{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T03:42:33Z","timestamp":1780112553008,"version":"3.54.0"},"reference-count":52,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n To identify malocclusion characteristics generated after using oral appliances (OAs) for at least 5 years for the management of snoring and obstructive sleep apnea (OSA) in adults.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n PubMed, MEDLINE (Ovid), Scopus, CINAHL, and Informit were searched without language restrictions through January 20, 2021. Unpublished literature was searched on ClinicalTrials.gov, the National Research Register, and the Pro-Quest Dissertation Abstracts and Thesis database. Authors were contacted when necessary, and reference lists of the included studies were screened. Risk of bias was assessed through the revised Cochrane Risk of Bias tool for randomized controlled trials (RoB2) and Non-Randomized Studies of Interventions for non-RCTs and uncontrolled before\u2013after studies (ROBINS-I). A random-effects meta-analysis was conducted only on studies that used the same OAs to exclude biomechanical differences. Risk of bias across studies was assessed with the Grading of Recommendations, Assessment, Development and Evaluation tool.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 12 studies were included in the final qualitative synthesis. Eight included studies had high, one had moderate, and three had low risks of bias. Significant progressive decreases of overjet (OJ; \u22121.43 mm; 95% confidence interval [CI], \u22121.66 to \u22121.20) and overbite (OB; \u22121.94 mm; 95% CI, \u22122.14 to \u22121.74) associated with maxillary incisor retroclination and mandibular incisor proclination were reported long term. Although most studies showed no sagittal skeletal changes, some degree of vertical skeletal changes were noted.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Based on a very low evidence level, inevitable anterior teeth positional changes seem to be a common long-term adverse effect of OAs. The magnitude of those changes could be considered clinically irrelevant for most pretreatment occlusions, but in occlusions with limited OJ and OB, it may be worth clinical consideration.<\/jats:p>\n <\/jats:sec>","DOI":"10.2319\/041921-316.1","type":"journal-article","created":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T15:47:58Z","timestamp":1640015278000},"page":"255-264","source":"Crossref","is-referenced-by-count":9,"title":["Oral appliance\u2013generated malocclusion traits during the long-term management of obstructive sleep apnea in adults:"],"prefix":"10.2319","volume":"92","author":[{"given":"Carmen","family":"Karadeniz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken Wei Chen","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Lindsay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ersan I.","family":"Karadeniz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Flores-Mir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"issue":"(1)","key":"i1945-7103-92-2-255-b01","series-title":"Am J Orthod Dentofac Orthop","first-page":"13","article-title":"Obstructive sleep apnea and orthodontics: an American Association of Orthodontists White Paper","volume":"156","author":"Behrents","year":"2019","unstructured":"Behrents\n RG,\n \n \n Shelgikar\n AV,\n \n \n Conley\n RS,\n \n et al.\n \n Obstructive sleep apnea and orthodontics: an American Association of Orthodontists White Paper.\n\t\t\t\t\tAm J Orthod Dentofac Orthop.\n\t\t\t\t\t2019;\n\t\t\t\t\t156(1):\n\t\t\t\t\t13\u2013\n\t\t\t\t\t28.e11."},{"key":"i1945-7103-92-2-255-b02","series-title":"Contemporary Orthodontics E-Book","author":"Proffit","year":"2018","unstructured":"Proffit\n WR,\n \n \n Fields\n HW,\n \n \n Larson\n B,\n \n \n Sarver\n DM.\n \n \n \n Contemporary Orthodontics E-Book\n .\n\t\t\t\t\tAmsterdam, the Netherlands:\n\t\t\t\t\tElsevier Health Sciences;2018."