Prevalence and Incidence of Temporomandibular Signs and Symptoms during Oral Appliance Therapy for the Management of Obstructive Sleep Apnea: A Retrospective Study.

Author(s): Fernandez-Vial, Diego; Sangalli, Linda; Yanez-Regonesi, Fernanda; Martinez- Porras, Andres; Moreno-Hay, Isabel.

Affiliations: Department of Oral Health Science, Division of Orofacial Pain, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA

Aim of Investigation: To evaluate the prevalence and incidence of TMD signs/symptoms at 3 time-points during the management of OSA with a mandibular advancement device.

Methods: Retrospective data of patients referred to the Orofacial Pain Clinic at University of Kentucky between July 2012 to June 2020 for the management of OSA with MAD were included. Analyses were performed at initial visit (t0), first follow-up after MAD delivery (t1, at 68±28.05 days), mid-treatment (t2, at 129±26.59 days) and the closest follow-up before second sleep study (t3, at 235±116.83 days). Differences between baseline visit and subsequent visits were assessed with McNemar test (α=0.05).

Results: The final sample comprised 37 patients (18 women, 19 men) with pre-treatment AHI of 23.09±18.81, BMI =30.54±4.83. No statistically significant differences were found between the prevalence of signs and symptoms among the follow up visits. Symptoms of jaw pain decreased from 24.3%/t0, 18.9%/t1, 29.7%/t2, to 16.2% at t3. TMJ pain at palpation increased from 5.4%/t0, 13.5%/t1, 21.6%/t2, to 18.9% at t3. Muscle pain at palpation experienced small fluctuations, but no final changes were detected (25.0%/t0; 22.2%/t1; 19.4%/t2, 25%/t3). TMJ sounds at clinical examination presented an increase from 16.2%/t0, 13.5%/t1, 18.9%/t2, to 21.6% at t3. The overall incidence of signs and symptoms was estimated around 10%.

Conclusions: Based on the results of this preliminary study, despite some fluctuation during the follow up visits, the use of MAD did not increase the risk for development of TMD signs and symptoms.

Acknowledgements and/or Funding Source: None