{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:43:24Z","timestamp":1791215004967,"version":"4.1.0"},"reference-count":28,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n        <jats:p>\n          <jats:bold>Objective:<\/jats:bold> To determine the variation in prevalence of temporomandibular disorders (TMD), other side effects, and technical complications during 5 years of sleep apnea treatment with a mandibular advancement device.<\/jats:p>\n        <jats:p>\n          <jats:bold>Materials and Methods:<\/jats:bold> Forty patients diagnosed with obstructive sleep apnea received an adjustable appliance at 70% of the maximum protrusion. The protrusion was then progressively increased. TMD (diagnosed according to the Research Diagnostic Criteria for TMD), overjet, overbite, occlusal contacts, subjective side effects, and technical complications were recorded before and a mean of 14, 21, and 58 months after treatment and analyzed by the Wilcoxon test (<jats:italic>P<\/jats:italic> &lt; .05).<\/jats:p>\n        <jats:p>\n          <jats:bold>Results:<\/jats:bold> Fifteen patients still used the oral appliance at the 5-year follow-up, and no significant variation in TMD prevalence was observed. Subjective side effects were common, and a significant reduction was found in overjet, overbite, and in the number of occlusal contacts. Furthermore, the patients made a mean of 2.5 unscheduled dental visits per year and a mean of 0.8 appliance repairs\/relines per year by a dental technician. The most frequent unscheduled visits were needed during the first year and were a result of acrylic breakage on the lateral telescopic attachment, poor retention, and other adjustments to improve comfort.<\/jats:p>\n        <jats:p>\n          <jats:bold>Conclusions:<\/jats:bold> Five-year oral appliance treatment does not affect TMD prevalence but is associated with permanent occlusal changes in most sleep apnea patients during the first 2 years. Patients seek several unscheduled visits, mainly because of technical complications.<\/jats:p>","DOI":"10.2319\/030309-122.1","type":"journal-article","created":{"date-parts":[[2009,10,15]],"date-time":"2009-10-15T01:00:59Z","timestamp":1255568459000},"page":"30-36","source":"Crossref","is-referenced-by-count":101,"title":["Five Years of Sleep Apnea Treatment with a Mandibular Advancement Device"],"prefix":"10.2319","volume":"80","author":[{"given":"Jordi","family":"Mart\u00ednez-Gomis","sequence":"first","affiliation":[{"name":"Associate Professor, Department of Prosthodontics, Faculty of Dentistry, University of Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Willaert","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Prosthodontics, Faculty of Dentistry, University of Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lluis","family":"Nogues","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Prosthodontics, Faculty of Dentistry, University of Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maribel","family":"Pascual","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Prosthodontics, Faculty of Dentistry, University of Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Somoza","sequence":"additional","affiliation":[{"name":"Medical Doctor, Sleep Unit, Respiratory Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Monasterio","sequence":"additional","affiliation":[{"name":"Medical Doctor, CIBER respiratory diseases and IDIBELL, Sleep Unit, Respiratory Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"issue":"1","key":"i0003-3219-80-1-30-b01","series-title":"Cochrane Database Syst Rev","first-page":"CD004435","article-title":"Oral appliances for obstructive sleep apnoea.","author":"Lim, J.","year":"2006 Jan 25","unstructured":"Lim, J., T. J.Lasserson, J.Fleetham, and J.Wright. Oral appliances for obstructive sleep apnoea.Cochrane Database Syst Rev2006 Jan 25. (1):CD004435."},{"key":"i0003-3219-80-1-30-b02","series-title":"Sleep Med Rev","first-page":"443","article-title":"Treatment of snoring and obstructive sleep apnea with mandibular repositioning appliances.","volume":"8","author":"Cistulli, P. A.","year":"2004","unstructured":"Cistulli, P. A., H.Gotsopoulos, M.Marklund, and A. A.Lowe. Treatment of snoring and obstructive sleep apnea with mandibular repositioning appliances.Sleep Med Rev2004. 8:443\u2013457."},{"key":"i0003-3219-80-1-30-b03","series-title":"Sleep","first-page":"244","article-title":"Oral appliances for snoring and obstructive sleep apnea: a review.","volume":"29","author":"Ferguson, K. A.","year":"2006","unstructured":"Ferguson, K. A., R.Cartwright, R.Rogers, and W.Schmidt-Nowara. 