},{"issue":"(2)","key":"i1945-7103-92-2-255-b03","series-title":"Sleep Breath","first-page":"781","article-title":"Forces created by mandibular advancement devices in OSAS patients","volume":"17","author":"Cohen-Levy","year":"2013","unstructured":"Cohen-Levy\n J,\n \n \n Petelle\n B,\n \n \n Pinguet\n J,\n \n \n Limerat\n E,\n \n \n Fleury\n B.\n \n \n Forces created by mandibular advancement devices in OSAS patients.\n\t\t\t\t\tSleep Breath.\n\t\t\t\t\t2013;\n\t\t\t\t\t17(2):\n\t\t\t\t\t781\u2013\n\t\t\t\t\t789."},{"issue":"(9)","key":"i1945-7103-92-2-255-b04","series-title":"Clin Oral Investig","first-page":"3069","article-title":"Dental side effects of long-term obstructive sleep apnea therapy: a 10-year follow-up study","volume":"24","author":"Uniken Venema","year":"2020","unstructured":"Uniken Venema\n JAM,\n \n \n Doff\n MHJ,\n \n \n Joffe-Sokolova\n DS,\n \n et al\n .\n\t\t\t\t\tDental side effects of long-term obstructive sleep apnea therapy: a 10-year follow-up study.\n\t\t\t\t\tClin Oral Investig.\n\t\t\t\t\t2020;\n\t\t\t\t\t24(9):\n\t\t\t\t\t3069\u2013\n\t\t\t\t\t3076."},{"key":"i1945-7103-92-2-255-b05","series-title":"Sleep Med Rev","first-page":"161","article-title":"Dental and skeletal changes associated with long-term oral appliance use for obstructive sleep apnea: a systematic review and meta-analysis","volume":"41","author":"Araie","year":"2018","unstructured":"Araie\n T,\n \n \n Okuno\n K,\n \n \n Ono Minagi\n H,\n \n \n Sakai\n T.\n \n \n Dental and skeletal changes associated with long-term oral appliance use for obstructive sleep apnea: a systematic review and meta-analysis.\n\t\t\t\t\tSleep Med Rev.\n\t\t\t\t\t2018;\n\t\t\t\t\t41:\n\t\t\t\t\t161\u2013\n\t\t\t\t\t172."},{"issue":"(1)","key":"i1945-7103-92-2-255-b06","series-title":"Int Orthod","first-page":"3","article-title":"Long-term dental and skeletal effects of mandibular advancement devices in adults with obstructive sleep apnoea: a systematic review","volume":"17","author":"Patel","year":"2019","unstructured":"Patel\n S,\n \n \n Rinchuse\n D,\n \n \n Zullo\n T,\n \n \n Wadhwa\n R.\n \n \n Long-term dental and skeletal effects of mandibular advancement devices in adults with obstructive sleep apnoea: a systematic review.\n\t\t\t\t\tInt Orthod.\n\t\t\t\t\t2019;\n\t\t\t\t\t17(1):\n\t\t\t\t\t3\u2013\n\t\t\t\t\t11."},{"issue":"(1)","key":"i1945-7103-92-2-255-b07","series-title":"Euro J Orthod","first-page":"89","article-title":"Dental and skeletal long-term side effects of mandibular advancement devices in obstructive sleep apnea patients: a systematic review with meta-regression analysis","volume":"41","author":"Bartolucci","year":"2019","unstructured":"Bartolucci\n ML,\n \n \n Bortolotti\n F,\n \n \n Martina\n S,\n \n \n Corazza\n G,\n \n \n Michelotti\n A,\n \n \n Alessandri-Bonetti\n G.\n \n \n Dental and skeletal long-term side effects of mandibular advancement devices in obstructive sleep apnea patients: a systematic review with meta-regression analysis.\n\t\t\t\t\tEuro J Orthod.\n\t\t\t\t\t2019;\n\t\t\t\t\t41(1):\n\t\t\t\t\t89\u2013\n\t\t\t\t\t100."},{"issue":"(4)","key":"i1945-7103-92-2-255-b08","series-title":"Dental Press J","first-page":"45","article-title":"Side effects of mandibular advancement splints for the treatment of snoring and obstructive sleep apnea: a systematic review","volume":"23","author":"Martins","year":"2018","unstructured":"Martins\n OdFM,\n \n \n Chaves\n CM,\n Junior\n \n \n Rossi\n RRP,\n \n \n Cunali\n PA,\n \n \n Dal-Fabbro\n C,\n \n \n Bittencourt\n L.\n \n \n Side effects of mandibular advancement splints for the treatment of snoring and obstructive sleep apnea: a systematic review.\n\t\t\t\t\tDental Press J.\n\t\t\t\t\t2018;\n\t\t\t\t\t23(4):\n\t\t\t\t\t45\u2013\n\t\t\t\t\t54."},{"key":"i1945-7103-92-2-255-b09","series-title":"elaboration and explanation. BMJ 2015;350: g7647.","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015","author":"Shamseer","unstructured":"Shamseer\n L,\n \n \n Moher\n D,\n \n \n Clarke\n M,\n \n et al.\n \n Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015:\n\t\t\t\t\telaboration and explanation. BMJ 2015;350: g7647."