3-D changes in tooth position after treatment with mandibular advancement devices -a retrospective study in a non-university setting.

BACKGROUND

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.

METHODS

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).

RESULTS

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).

CONCLUSIONS

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.

TRIAL REGISTRATION: 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.