Gepubliceerd op: 26-04-2013

Slaapapneubehandeling kan dentitie beschadigen

Patiënt is gebaat bij een langdurige follow-up

Volgens schattingen van de Nederlandse Vereniging Slaap Apneu Patiënten zijn er in Nederland ongeveer 18.000 mensen die lijden aan het slaapapneusyndroom, een afwijking die ernstige gevolgen voor de algemene gezondheid kan hebben. Er zijn geen medicijnen om slaapapneu te genezen, maar er bestaan wel enige therapeutische mogelijkheden om de aandoening te bestrijden. Ook de tandarts kan een rol spelen. Een risico op gebitsbeschadiging is bij een dergelijke behandeling echter niet uit te sluiten en bovendien moeten de patiënten langdurig worden gevolgd.

This study aimed to assess possible dental side effects associated with long-term use of an adjustable oral appliance compared with continuous positive airway pressure (CPAP) in patients with the obstructive sleep apnea syndrome and to study the relationship between these possible side effects and the degree of mandibular protrusion associated with oral appliance therapy. As part of a previously conducted RCT, 51 patients were randomized to oral appliance therapy and 52 patients to CPAP therapy. At baseline and after a 2-year follow-up, dental plaster study models in full occlusion were obtained which were thereupon analyzed with respect to relevant variables. Long-term use of an oral appliance resulted in small but significant dental changes compared with CPAP. In the oral appliance group, overbite and overjet decreased 1.2 (±1.1) mm and 1.5 (±1.5) mm, respectively. Furthermore, we found a significantly larger anterior-posterior change in the occlusion (-1.3 ± 1.5 mm) in the oral appliance group compared to the CPAP group (-0.1 ± 0.6 mm). Moreover, both groups showed a significant decrease in number of occlusal contact points in the (pre)molar region. Linear regression analysis revealed that the decrease in overbite was associated with the mean mandibular protrusion during follow-up [regression coefficient (β) = -0.02, 95 % confidence interval (-0.04 to -0.00)]. Oral appliance therapy should be considered as a lifelong treatment, and there is a risk of dental side effects to occur. Patients treated with the oral appliance need a thorough follow-up by a dentist or dental-specialist experienced in the field of dental sleep medicine.

Bron

Doff MH, Finnema KJ, Hoekema A, Wijkstra PJ, Bont LG de, Stegenga B. Long-term oral appliance therapy in obstructive sleep apnea syndrome: a controlled study on dental side effects. Clinical Oral Investig 2013; 17: 475-482. doi: 10.1007/s00784-012-0737-x. Epub 2012 May 6.

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