The global occurrence of obstructive sleep apnea (OSA) highlights the demand for effective management strategies. Mandibular advancement devices (MADs) have proven to be a reliable intervention for mild to moderate OSA, despite their potential to cause dental changes. This research examined the characteristics, onset, and persistence of such dental alterations. In the prospective cohort (n = 12), dental impressions were recorded before MAD insertion and subsequently after three, six, nine, and twelve months to assess occlusal modifications. The retrospective cohort included individuals (n = 8) who had used MADs for an average of 7 years; their recent lateral cephalograms were compared with baseline radiographs. All participants completed a standardized questionnaire. Data were analyzed using t-tests, with statistical significance set at p < 0.05.
Most participants maintained consistent MAD use and noted substantial improvements in sleep quality, with minimal reports of jaw stiffness or discomfort. Significant reductions in overjet were identified across both cohorts: in the prospective group at six months (p = 0.001), nine months (p > 0.001), and twelve months (p = 0.019), and in the retrospective group between initial and seven-year follow-up measures (p = 0.004). A minor overbite increase of 0.2 mm was seen after one year in the prospective sample, while the long-term group showed a slight decrease (p = 0.003). No meaningful shifts were recorded in angle classification or lower incisor inclination. Cephalometric analysis revealed a notable change in the IOK-NL angle, from 98.2° pre-treatment to 95.2° following long-term therapy (p = 0.020). The findings indicate that MAD therapy effectively mitigates OSA symptoms while producing only minimal dental side effects. Moderate mandibular advancement appears optimal for balancing efficacy and oral health preservation. Nonetheless, the relatively small participant pool limits broader applicability of these outcomes.
