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Abordagem ao tratamento das complicações associadas ao uso de dispositivos de avanço mandibular: revisão narrativa
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| Projeto de pós-graduação_40423 | 857.05 KB | Adobe PDF |
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Abstract(s)
A apneia do sono afeta 936 milhões de pessoas no mundo. É um distúrbio que pode causar uma série de complicações médicas, como hipertensão arterial, risco de diabetes tipo 2, acidente vascular cerebral, depressão/ansiedade, entre outras. O tratamento de referência é o CPAP, mas os dispositivos de avanço mandibular (DAM) são alternativas viáveis em casos específicos. Apesar da eficácia (60-70%), os DAM não estão isentos de efeitos secundários como dores musculares/articulares, xerostomia, sialorreia, sensibilidade dentária, alterações oclusais e problemas na articulação temporomandibular.
Este trabalho teve como objetivo abordar os efeitos colaterais associados aos DAM e os tratamentos que podem ser oferecidos para os minimizar ou eliminar. Foi realizada uma pesquisa bibliográfica nas bases PubMed e ScienceDirect entre novembro de 2023 e abril de 2024. As palavras-chave utilizadas foram: “Obstructive Sleep Apnea”, “Mandibular Advancement Device”, “Side effects”, “Adult”, “Treatment”. Foram incluídos 81 artigos entre 1996 e 2024.
Verificou-se que os efeitos adversos mais comuns incluem: sensibilidade dentária, xerostomia, sialorreia, irritação gengival, alteração da oclusão dentária, dor muscular, disfunções na articulação temporomandibular e cefaleia. As estratégias de controlo incluem intervenções físicas (ajustes no dispositivo, fisioterapia, osteopatia, acupuntura, exercícios mandibulares, higiene oral) e farmacológicas (AINE, paracetamol, miorrelaxantes, anticolinérgicos, entre outros).
Conclui-se que o controlo dos efeitos secundários é essencial para garantir adesão ao tratamento e qualidade de vida. São necessários mais estudos clínicos sobre estratégias terapêuticas de longo prazo para estas complicações.
Sleep apnea affects 936 million people worldwide and can lead to several medical complications such as hypertension, type 2 diabetes, stroke, depression/anxiety. While CPAP remains the gold standard, mandibular advancement devices (MADs) are considered viable alternatives in specific cases. Despite their 60–70% effectiveness, MADs may cause side effects including muscle/joint pain, xerostomia, sialorrhea, dental sensitivity, occlusal changes, and temporomandibular joint disorders. This narrative review aimed to identify the most common adverse effects associated with MADs and outline treatments that reduce, combat, or eliminate them. A literature review was conducted in PubMed and ScienceDirect from November 2023 to April 2024. Keywords used were: “Obstructive Sleep Apnea”, “Mandibular Advancement Device”, “Side effects”, “Adult”, “Treatment.” A total of 81 articles from 1996 to 2024 were analyzed. The most commonly reported side effects include dental sensitivity, xerostomia, sialorrhea, gingival irritation, occlusal changes, muscular pain, TMJ alterations, and headaches. Management strategies involve physical interventions (device adjustments, physiotherapy, osteopathy, acupuncture, mandibular exercises, oral hygiene) and pharmacological treatments (NSAIDs, paracetamol, muscle relaxants, anticholinergics, among others). In conclusion, controlling adverse effects is crucial for treatment adherence and improving patient quality of life. Further clinical studies are needed to support long-term management strategies for these complications.
Sleep apnea affects 936 million people worldwide and can lead to several medical complications such as hypertension, type 2 diabetes, stroke, depression/anxiety. While CPAP remains the gold standard, mandibular advancement devices (MADs) are considered viable alternatives in specific cases. Despite their 60–70% effectiveness, MADs may cause side effects including muscle/joint pain, xerostomia, sialorrhea, dental sensitivity, occlusal changes, and temporomandibular joint disorders. This narrative review aimed to identify the most common adverse effects associated with MADs and outline treatments that reduce, combat, or eliminate them. A literature review was conducted in PubMed and ScienceDirect from November 2023 to April 2024. Keywords used were: “Obstructive Sleep Apnea”, “Mandibular Advancement Device”, “Side effects”, “Adult”, “Treatment.” A total of 81 articles from 1996 to 2024 were analyzed. The most commonly reported side effects include dental sensitivity, xerostomia, sialorrhea, gingival irritation, occlusal changes, muscular pain, TMJ alterations, and headaches. Management strategies involve physical interventions (device adjustments, physiotherapy, osteopathy, acupuncture, mandibular exercises, oral hygiene) and pharmacological treatments (NSAIDs, paracetamol, muscle relaxants, anticholinergics, among others). In conclusion, controlling adverse effects is crucial for treatment adherence and improving patient quality of life. Further clinical studies are needed to support long-term management strategies for these complications.
Description
Keywords
Apneia obstrutiva do sono Dispositivo de avanço mandibular Efeitos secundários Adulto Tratamento Obstructive sleep apnea Mandibular advancement device Side effects Adult Treatment