Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnea: A randomized, placebo-controlled trial on temporomandibular side-effects.

Abstract

PURPOSE:

To assess the differences in the frequency of clinical signs of temporomandibular disorder (TMD) pain and mandibular function impairment between mandibular advancement device (MAD) and nasal continuous positive airway pressure (nCPAP) therapies in obstructive sleep apnea (OSA) patients at baseline and after 6 month of treatment.

METHODS:

This study concerns a secondary analysis of a randomized placebo-controlled trial in which different treatment effects of an objectively titrated MAD were compared with those of nCPAP and an intra-oral placebo appliance in a parallel design. Sixty-four mild to severe OSA patients (52.0 ± 9.6 years) were randomly assigned to these three groups. All patients underwent a shortened functional examination of their masticatory system at baseline and after 6 months to establish the presence of clinical signs of TMD pain. Mandibular function impairment was assessed with a questionnaire.

RESULTS:

Clinical signs of TMD pain were only rarely present at baseline and therapy evaluation. No significant differences were found between the three groups in the (low) frequency of clinical signs of TMD pain at both time points (p = .401-.176). In addition, the (low) scores of mandibular function impairment did not differ between the three groups either, neither at baseline (p = .744) nor after 6 months (p = .359).

CONCLUSIONS:

A low frequency of clinical signs of TMD pain in mild to severe OSA patients was found after 6 months, regardless of treatment with MAD or nCPAP. In addition, no difference in mandibular function impairment was observed between the different treatment modalities.

• Authors: Maria Nikolopoulou, Ghizlane Aarab, Jari Ahlberg, Hans L Hamburger, Jan de Lange, Frank Lobbezoo
• Journal: Clinical and experimental dental research (Clin Exp Dent Res) Vol. 6 Issue 4 Pg. 400-406 (08 2020) ISSN: 2057-4347 [Electronic] United States
• PMID: 32246748 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: © 2020 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.

Topics

• Continuous Positive Airway Pressure (adverse effects)
• Humans
• Mandibular Advancement (instrumentation)
• Occlusal Splints (adverse effects)
• Placebo Effect
• Sleep Apnea, Obstructive (pathology, therapy)
• Surveys and Questionnaires
• Temporomandibular Joint Disorders (etiology, pathology)
• Treatment Outcome