Long-Term Side Effects of Mandibular Advancement Devices in Patients with Obstructive Sleep Apnea

ABSTRACT

To evaluate the side effects of long-term mandibular advancement device (MAD) treatment associated with dental and skeletal changes. The search for clinical trials, retrospective studies and systematic review used PubMed with the following Mesh terms sleep apnea, mandibular advancement device, and long-term. Patients with obstructive sleep apnea in long-term treatment with MAD may experience side effects due to the protruded jaw position. The side effects reported were reduction in overjet, overbite, development of anterior crossbite, posterior openbite, and deteriorations in apnea-hypopnea index severity and treatment efficacy. Also, the use of MAD may lead to the development of temporomandibular disorders in a small number of patients, but these signs are most likely transient. MAD treatment produces time-related dental and skeletal side effects. Since the side effects are progressive, patients in long-term treatment with MAD must be regularly followed up and the device adjusted.