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Influence on the masticatory system in treatment of obstructive sleep apnea and snoring with a mandibular protruding device: a 2-year follow-up.Am J Orthod Dentofacial Orthop2004. 126:687\u2013693."},{"key":"i0003-3219-80-1-30-b11","series-title":"Clin Otolaryngol","first-page":"149","article-title":"Dental side-effects of mandibular advancement splint wear in patients who snore.","volume":"30","author":"Battagel, J. M.","year":"2005","unstructured":"Battagel, J. M. and B.Kotecha. Dental side-effects of mandibular advancement splint wear in patients who snore.Clin Otolaryngol2005. 30:149\u2013156."},{"key":"i0003-3219-80-1-30-b12","series-title":"Angle Orthod","first-page":"432","article-title":"Long-term dentofacial changes in Chinese obstructive sleep apnea patients after treatment with a mandibular advancement device.","volume":"76","author":"Hou, H. M.","year":"2006","unstructured":"Hou, H. M., K.Sam, U.H\u00e4gg, et al. Long-term dentofacial changes in Chinese obstructive sleep apnea patients after treatment with a mandibular advancement device.Angle Orthod2006. 76:432\u2013440."},{"key":"i0003-3219-80-1-30-b13","series-title":"Am J Orthod Dentofacial Orthop","first-page":"214","article-title":"Predictors of long-term orthodontic side effects from mandibular advancement devices in patients with snoring and obstructive sleep apnea.","volume":"129","author":"Marklund, M.","year":"2006","unstructured":"Marklund, M.\n          \n          Predictors of long-term orthodontic side effects from mandibular advancement devices in patients with snoring and obstructive sleep apnea.\n          Am J Orthod Dentofacial Orthop\n          2006. 129:214\u2013221."},{"key":"i0003-3219-80-1-30-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"205","article-title":"Long-term sequelae of oral appliance therapy in obstructive sleep apnea patients: part 2. Study-model analysis.","volume":"129","author":"Almeida, F. R.","year":"2006","unstructured":"Almeida, F. R., A. A.Lowe, R.Otsuka, S.Fastlicht, M.Farbood, and S.Tsuiki. Long-term sequelae of oral appliance therapy in obstructive sleep apnea patients: part 2. Study-model analysis.Am J Orthod Dentofacial Orthop2006. 129:205\u2013213."},{"key":"i0003-3219-80-1-30-b15","series-title":"Am J Orthod Dentofacial Orthop","first-page":"176","article-title":"The effects of oral appliance therapy on occlusal function in patients with obstructive sleep apnea: a short-term prospective study.","volume":"131","author":"Otsuka, R.","year":"2007","unstructured":"Otsuka, R., F. R.de Almeida, and A. A.Lowe. The effects of oral appliance therapy on occlusal function in patients with obstructive sleep apnea: a short-term prospective study.Am J Orthod Dentofacial Orthop2007. 131:176\u2013183."},{"key":"i0003-3219-80-1-30-b16","series-title":"Am J Orthod Dentofacial Orthop","first-page":"806","article-title":"A follow-up study of dental and skeletal changes associated with mandibular advancement splint use in obstructive sleep apnea.","volume":"132","author":"Hammond, R. J.","year":"2007","unstructured":"Hammond, R. J., H.Gotsopoulos, G.Shen, P.Petocz, P. A.Cistulli, and M. A.Darendeliler. 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M.Anglada, and J.Sams\u00f3. Reproducibility of lateral excursive tooth contact in a semi-adjustable articulator depending on the type of lateral guidance.J Oral Rehabil2005. 32:174\u2013179."},{"key":"i0003-3219-80-1-30-b25","series-title":"Eur J Oral Sci","first-page":"229","article-title":"Influence of static and dynamic occlusal characteristics and muscle force on masticatory performance in dentate adults.","volume":"116","author":"Lujan-Climent, M.","year":"2008","unstructured":"Lujan-Climent, M., J.Martinez-Gomis, S.Palau, R.Ayuso-Montero, J.Salsench, and M.Peraire. 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T.\n          \n          Mandibular advancement devices and sleep disordered breathing.\n          Sleep Med Rev\n          1998. 2:163\u2013174."},{"key":"i0003-3219-80-1-30-b28","series-title":"Sleep","first-page":"507","article-title":"Effects of mandibular posture on obstructive sleep apnea severity and the temporomandibular joint in patients fitted with an oral appliance.","volume":"25","author":"de Almeida, F. R.","year":"2002","unstructured":"de Almeida, F. R., L. R.Bittencourt, C. I.de Almeida, S.Tsuiki, A. A.Lowe, and S.Tufik. 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