},{"key":"i1945-7103-92-2-255-b10","series-title":"ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ.","first-page":"i4919","author":"Sterne","year":"2016","unstructured":"Sterne\n JA,\n \n \n Hern\u00e1n\n MA,\n \n \n Reeves\n BC,\n \n et al.\n \n ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ.\n 2016;\n\t\t\t\t\t355:i4919."},{"issue":"(1)","key":"i1945-7103-92-2-255-b11","series-title":"Res Synth Methods","first-page":"55","article-title":"Risk-of-bias VISualization (robvis): an R package and Shiny web app for visualizing risk-of-bias assessments","volume":"12","author":"McGuinness","year":"2021","unstructured":"McGuinness\n LA,\n \n \n Higgins\n JPT.\n \n \n Risk-of-bias VISualization (robvis): an R package and Shiny web app for visualizing risk-of-bias assessments.\n\t\t\t\t\tRes Synth Methods.\n\t\t\t\t\t2021;\n\t\t\t\t\t12(1):\n\t\t\t\t\t55\u2013\n\t\t\t\t\t61."},{"key":"i1945-7103-92-2-255-b12","series-title":"GRADEpro guideline development tool [software]. gradepro.org. McMaster University and Evidence Prime, 2021. Accessed 5 November 2020","author":"GRADEpro","unstructured":"GRADEpro\n GDT:\n \n \n GRADEpro guideline development tool [software]. gradepro.org. McMaster University and Evidence Prime, 2021. Accessed 5 November 2020."},{"key":"i1945-7103-92-2-255-b13","series-title":"Long-Term Periodontal Changes During Oral Appliance Treatment for Sleep Apnea [master's thesis]","author":"Heda","year":"2019","unstructured":"Heda\n P.\n \n \n \n Long-Term Periodontal Changes During Oral Appliance Treatment for Sleep Apnea [master's thesis].\n\t\t\t\t\tVancouver, Canada:\n\t\t\t\t\tUniversity of British Columbia;2019."},{"key":"i1945-7103-92-2-255-b14","series-title":"Sleep Medicine","first-page":"184","article-title":"Long-term side effects of sleep apnea treatment with oral appliances: nature, magnitude and predictors of long-term changes","volume":"56","author":"Hamoda","year":"2019","unstructured":"Hamoda\n MM,\n \n \n Almeida\n FR,\n \n \n Pliska\n BT.\n \n \n Long-term side effects of sleep apnea treatment with oral appliances: nature, magnitude and predictors of long-term changes.\n\t\t\t\t\tSleep Medicine.\n\t\t\t\t\t2019;\n\t\t\t\t\t56:\n\t\t\t\t\t184\u2013\n\t\t\t\t\t191."},{"issue":"(1)","key":"i1945-7103-92-2-255-b15","series-title":"Am J Orthod Dentofac Orthop","first-page":"91","article-title":"A prospective 10-year cephalometric follow-up study of patients with obstructive sleep apnea and snoring who used a mandibular protruding device","volume":"157","author":"Fransson","year":"2020","unstructured":"Fransson\n AMC,\n \n \n Benavente-Lundahl\n C,\n \n \n Isacsson\n G.\n \n \n A prospective 10-year cephalometric follow-up study of patients with obstructive sleep apnea and snoring who used a mandibular protruding device.\n\t\t\t\t\tAm J Orthod Dentofac Orthop.\n\t\t\t\t\t2020;\n\t\t\t\t\t157(1):\n\t\t\t\t\t91\u2013\n\t\t\t\t\t97."},{"issue":"(12)","key":"i1945-7103-92-2-255-b16","series-title":"J Clin Sleep Med","first-page":"1285","article-title":"Obstructive sleep apnea and mandibular advancement splints: occlusal effects and progression of changes associated with a decade of treatment","volume":"10","author":"Pliska","year":"2014","unstructured":"Pliska\n BT,\n \n \n Nam\n H,\n \n \n Chen\n H,\n \n \n Lowe\n AA,\n \n \n Almeida\n FR.\n \n \n Obstructive sleep apnea and mandibular advancement splints: occlusal effects and progression of changes associated with a decade of treatment.\n\t\t\t\t\tJ Clin Sleep Med.\n\t\t\t\t\t2014;\n\t\t\t\t\t10(12):\n\t\t\t\t\t1285\u2013\n\t\t\t\t\t1291."},{"issue":"(1)","key":"i1945-7103-92-2-255-b17","series-title":"Sleep Breath","first-page":"111","article-title":"Subjective versus objective dental side effects from oral sleep apnea appliances","volume":"24","author":"Marklund","year":"2019","unstructured":"Marklund\n M.\n \n \n Subjective versus objective dental side effects from oral sleep apnea appliances.\n\t\t\t\t\tSleep Breath.\n\t\t\t\t\t2019;\n\t\t\t\t\t24(1):\n\t\t\t\t\t111\u2013\n\t\t\t\t\t117."