Obstructive Sleep Apnea: The Expanding Role of Dental Sleep Medicine—A Systematic Review of Mandibular Advancement Devices, Treatment Efficacy, and Occlusal Complications
Abstract
1. Introduction
2. Materials and Methods
- OSA diagnostic criteria, particularly questionnaires (STOP-BANG) and polysomnography (PSG);
- values of the apnea–hypopnea index (AHI) and respiratory disturbance index (RDI), used to determine the severity of the disease;
- patient populations eligible for MAD therapy,
- effectiveness of oral appliances in reducing the number of apneic events, improving oxygen saturation, and enhancing subjective sleep quality;
- potential adverse effects, including occlusal changes, temporomandibular joint symptoms, and the impact of therapy on dentition and periodontal tissues.
3. Literature Review
3.1. Diagnosis of Obstructive Sleep Apnea
3.2. Treatment
4. Conclusions
Supplementary Materials
Author Contributions
Funding
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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| Number of the Citation in the Publication | Article |
|---|---|
| [4] | Nanda N, Robertson A, Upton DC. “Patient Selection for Efficacious Mandibular Advancement Device Therapy in OSA.” Ann Otol Rhinol LaryngdES2025. |
| [5] | Rana A, Raut A, Mathur A. “The Occlusal Side Effects of Mandibular Advancement Device Therapy.” Cureus. 2023. |
| [6] | Kim HK, Kim ME. “Treatment Outcomes of Mandibular Advancement Devices in OSA.” J Oral Med Pain. 2023. |
| [7] | “Definition of an Effective Oral Appliance for Treatment of OSA and Snoring.” JDSM. 2025. |
| [8] | Tan WMN, Lye KW, Saffari SE, Poon CY. “MAD effectiveness in young OSA patients.” Sleep Sci Pract. 2025. |
| [9] | “Diagnostic & Therapeutic Indications of Different MAD Types for OSA.” 2025. |
| [10] | Uyaner A et al. “Impact of MADs on Occlusal Dynamics & Tooth Alignment.” Dent J. 2024. |
| [11] | Uniken Venema JAM et al. “Dental side effects of long-term OSA therapy.” Clin Oral Investig. 2020. |
| Methods of Treating Obstructive Sleep Apnea [32] | |
|---|---|
| CPAP (Continuous Positive Airway Pressure) | This involves maintaining continuous positive airway pressure during sleep through the use of a nasal mask. |
| Lifestyle modifications and weight loss | This is particularly recommended for patients who are overweight or obese. |
| Positional therapy | This involves encouraging patients to sleep in specific positions to reduce the frequency of apneic episodes. |
| Hypoglossal Nerve Stimulation (HNS) | This therapy involves stimulating the hypoglossal nerve to help keep the airways open during sleep. |
| STOP-BANG Questionnaire | YES | NO |
|---|---|---|
| Snoring: Do you snore loudly (enough to be heard through closed doors)? | ||
| Fatigue: Do you often feel tired, exhausted, or sleepy during the day (e.g., falling asleep while driving)? | ||
| Observations by others: Has anyone noticed that you stop breathing during sleep or choke/gasp? | ||
| Blood pressure: Do you have hypertension or take medications for hypertension? | ||
| BMI: Is your body mass index (BMI) greater than 35 kg/m2? | ||
| Age: Are you over 50 years old? | ||
| Neck circumference: Do you have a collar size of 41 cm or larger (for women) or 43 cm or larger (for men)? | ||
| Gender: Are you male? | ||
| For the general population, the results of the STOP-BANG questionnaire are as follows: Low Risk of OSA: “Yes” to 0–2 questions Medium Risk of OSA: “Yes” to 3–4 questions High Risk of OSA: “Yes” to 5–8 questions | ||
| The Severity of Obstructive Sleep Apnea | Level of AHI |
|---|---|
| Mild OSA | 5 to 15 |
| Moderate OSA | 15 to 30 |
| Severe OSA | Above 30 |
| The Criteria for Children | Level of AHI |
| Mild OSA | 1 to 5 |
| Moderate OSA | 5 to 10 |
| Severe OSA | Above 10 |
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© 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.
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Szmyt, J.; Szczapa, T.; Chyła, M.; Bęben, A.; Maciejewska, I. Obstructive Sleep Apnea: The Expanding Role of Dental Sleep Medicine—A Systematic Review of Mandibular Advancement Devices, Treatment Efficacy, and Occlusal Complications. Dent. J. 2026, 14, 62. https://doi.org/10.3390/dj14010062
Szmyt J, Szczapa T, Chyła M, Bęben A, Maciejewska I. Obstructive Sleep Apnea: The Expanding Role of Dental Sleep Medicine—A Systematic Review of Mandibular Advancement Devices, Treatment Efficacy, and Occlusal Complications. Dentistry Journal. 2026; 14(1):62. https://doi.org/10.3390/dj14010062
Chicago/Turabian StyleSzmyt, Jędrzej, Tymoteusz Szczapa, Maksymilian Chyła, Adam Bęben, and Izabela Maciejewska. 2026. "Obstructive Sleep Apnea: The Expanding Role of Dental Sleep Medicine—A Systematic Review of Mandibular Advancement Devices, Treatment Efficacy, and Occlusal Complications" Dentistry Journal 14, no. 1: 62. https://doi.org/10.3390/dj14010062
APA StyleSzmyt, J., Szczapa, T., Chyła, M., Bęben, A., & Maciejewska, I. (2026). Obstructive Sleep Apnea: The Expanding Role of Dental Sleep Medicine—A Systematic Review of Mandibular Advancement Devices, Treatment Efficacy, and Occlusal Complications. Dentistry Journal, 14(1), 62. https://doi.org/10.3390/dj14010062

