Today, the field of orthodontia plays an important role in the diagnosis and treatment of sleep-disordered breathing syndromes. Oral appliances have been used to treat mild-to-moderate obstructive sleep apnea [1]. Objective evaluation of oral appliances with polysomnography is not routinely performed, thereby making long-term follow-up reports on the efficacy of these devices sparse. There has been a shift from monobloc dental devices to traction/compression-based mandibular advancement appliances in an effort to minimize complications and improve efficacy. Recently, Vezina et al. [2] reported on the long-term efficacy (>2 years) of traction/compression-based mandibular advancement appliances with regular medical visits, questionnaires, repeat cephalometrics, and polygraphic recordings in more than 150 moderately overweight, non-obese subjects with baseline mean AASM apnea–hypopnea index (AHI) of 30.5 per hour. An AHI ≤5 per hour was achieved in 28% and 24% of subjects with traction and compression devices, respectively. Partial efficacy was noted in about 59% of subjects with a mean AHI of 14 per hour. Pain was the primary reason for discontinuing therapy. In short, long-term follow-up studies such as Vezina et al. are needed to make mandibular advancement appliances a cornerstone of obstructive sleep apnea (OSA) therapy.

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Chad M. Ruoff & Christian Guilleminault

This article originally appeared in Sleep and Breathing