},{"issue":"(2)","key":"i1945-7103-92-2-255-b18","series-title":"Am J Orthod Dentofac 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","year":"2006","unstructured":"Marklund\n M.\n \n \n Predictors of long-term orthodontic side effects from mandibular advancement devices in patients with snoring and obstructive sleep apnea.\n\t\t\t\t\tAm J Orthod Dentofac Orthop.\n\t\t\t\t\t2006;\n\t\t\t\t\t129(2):\n\t\t\t\t\t214\u2013\n\t\t\t\t\t221."},{"issue":"(5)","key":"i1945-7103-92-2-255-b19","series-title":"Euro J Orthod","first-page":"502","article-title":"A prospective 10-year follow-up dental cast study of patients with obstructive sleep apnoea\/snoring who use a mandibular protruding device","volume":"39","author":"Fransson","year":"2017","unstructured":"Fransson\n AM,\n \n \n Kowalczyk\n A,\n \n \n Isacsson\n G.\n \n \n A prospective 10-year follow-up dental cast study of patients with obstructive sleep apnoea\/snoring who use a mandibular protruding device.\n\t\t\t\t\tEuro J Orthod.\n\t\t\t\t\t2017;\n\t\t\t\t\t39(5):\n\t\t\t\t\t502\u2013\n\t\t\t\t\t508."},{"issue":"(3)","key":"i1945-7103-92-2-255-b20","series-title":"Am J Orthod Dentofacial Orthop","first-page":"408","article-title":"Three-dimensional computer-assisted study model analysis of long-term oral-appliance wear. Part 2. side effects of oral appliances in obstructive sleep apnea patients","volume":"134","author":"Chen","year":"2008","unstructured":"Chen\n H,\n \n \n Lowe\n AA,\n \n \n de Almeida\n FR,\n \n \n Fleetham\n JA,\n \n \n Wang\n B.\n \n \n Three-dimensional computer-assisted study model analysis of long-term oral-appliance wear. Part 2. side effects of oral appliances in obstructive sleep apnea patients.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2008;\n\t\t\t\t\t134(3):\n\t\t\t\t\t408\u2013\n\t\t\t\t\t417."},{"issue":"(2)","key":"i1945-7103-92-2-255-b21","series-title":"Am J Orthod Dentofacial Orthop","first-page":"195","article-title":"Long-term sequellae of oral appliance therapy in obstructive sleep apnea patients: part 1. Cephalometric analysis","volume":"129","author":"Almeida","year":"2006","unstructured":"Almeida\n FR,\n \n \n Lowe\n AA,\n \n \n Sung\n JO,\n \n \n Tsuiki\n S,\n \n \n Otsuka\n R.\n \n \n Long-term sequellae of oral appliance therapy in obstructive sleep apnea patients: part 1. Cephalometric analysis.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2006;\n\t\t\t\t\t129(2):\n\t\t\t\t\t195\u2013\n\t\t\t\t\t204."},{"issue":"(2)","key":"i1945-7103-92-2-255-b22","series-title":"Am J Orthod Dentofacial Orthop","first-page":"205","article-title":"Long-term sequellae of oral appliance therapy in obstructive sleep apnea patients: part 2. Study-model analysis","volume":"129","author":"Almeida","year":"2006","unstructured":"Almeida\n FR,\n \n \n Lowe\n AA,\n \n \n Otsuka\n R,\n \n \n Fastlicht\n S,\n \n \n Farbood\n M,\n \n \n Tsuiki\n S.\n \n \n Long-term sequellae of oral appliance therapy in obstructive sleep apnea patients: part 2. Study-model analysis.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2006;\n\t\t\t\t\t129(2):\n\t\t\t\t\t205\u2013\n\t\t\t\t\t213."},{"issue":"(2)","key":"i1945-7103-92-2-255-b23","series-title":"Sleep Breath","first-page":"689","article-title":"Long-term efficacy of an oral appliance in early treated patients with obstructive sleep apnea","volume":"20","author":"Marklund","year":"2016","unstructured":"Marklund\n M.\n \n \n Long-term efficacy of an oral appliance in early treated patients with obstructive sleep apnea.\n\t\t\t\t\tSleep Breath.\n\t\t\t\t\t2016;\n\t\t\t\t\t20(2):\n\t\t\t\t\t689\u2013\n\t\t\t\t\t694."},{"issue":"(9)","key":"i1945-7103-92-2-255-b24","series-title":"New Engl J Med","first-page":"780","article-title":"Shared decision making\u2014the pinnacle of patient-centered care","volume":"366","author":"Barry","year":"2012","unstructured":"Barry\n MJ,\n \n \n Edgman-Levitan\n S.\n \n \n Shared decision making\u2014the pinnacle of patient-centered care.\n\t\t\t\t\tNew Engl J Med.\n\t\t\t\t\t2012;\n\t\t\t\t\t366(9):\n\t\t\t\t\t780\u2013\n\t\t\t\t\t781.\n\t\t\t\t\tdoi: 10.1056\/nejmp1109283."