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Influence of oral appliances for mandibular advancement on occlusal function

Introduction 
Oral appliances (OAs) that aim to enlarge the upper airway by repositioning the mandible forward have been established as a lifelong treatment tool for primary snoring and mild-to-moderate obstructive sleep apnea (OSA). Recent OSA studies have reported that the use of OAs produces jaw discomfort with difficulty in chewing immediately after waking. The aim of this study was to evaluate the influence of nocturnal OA use on occlusal function.

Materials and methods 
The subjects consisted of 10 adults (mean age 26.2 ± 5.8 years) selected from volunteers in the Department of Orthodontics at Hiroshima University Hospital. Occlusal contact area (OCA), maximum bite force (MBF) and centre of occlusal load (COL) were measured using a Dental Prescale Occluzer immediately after nocturnal OA use. Tooth mobility was measured using the Periotest and tooth pain was evaluated with the visual analogue scale. Recordings were obtained 6 times immediately after OA removal (0 min) with an interval of 5, 10, 15, 30 and 60 min between each respective measurement, resulting in a total period of 120 min.

Results 
Significant differences in OCA, MBF and COL were found between the readings obtained after the 0 min and 30 min intervals. Although some subjects achieved 80 % of the baseline OCA and MBF values, these values remained at 50 % of the baseline for several subjects after 120 min. Only the lower incisors showed significantly high mobility between 0 min and baseline. The degree of tooth pain significantly decreased in most cases after the 15 min interval.

Conclusions 
Although OA side effects may be mild, acceptable and transient close attention must be paid to the use of OAs for the treatment of OSA.

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