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Instructions for supportive jaw exercises and a morning occlusal guide were supplied. Orofacial pain, tenderness of masticatory muscles and temporomandibular joints, interdental contact analysis (digital bite registration system, Greifswald Digital Analyzing System (GEDAS) and Shimstock-foil), Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, and the Oral Health Impact Profile 5 were assessed before and after one year of treatment. MADs were compared using linear models, which were adjusted for study center, age, sex, and baseline values. Tooth type and tooth status were also included in the multilevel model of interdental contacts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study did not contradict the supposition that both MADs yield the same mean for the primary outcome, orofacial pain (P\u2009=\u20090.107; n\u2009=\u200949), possibly because of the reduced sample size due to the COVID-19 pandemic. Significant loss of posterior tooth contacts (n\u2009=\u200937) was established when applying the digital analysis for both MADs. Somnological variables were decreased in the follow-up examination, with no relevant differences between both MAD designs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>For comparing pain in MAD groups, more data will be needed to pool in meta-analyses. However, in our study, loss of interocclusal contacts in posterior teeth could not be prevented by jaw exercises or the use of an occlusal guide.<\/jats:p>\n                    <jats:p>ClinicalTrials.gov ID: NCT04050514, 08\/01\/2019.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11325-026-03576-4","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T21:43:04Z","timestamp":1770154984000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Side effects of mandibular advancement devices in obstructive sleep apnea patients \u2013 observational results of a randomized controlled trial"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1093-8740","authenticated-orcid":false,"given":"Olaf","family":"Bernhardt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos Nikitas","family":"Giannakopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horst","family":"Kares","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl-Maximilian","family":"N\u00fcrnberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Ruge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Schwahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Schlieper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Yousif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik","family":"Zenner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Kanzow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"3576_CR1","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1007\/s40675-017-0080-5","volume":"3","author":"M Marklund","year":"2017","unstructured":"Marklund M (2017) Update on oral appliance therapy for OSA. 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The study protocol was approved by the responsible ethics committee, University Medicine Greifswald, BB030\/19.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All patients gave written informed consent to participate.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"All patients gave personal consent for the publication of this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publication"}},{"value":"Olaf Bernhardt, Nikolaos Nikitas Giannakopoulos, Philipp Kanzow, Horst Kares, Alexander Meyer, Carl-Maximilian N\u00fcrnberger, Sebastian Ruge, Christian Schwahn, Sarah Yousif and Hendrik Zenner have no conflicts of interest or competing interest. Joerg Schlieper declares conflict of interest regarding MAD design, and adjustability.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}],"article-number":"32"}}