A prospective 10-year follow-up dental cast study of patients with obstructive sleep apnoea/snoring who use a mandibular protruding device
A prospective 10-year follow-up dental cast study of patients with obstructive sleep apnoea/snoring who use a mandibular protruding device
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DOI：
10.1093/ejo/cjw081
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发表时间：
2017-10-01
影响因子：
2.6
通讯作者：
Isacsson, Goran
中科院分区：
文献类型：
--
作者：
Fransson, Anette M. C.;Kowalczyk, Agata;Isacsson, Goran
目的：这项为期10年的前瞻性研究旨在测量和评估阻塞性睡眠呼吸暂停（OSA）或打鼾患者夜间使用下颌突出装置（MPD）后10年的牙齿位置和咬合。材料与方法：对77例连续诊断为OSA/打鼾的患者进行MPD治疗。在基线和随访时制作牙模，下颌配位指标在牙尖间位置，制作构建咬合，并安装MPD。在10年的随访中，所有受试者（n = 74）被邀请参加。在一系列的测量中分析了牙模。结果：60名受试者纳入随访检查，其中41名仍在使用MPD， 19名已停止使用MPD。MPD使用者在所有分析变量中都显示出显著的变化，除了下颌骨犬牙间宽度和上颌前后关系外，覆盖喷流减少（-1.8 mm），覆盖咬合减少（-1.5 mm）。停止使用MPD的受试者保留了其初始值，除了覆盖牙合减少。MPD使用者出现中膜闭塞和后侧下闭塞的人数也有所增加；那些停止使用MPD的人大多保留了他们最初的状态。结论：长期夜间使用MPD可能会导致有利和不利的咬合变化，例如覆盖和覆盖咬合或后侧下咬合的减少，这些变化可能在MPD治疗期间继续发展。由于下颌牙齿的近中漂移，III类关系的受试者可能不适合进行MPD治疗。
Objectives: This 10-year prospective study aimed to measure and evaluate the teeth position and occlusion following 10-year nocturnal use of a mandibular protruding device (MPD) in subjects with obstructive sleep apnoea (OSA) or snoring.Materials and methods: Seventy-seven consecutive patients diagnosed with OSA/snoring were treated with an MPD. Fabrication of dental casts with jaw registration indexes in the intercuspal position was carried out at baseline and at follow-up, a construction bite was made, and an MPD was fitted.At the 10-year follow-up, all subjects (n = 74) were invited to participate. The dental casts were analysed in a series of measurements.Results: Sixty subjects were included in the follow-up examination-41 were still using the device and 19 had ceased using the MPD.The MPD users showed significant changes in all analysed variables-decrease of overjet (-1.8 mm), overbite (-1.5 mm)-except the mandibular intercanine width and the maxillary anteroposterior relationship. Subjects who had ceased using their MPD retained their initial values, with the exception of a decreased overbite.The MPD users also showed an increased number of subjects with mesio-occlusion and posterior infra-occlusion; those who had ceased using their MPD mostly retained their initial status.Conclusions: Long-term nocturnal use of an MPD may cause both favourable and unfavourable occlusion changes, such as a decrease of the overjet and overbite or posterior infra-occlusion, and these changes may continue to develop during treatment with an MPD. Subjects with a Class III relationship may not be a suitable group for treatment with an MPD due to the mesial drift of the mandibular teeth.