IADR Abstract Archives
A Systematic Review of Mandibular Advancement Device Side Effects
Objectives: To assess the impact of time on mandibular advancement devices (MAD) and to investigate the long-term skeletal and dental side effects of MAD.
Methods: Six online databases were searched electronically including the Web of Science, Medline, PubMed, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL). Potential eligible randomized controlled trials were searched without restrictions in publication date or language. Descriptive cross-sectional studies, case-series, case reports, conference abstracts and opinion-based articles were excluded. Studies that were included involved patients with at least three years of wearing MAD for obstructive sleep apnea and the assessment of skeletal and/or dental side effects. For each parameter included in the studies, the 95 percent confidence interval was calculated between follow-up and baseline. A meta-regression analysis was completed.
Results: One thousand one hundred and twenty papers were identified from the electronic database search. Duplicate records were then excluded and the abstracts and titles of 432 were screened. A total of 25 studies were included in this systematic review which had a follow-up of 3 to 10 years. An increase in the anterior face height, ANB (A point, nasion, B point), and lower incisor inclination were reported as side effects. And a decrease in the inclination of upper incisors, overbite and overjet were also identified as side effects. All the outcomes had a moderate quality of evidence according to the Grading of Recommendations Assessment, Development and Evaluation. For all parameters, the duration of therapy influenced the side effects (P < 0.05).
Conclusions: Skeletal and dental side effects were evident in the use of MAD therapy and were influenced by the therapy duration. The skeletal side effects were less clinically relevant compared to the dental side effects. Obstructive sleep apnea patients require continuous monitoring as the side effects may progress.
Methods: Six online databases were searched electronically including the Web of Science, Medline, PubMed, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL). Potential eligible randomized controlled trials were searched without restrictions in publication date or language. Descriptive cross-sectional studies, case-series, case reports, conference abstracts and opinion-based articles were excluded. Studies that were included involved patients with at least three years of wearing MAD for obstructive sleep apnea and the assessment of skeletal and/or dental side effects. For each parameter included in the studies, the 95 percent confidence interval was calculated between follow-up and baseline. A meta-regression analysis was completed.
Results: One thousand one hundred and twenty papers were identified from the electronic database search. Duplicate records were then excluded and the abstracts and titles of 432 were screened. A total of 25 studies were included in this systematic review which had a follow-up of 3 to 10 years. An increase in the anterior face height, ANB (A point, nasion, B point), and lower incisor inclination were reported as side effects. And a decrease in the inclination of upper incisors, overbite and overjet were also identified as side effects. All the outcomes had a moderate quality of evidence according to the Grading of Recommendations Assessment, Development and Evaluation. For all parameters, the duration of therapy influenced the side effects (P < 0.05).
Conclusions: Skeletal and dental side effects were evident in the use of MAD therapy and were influenced by the therapy duration. The skeletal side effects were less clinically relevant compared to the dental side effects. Obstructive sleep apnea patients require continuous monitoring as the side effects may progress.