained. Clinical crown height for mandibular anterior teeth and cephalometric variables were measured and compared before and after treatment. A full periodontal evaluation was performed at the follow-up visit.
Twenty-one patients enrolled with a mean treatment length of 7.9 ± 3.3 years. For the mandibular anterior teeth, clinical crown height did not change over the evaluated period. At follow-up, all the periodontal assessed variables were within normal limits, with the mean probing depth of 1.4 ± 0.5 mm, recession 0.6 ± 1.1 mm, and clinical attachment loss 0.8 ± 1.0 mm. Compared with baseline, there was a significant proclination of mandibular incisors (mean increase of 5.1 degrees) with the continued use of an oral appliance. Gingival levels were maintained with clinically insignificant changes during the observation period.
Inclination of the mandibular incisors increases significantly with the use of an oral appliance in patients with obstructive sleep apnea. Positional changes in these teeth were not associated with any measured evidence of increase in clinical crown height or gingival recession.
Heda P, Alalola B, Almeida FR, Kim H, Peres BU, Pliska BT. Long-term periodontal changes associated with oral appliance treatment of obstructive sleep apnea. . 2021;17(10):2067-2074.
描述下颌前牙冠高作为牙周变化的标志物，以及作为佩戴口腔矫治器 4.5 年以上的副作用导致的骨丢失。
这是一项回顾性研究，纳入了基线牙周健康的患者，这些患者均为 2004 年至 2014 年期间因阻塞性睡眠呼吸暂停而接受口腔矫治器治疗的连续患者中的参与者。合格的参与者被召回进行随访，在此期间进行了牙周检查，并获得了侧位头颅侧位片和牙印模。测量并比较了治疗前后下颌前牙的临床冠高和头影测量变量。在随访时进行了全面的牙周评估。
21 名患者入组，平均治疗时间为 7.9±3.3 年。对于下颌前牙，在评估期间，临床冠高没有变化。在随访时，所有评估的牙周变量均在正常范围内，平均探诊深度为 1.4±0.5mm，牙龈退缩为 0.6±1.1mm，临床附着丧失为 0.8±1.0mm。与基线相比，下颌切牙有明显的前倾（平均增加 5.1 度），继续使用口腔矫治器。在观察期间，牙龈水平保持不变，临床无明显变化。
在阻塞性睡眠呼吸暂停患者中，使用口腔矫治器会导致下颌切牙明显倾斜。这些牙齿的位置变化与临床冠高或牙龈退缩的任何可测量证据的增加无关。
Heda P, Alalola B, Almeida FR, Kim H, Peres BU, Pliska BT. 长期使用口腔矫治器治疗阻塞性睡眠呼吸暂停与牙周变化的相关性。. 2021;17(10):2067-2074.