},{"issue":"(2)","key":"i1945-7103-92-2-255-b25","series-title":"Euro J Orthod","first-page":"230","article-title":"40 years follow-up of dental arch dimensions and incisor irregularity in adults","volume":"35","author":"Tsiopas","year":"2011","unstructured":"Tsiopas\n N,\n \n \n Nilner\n M,\n \n \n Bondemark\n L,\n \n \n Bjerklin\n K,\n \n \n Malm\u00f6\n U. A\n \n \n 40 years follow-up of dental arch dimensions and incisor irregularity in adults.\n\t\t\t\t\tEuro J Orthod.\n\t\t\t\t\t2011;\n\t\t\t\t\t35(2):\n\t\t\t\t\t230\u2013\n\t\t\t\t\t235."},{"issue":"(4)","key":"i1945-7103-92-2-255-b26","series-title":"Am J Orthod Dentofacial Orthop","first-page":"419","article-title":"A longitudinal study of arch size and form in untreated adults","volume":"111","author":"Harris","year":"1997","unstructured":"Harris\n EF.\n \n \n A longitudinal study of arch size and form in untreated adults.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t1997;\n\t\t\t\t\t111(4):\n\t\t\t\t\t419\u2013\n\t\t\t\t\t427."},{"issue":"(1)","key":"i1945-7103-92-2-255-b01","series-title":"Am J Orthod Dentofac Orthop","first-page":"13","article-title":"Obstructive sleep apnea and orthodontics: an American Association of Orthodontists White Paper","volume":"156","author":"Behrents","year":"2019","unstructured":"Behrents\n RG,\n \n \n Shelgikar\n AV,\n \n \n Conley\n RS,\n \n et al.\n \n Obstructive sleep apnea and orthodontics: an American Association of Orthodontists White Paper.\n\t\t\t\t\tAm J Orthod Dentofac Orthop.\n\t\t\t\t\t2019;\n\t\t\t\t\t156(1):\n\t\t\t\t\t13\u2013\n\t\t\t\t\t28.e11."},{"key":"i1945-7103-92-2-255-b02","series-title":"Contemporary Orthodontics E-Book","author":"Proffit","year":"2018","unstructured":"Proffit\n WR,\n \n \n Fields\n HW,\n \n \n Larson\n B,\n \n \n Sarver\n DM.\n \n \n \n Contemporary Orthodontics E-Book\n .\n\t\t\t\t\tAmsterdam, the Netherlands:\n\t\t\t\t\tElsevier Health Sciences;2018."},{"issue":"(2)","key":"i1945-7103-92-2-255-b03","series-title":"Sleep Breath","first-page":"781","article-title":"Forces created by mandibular advancement devices in OSAS patients","volume":"17","author":"Cohen-Levy","year":"2013","unstructured":"Cohen-Levy\n J,\n \n \n Petelle\n B,\n \n \n Pinguet\n J,\n \n \n Limerat\n E,\n \n \n Fleury\n B.\n \n \n Forces created by mandibular advancement devices in OSAS patients.\n\t\t\t\t\tSleep Breath.\n\t\t\t\t\t2013;\n\t\t\t\t\t17(2):\n\t\t\t\t\t781\u2013\n\t\t\t\t\t789."},{"issue":"(9)","key":"i1945-7103-92-2-255-b04","series-title":"Clin Oral Investig","first-page":"3069","article-title":"Dental side effects of long-term obstructive sleep apnea therapy: a 10-year follow-up study","volume":"24","author":"Uniken Venema","year":"2020","unstructured":"Uniken Venema\n JAM,\n \n \n Doff\n MHJ,\n \n \n Joffe-Sokolova\n DS,\n \n et al\n .\n\t\t\t\t\tDental side effects of long-term obstructive sleep apnea therapy: a 10-year follow-up study.\n\t\t\t\t\tClin Oral Investig.\n\t\t\t\t\t2020;\n\t\t\t\t\t24(9):\n\t\t\t\t\t3069\u2013\n\t\t\t\t\t3076."},{"key":"i1945-7103-92-2-255-b05","series-title":"Sleep Med Rev","first-page":"161","article-title":"Dental and skeletal changes associated with long-term oral appliance use for obstructive sleep apnea: a systematic review and meta-analysis","volume":"41","author":"Araie","year":"2018","unstructured":"Araie\n T,\n \n \n Okuno\n K,\n \n \n Ono Minagi\n H,\n \n \n Sakai\n T.\n \n \n Dental and skeletal changes associated with long-term oral appliance use for obstructive sleep apnea: a systematic review and meta-analysis.\n\t\t\t\t\tSleep Med Rev.\n\t\t\t\t\t2018;\n\t\t\t\t\t41:\n\t\t\t\t\t161\u2013\n\t\t\t\t\t172."},{"issue":"(1)","key":"i1945-7103-92-2-255-b06","series-title":"Int Orthod","first-page":"3","article-title":"Long-term dental and skeletal effects of mandibular advancement devices in adults with obstructive sleep apnoea: a systematic review","volume":"17","author":"Patel","year":"2019","unstructured":"Patel\n S,\n \n \n Rinchuse\n D,\n \n \n Zullo\n T,\n \n \n Wadhwa\n R.