Irreversible alteration in occlusion caused by a mandibular advancement appliance: an unexpected complication of sleep apnea treatment.

A 56-year-old woman who had suffered from socially disturbing snoring, daytime tiredness, and panic-like apnea episodes showed mild obstructive apnea in somnography. She was examined in the Oral and Maxillofacial Unit of Vaasa Central Hospital, Finland. She did not wish to have her malocclusion and lower airway obstruction corrected with orthognathic surgery, but instead chose to be treated with a mandibular advancement appliance. After having used the appliance nightly for more than 3 years, an irreversible alteration in her occlusion was noticed. The case is presented and possible reasons for this change are discussed.