Effect of oral appliances on cephalometric measurements and sleep apnea severity: A clinical study

Aim: This study aimed to evaluate the effects of oral appliances (OA) in OSA cases by using cephalometric measurements that rejected the use of CPAP therapy.The research question focused on whether oral appliances could significantly alter craniofacial structure and reduce sleep apnea severity.Materials and Methods: Ten participants (8 males and 2 females) from the sleep clinic were included in this study.The medical instructor advised them to use the CPAP device, but the participants confirmed to use OA.The patients underwent the same polysomnography laboratory with a sleep oral appliance continuously one month after using it all night.Cephalometric radiographs were taken before and after using the OA.The Apnea-Hypopnea Index (AHI) and other sleep apnea parameters were measured through polysomnography.Statistical analysis was performed using the Mann-Whitney U test.Results: The median AHI significantly decreased from 26.2 events/hour to 11.3 events/hour (p=0.008) after using the oral appliance.The SNB angle increased from 75.6 to 78.8 degrees (p=0.003), and the ANB angle decreased from 5.6 to 2.8 degrees (p=0.01),indicating improved mandibular positioning.The Sn-GoGn angle also increased significantly from 37.0 to 43.1 degrees (p=0.001),suggesting changes in mandibular plane orientation.Discussion: The study demonstrated that oral appliances significantly reduce the severity of sleep apnea and induce favorable cephalometric changes.These appliances are effective alternatives for patients who are unable to tolerate CPAP, potentially improving airway patency by repositioning the jaw.