\n \n \n Long-term dental and skeletal effects of mandibular advancement devices in adults with obstructive sleep apnoea: a systematic review.\n\t\t\t\t\tInt Orthod.\n\t\t\t\t\t2019;\n\t\t\t\t\t17(1):\n\t\t\t\t\t3\u2013\n\t\t\t\t\t11."},{"issue":"(1)","key":"i1945-7103-92-2-255-b07","series-title":"Euro J Orthod","first-page":"89","article-title":"Dental and skeletal long-term side effects of mandibular advancement devices in obstructive sleep apnea patients: a systematic review with meta-regression analysis","volume":"41","author":"Bartolucci","year":"2019","unstructured":"Bartolucci\n ML,\n \n \n Bortolotti\n F,\n \n \n Martina\n S,\n \n \n Corazza\n G,\n \n \n Michelotti\n A,\n \n \n Alessandri-Bonetti\n G.\n \n \n Dental and skeletal long-term side effects of mandibular advancement devices in obstructive sleep apnea patients: a systematic review with meta-regression analysis.\n\t\t\t\t\tEuro J Orthod.\n\t\t\t\t\t2019;\n\t\t\t\t\t41(1):\n\t\t\t\t\t89\u2013\n\t\t\t\t\t100."},{"issue":"(4)","key":"i1945-7103-92-2-255-b08","series-title":"Dental Press J","first-page":"45","article-title":"Side effects of mandibular advancement splints for the treatment of snoring and obstructive sleep apnea: a systematic review","volume":"23","author":"Martins","year":"2018","unstructured":"Martins\n OdFM,\n \n \n Chaves\n CM,\n Junior\n \n \n Rossi\n RRP,\n \n \n Cunali\n PA,\n \n \n Dal-Fabbro\n C,\n \n \n Bittencourt\n L.\n \n \n Side effects of mandibular advancement splints for the treatment of snoring and obstructive sleep apnea: a systematic review.\n\t\t\t\t\tDental Press J.\n\t\t\t\t\t2018;\n\t\t\t\t\t23(4):\n\t\t\t\t\t45\u2013\n\t\t\t\t\t54."},{"key":"i1945-7103-92-2-255-b09","series-title":"elaboration and explanation. BMJ 2015;350: g7647.","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015","author":"Shamseer","unstructured":"Shamseer\n L,\n \n \n Moher\n D,\n \n \n Clarke\n M,\n \n et al.\n \n Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015:\n\t\t\t\t\telaboration and explanation. BMJ 2015;350: g7647."},{"key":"i1945-7103-92-2-255-b10","series-title":"ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ.","first-page":"i4919","author":"Sterne","year":"2016","unstructured":"Sterne\n JA,\n \n \n Hern\u00e1n\n MA,\n \n \n Reeves\n BC,\n \n et al.\n \n ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ.\n 2016;\n\t\t\t\t\t355:i4919."},{"issue":"(1)","key":"i1945-7103-92-2-255-b11","series-title":"Res Synth Methods","first-page":"55","article-title":"Risk-of-bias VISualization (robvis): an R package and Shiny web app for visualizing risk-of-bias assessments","volume":"12","author":"McGuinness","year":"2021","unstructured":"McGuinness\n LA,\n \n \n Higgins\n JPT.\n \n \n Risk-of-bias VISualization (robvis): an R package and Shiny web app for visualizing risk-of-bias assessments.\n\t\t\t\t\tRes Synth Methods.\n\t\t\t\t\t2021;\n\t\t\t\t\t12(1):\n\t\t\t\t\t55\u2013\n\t\t\t\t\t61."},{"key":"i1945-7103-92-2-255-b12","series-title":"GRADEpro guideline development tool [software]. gradepro.org. McMaster University and Evidence Prime, 2021. Accessed 5 November 2020","author":"GRADEpro","unstructured":"GRADEpro\n GDT:\n \n \n GRADEpro guideline development tool [software]. gradepro.org. McMaster University and Evidence Prime, 2021. Accessed 5 November 2020."},{"key":"i1945-7103-92-2-255-b13","series-title":"Long-Term Periodontal Changes During Oral Appliance Treatment for Sleep Apnea [master's thesis]","author":"Heda","year":"2019","unstructured":"Heda\n P.\n \n \n \n Long-Term Periodontal Changes During Oral Appliance Treatment for Sleep Apnea [master's thesis].\n\t\t\t\t\tVancouver, Canada:\n\t\t\t\t\tUniversity of British Columbia;2019."},{"key":"i1945-7103-92-2-255-b14","series-title":"Sleep Medicine","first-page":"184","article-title":"Long-term side effects of sleep apnea treatment with oral appliances: nature, magnitude and predictors of long-term changes","volume":"56","author":"Hamoda","year":"2019","unstructured":"Hamoda\n MM,\n \n \n Almeida\n FR,\n \n \n Pliska\n BT.\n \n \n Long-term side effects of sleep apnea treatment with oral appliances: nature, magnitude and predictors of long-term changes.