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Sleep Breath. 2009 Nov;13(4):375-81. doi: 10.1007/s11325-009-0257-3. Epub 2009 May 1.

Systematic assessment of the impact of oral appliance therapy on the temporomandibular joint during treatment of obstructive sleep apnea: long-term evaluation.

Author information

1
Institute of Research and Development IP&D, University of Vale do Paraíba, São Paulo, Brazil. odontogiannasi@uol.com.br

Abstract

OBJECTIVE:

The aim of the present study was to evaluate the symptoms of temporomandibular dysfunction (TMD) in patients with obstructive sleep apnea treated with long-term use of an oral appliance (OA) using a questionnaire based on the Helkimo Anamnestic Dysfunction Index. A further aim of the study was to evaluate the presence of daytime sleepiness using the Epworth Sleep Scale (ESS) and otologic symptoms.

MATERIALS AND METHODS:

Polysomnograms of 34 patients were performed at baseline and after 6 months of OA use. As follow-up, the patients were contacted by telephone interview to answer the same questionnaires after 36.0 +/- 17.0 months.

RESULTS AND DISCUSSION:

The intensity of TMD symptoms decreased significantly throughout treatment (p < 0.01). ESS values improved from 12.2 +/- 5.0 to 6.9 +/- 2.6 (p < or = 0.05). Tinnitus was present in nine patients at baseline and decreased in intensity in seven patients by the final assessment while remaining at the same level in two patients.

CONCLUSIONS:

We conclude that long-term usage of an OA does not cause impairment to the temporomandibular joint. The Helkimo and otologic indexes are simple and useful in long-term patient follow-up. There was a long-term improvement in the ESS values over the years analyzed. A follow-up program could increase compliance by motivating patients to use the device regularly.

PMID:
19437057
DOI:
10.1007/s11325-009-0257-3
[Indexed for MEDLINE]

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