Can the use of morning occlusal guides after oral sleep appliances cause root resorption similar to orthodontic jiggling?

Objective: To evaluate root length changes associated with the use of mandibular advancement devices (MADs) to treat obstructive sleep apnea (OSA), in conjunction with morning occlusal guides.

Methods: This was a retrospective cohort study where the sample included panoramic radiographs of 68 subjects (52.1 ± 8.4 years) who wore MADs in conjunction with morning occlusal guides, for at least 3 years. Root and crown lengths were measured to assess root to crown (R/C) ratios before the initiation of MAD use (T1), and after at least 3 years of wearing the MAD and the morning occlusal guide (T2). Mixed analysis of variance was used to compare R/C ratios at T1 and T2. To assess the change in root lengths and distribution of root resorption (RR) severity, relative root to crown ratio (rRCR) was calculated. Severe RR was assumed when there was > 20% reduction in pre-treatment length.

Results: There were statistically significant differences between the R/C ratios at T1 compared to T2 for multiple teeth (p < 0.05). The greatest mean differences were found among the mandibular incisors(p ≤ 0.01). The mean rRCR for all teeth was > 90% indicating slight or no RR.

Conclusion: Statistically significant RR was found with the use of MADs with morning occlusal guides, albeit the amount of RR was not clinically significant.

Practical implications: New consent forms should be developed to make patients aware that RR may occur during treatment with MADs in conjunction with morning occlusal guides.

Keywords: OSA; Root resorption; Sleep apnea; Sleep appliance; Sleep device; Snoring.

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Can the use of morning occlusal guides ...dontic jiggling_ _ Sleep and Breathing.pdf

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