\n\t\t\t\t\tSleep Medicine.\n\t\t\t\t\t2019;\n\t\t\t\t\t56:\n\t\t\t\t\t184\u2013\n\t\t\t\t\t191."},{"issue":"(1)","key":"i1945-7103-92-2-255-b15","series-title":"Am J Orthod Dentofac Orthop","first-page":"91","article-title":"A prospective 10-year cephalometric follow-up study of patients with obstructive sleep apnea and snoring who used a mandibular protruding device","volume":"157","author":"Fransson","year":"2020","unstructured":"Fransson\n AMC,\n \n \n Benavente-Lundahl\n C,\n \n \n Isacsson\n G.\n \n \n A prospective 10-year cephalometric follow-up study of patients with obstructive sleep apnea and snoring who used a mandibular protruding device.\n\t\t\t\t\tAm J Orthod Dentofac Orthop.\n\t\t\t\t\t2020;\n\t\t\t\t\t157(1):\n\t\t\t\t\t91\u2013\n\t\t\t\t\t97."},{"issue":"(12)","key":"i1945-7103-92-2-255-b16","series-title":"J Clin Sleep Med","first-page":"1285","article-title":"Obstructive sleep apnea and mandibular advancement splints: occlusal effects and progression of changes associated with a decade of treatment","volume":"10","author":"Pliska","year":"2014","unstructured":"Pliska\n BT,\n \n \n Nam\n H,\n \n \n Chen\n H,\n \n \n Lowe\n AA,\n \n \n Almeida\n FR.\n \n \n Obstructive sleep apnea and mandibular advancement splints: occlusal effects and progression of changes associated with a decade of treatment.\n\t\t\t\t\tJ Clin Sleep Med.\n\t\t\t\t\t2014;\n\t\t\t\t\t10(12):\n\t\t\t\t\t1285\u2013\n\t\t\t\t\t1291."},{"issue":"(1)","key":"i1945-7103-92-2-255-b17","series-title":"Sleep Breath","first-page":"111","article-title":"Subjective versus objective dental side effects from oral sleep apnea appliances","volume":"24","author":"Marklund","year":"2019","unstructured":"Marklund\n M.\n \n \n Subjective versus objective dental side effects from oral sleep apnea appliances.\n\t\t\t\t\tSleep Breath.\n\t\t\t\t\t2019;\n\t\t\t\t\t24(1):\n\t\t\t\t\t111\u2013\n\t\t\t\t\t117."},{"issue":"(2)","key":"i1945-7103-92-2-255-b18","series-title":"Am J Orthod Dentofac 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","year":"2006","unstructured":"Marklund\n M.\n \n \n Predictors of long-term orthodontic side effects from mandibular advancement devices in patients with snoring and obstructive sleep apnea.\n\t\t\t\t\tAm J Orthod Dentofac Orthop.\n\t\t\t\t\t2006;\n\t\t\t\t\t129(2):\n\t\t\t\t\t214\u2013\n\t\t\t\t\t221."},{"issue":"(5)","key":"i1945-7103-92-2-255-b19","series-title":"Euro J Orthod","first-page":"502","article-title":"A prospective 10-year follow-up dental cast study of patients with obstructive sleep apnoea\/snoring who use a mandibular protruding device","volume":"39","author":"Fransson","year":"2017","unstructured":"Fransson\n AM,\n \n \n Kowalczyk\n A,\n \n \n Isacsson\n G.\n \n \n A prospective 10-year follow-up dental cast study of patients with obstructive sleep apnoea\/snoring who use a mandibular protruding device.\n\t\t\t\t\tEuro J Orthod.\n\t\t\t\t\t2017;\n\t\t\t\t\t39(5):\n\t\t\t\t\t502\u2013\n\t\t\t\t\t508."},{"issue":"(3)","key":"i1945-7103-92-2-255-b20","series-title":"Am J Orthod Dentofacial Orthop","first-page":"408","article-title":"Three-dimensional computer-assisted study model analysis of long-term oral-appliance wear. Part 2. side effects of oral appliances in obstructive sleep apnea patients","volume":"134","author":"Chen","year":"2008","unstructured":"Chen\n H,\n \n \n Lowe\n AA,\n \n \n de Almeida\n FR,\n \n \n Fleetham\n JA,\n \n \n Wang\n B.\n \n \n Three-dimensional computer-assisted study model analysis of long-term oral-appliance wear. Part 2. side effects of oral appliances in obstructive sleep apnea patients.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2008;\n\t\t\t\t\t134(3):\n\t\t\t\t\t408\u2013\n\t\t\t\t\t417."},{"issue":"(2)","key":"i1945-7103-92-2-255-b21","series-title":"Am J Orthod Dentofacial Orthop","first-page":"195","article-title":"Long-term sequellae of oral appliance therapy in obstructive sleep apnea patients: part 1. Cephalometric analysis","volume":"129","author":"Almeida","year":"2006","unstructured":"Almeida\n FR,\n \n \n Lowe\n AA,\n \n \n Sung\n JO,\n \n \n Tsuiki\n S,\n \n \n Otsuka\n R.