Linsen Sabine S, Meyer Alexander, Daratsianos Nikolaos, Kares Anton
Department of Prosthodontics, Preclinical Education and Dental Material Science, University Hospital Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany.
Private Practice, Friedrich-Ebert-Str. 21, 42719, Solingen, Germany.
BMC Oral Health. 2025 Apr 11;25(1):543. doi: 10.1186/s12903-025-05914-6.
While mandibular advancement devices (MADs) are effective in reducing obstructive sleep apnoea (OSA)-related events, they can also cause occlusal changes. Three-dimensional (3D) techniques have rarely been used to evaluate the dental side effects. The aim of this study was to evaluate 3D tooth movement in patients with sleep apnea and to assess the effects of two designs: side wing and side thrust.
Virtual models of dental casts were superimposed at baseline (T0), after 11.9 ± 7.1 months (T1), and 31.9 ± 25.4 months (T2), evaluating 3D tooth movement, overjet, and overbite. Teeth were grouped into anterior (canine to canine) and posterior (bilateral first premolar to second molar) segments. Normality was checked (Shapiro-Wilk). T-tests, ANOVA, and regression analyses assessed differences in tooth movement, overjet/overbite changes, and influencing factors (P <.05).
A total of 58 patients diagnosed with obstructive sleep apnea (mean age: 50.7 ± 12.4 years; 44 males) were included. Observation period 1 (T0 and T1; OP1, n = 58) involved 28 wing (Somnodent flex and fusion) and 30 thrust (IST + and classic, Narval CC, Hamburger UPS) appliances, while observation period 2 (T0 and T2; OP2, n = 21) included 12 and 9, respectively. Over the treatment period, overjet and overbite decreased (p ≤.06), with increased maxillary palatal inclination, distal tooth translation in the anterior/posterior segments, and palatal movement of the anterior segment (p ≤.037). Wing appliances demonstrated greater reductions in overjet and overbite (p ≤.06), maxillary posterior segment extrusion (p =.003), and mesio-buccal translation in mandibular segments (p ≤.023) during OP2. Regression analysis indicated that wing appliances significantly influenced overjet and overbite in OP2 (p ≤.047).
MAD therapy resulted in progressive dental changes, including mesio-occlusion and anterior open bite, and appeared to be tilting of the entire row rather than physical movement, with wing appliances showing greater, although clinically insignificant, effects.
Registry: drks.de; Name: Changes in tooth position after treatment with mandibular advancement devices as part of the treatment of sleep-related breathing disorders; URL: https://drks.de/search/en/trial/DRKS00034679 Identifier: DRKS00034679, date of registration: 17. July 2024.
虽然下颌前移装置（MADs）在减少阻塞性睡眠呼吸暂停（OSA）相关事件方面有效，但它们也会引起咬合变化。三维（3D）技术很少用于评估牙齿副作用。本研究的目的是评估睡眠呼吸暂停患者的3D牙齿移动情况，并评估两种设计：侧翼型和侧推型的效果。
在基线（T0）、11.9±7.1个月后（T1）和31.9±25.4个月后（T2）对牙模的虚拟模型进行叠加，评估3D牙齿移动、覆盖和覆合情况。牙齿被分为前部（尖牙到尖牙）和后部（双侧第一前磨牙到第二磨牙）节段。进行正态性检验（Shapiro-Wilk检验）。采用t检验、方差分析和回归分析评估牙齿移动、覆盖/覆合变化及影响因素的差异（P<.05）。
共纳入58例诊断为阻塞性睡眠呼吸暂停的患者（平均年龄：50.7±12.4岁；44例男性）。观察期1（T0和T1；OP1，n=58）涉及28个侧翼型（Somnodent flex和fusion）和30个侧推型（IST+和经典型、Narval CC、Hamburger UPS）矫治器，而观察期2（T0和T2；OP2，n=21）分别包括12个和9个。在治疗期间，覆盖和覆合减小（p≤.06），上颌腭向倾斜增加，前部/后部节段牙齿远中移位，以及前部节段腭向移动（p≤.037）。在OP2期间，侧翼型矫治器在覆盖和覆合减小（p≤.06）、上颌后段伸长（p=.003）以及下颌段近中颊向移位（p≤.023）方面表现更明显。回归分析表明，侧翼型矫治器在OP2期间对覆盖和覆合有显著影响（p≤.047）。
MAD治疗导致渐进性牙齿变化，包括近中咬合和前牙开颌，并且似乎是整排牙齿的倾斜而非物理移动，侧翼型矫治器显示出更大的效果，尽管在临床上不显著。
注册机构：drks.de；名称：作为睡眠相关呼吸障碍治疗一部分的下颌前移装置治疗后牙齿位置的变化；网址：https://drks.de/search/en/trial/DRKS00034679；标识符：DRKS00034679，注册日期：2024年7月17日。