\n \n \n Long-term sequellae of oral appliance therapy in obstructive sleep apnea patients: part 1. Cephalometric analysis.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2006;\n\t\t\t\t\t129(2):\n\t\t\t\t\t195\u2013\n\t\t\t\t\t204."},{"issue":"(2)","key":"i1945-7103-92-2-255-b22","series-title":"Am J Orthod Dentofacial Orthop","first-page":"205","article-title":"Long-term sequellae of oral appliance therapy in obstructive sleep apnea patients: part 2. Study-model analysis","volume":"129","author":"Almeida","year":"2006","unstructured":"Almeida\n FR,\n \n \n Lowe\n AA,\n \n \n Otsuka\n R,\n \n \n Fastlicht\n S,\n \n \n Farbood\n M,\n \n \n Tsuiki\n S.\n \n \n Long-term sequellae of oral appliance therapy in obstructive sleep apnea patients: part 2. Study-model analysis.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2006;\n\t\t\t\t\t129(2):\n\t\t\t\t\t205\u2013\n\t\t\t\t\t213."},{"issue":"(2)","key":"i1945-7103-92-2-255-b23","series-title":"Sleep Breath","first-page":"689","article-title":"Long-term efficacy of an oral appliance in early treated patients with obstructive sleep apnea","volume":"20","author":"Marklund","year":"2016","unstructured":"Marklund\n M.\n \n \n Long-term efficacy of an oral appliance in early treated patients with obstructive sleep apnea.\n\t\t\t\t\tSleep Breath.\n\t\t\t\t\t2016;\n\t\t\t\t\t20(2):\n\t\t\t\t\t689\u2013\n\t\t\t\t\t694."},{"issue":"(9)","key":"i1945-7103-92-2-255-b24","series-title":"New Engl J Med","first-page":"780","article-title":"Shared decision making\u2014the pinnacle of patient-centered care","volume":"366","author":"Barry","year":"2012","unstructured":"Barry\n MJ,\n \n \n Edgman-Levitan\n S.\n \n \n Shared decision making\u2014the pinnacle of patient-centered care.\n\t\t\t\t\tNew Engl J Med.\n\t\t\t\t\t2012;\n\t\t\t\t\t366(9):\n\t\t\t\t\t780\u2013\n\t\t\t\t\t781.\n\t\t\t\t\tdoi: 10.1056\/nejmp1109283."},{"issue":"(2)","key":"i1945-7103-92-2-255-b25","series-title":"Euro J Orthod","first-page":"230","article-title":"40 years follow-up of dental arch dimensions and incisor irregularity in adults","volume":"35","author":"Tsiopas","year":"2011","unstructured":"Tsiopas\n N,\n \n \n Nilner\n M,\n \n \n Bondemark\n L,\n \n \n Bjerklin\n K,\n \n \n Malm\u00f6\n U. A\n \n \n 40 years follow-up of dental arch dimensions and incisor irregularity in adults.\n\t\t\t\t\tEuro J Orthod.\n\t\t\t\t\t2011;\n\t\t\t\t\t35(2):\n\t\t\t\t\t230\u2013\n\t\t\t\t\t235."},{"issue":"(4)","key":"i1945-7103-92-2-255-b26","series-title":"Am J Orthod Dentofacial Orthop","first-page":"419","article-title":"A longitudinal study of arch size and form in untreated adults","volume":"111","author":"Harris","year":"1997","unstructured":"Harris\n EF.\n \n \n A longitudinal study of arch size and form in untreated adults.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t1997;\n\t\t\t\t\t111(4):\n\t\t\t\t\t419\u2013\n\t\t\t\t\t427."}],"container-title":["The Angle Orthodontist"],"original-title":[],"link":[{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/92\/2\/article-p255.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/meridian.allenpress.com\/angle-orthodontist\/article-pdf\/92\/2\/255\/3015482\/i1945-7103-92-2-255.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/92\/2\/article-p255.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/92\/2\/article-p255.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T14:37:49Z","timestamp":1780065469000},"score":1,"resource":{"primary":{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/92\/2\/article-p255.xml"}},"subtitle":["A systematic review and meta-analysis"],"short-title":[],"issued":{"date-parts":[[2022,3]]},"references-count":52,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.2319\/041921-316.1","relation":{},"ISSN":["1945-7103","0003-3219"],"issn-type":[{"value":"1945-7103","type":"electronic"},{"value":"0003-3219","type":"print"}],"subject":[],"published":{"date-parts":[[2022,3]]}}}