Objective:ORCADES study demonstrated efficacy of the Narval CC® MAD to treat OSA. Analysis of ORCADES patients who had lateral cephalometric radiographs (LCR) performed at baseline, 2 and 5 years of therapy was done to assess impact of MAD at the skeletal, dental and occlusal levels over time. Analysis were also performed to assess correlations between LCR changes over time and MAD clinical efficacy, tolerance and compliance.

Methods:LCR variable analysis consisted of 21 points and six reference plans. Statistical analysis was performed to assess variable changes over time. Correlation analyses between baseline, 2-year and 5-year FU were performed using paired tests.

Results :74 LCR were available at baseline, 61 and 21 at 2 and 5 years respectively. 8 measurements showed statistically significant changes. At the maxillary level, at 2-year FU, a posterior displacement of point A (-1.01°, p=0.023) and point B (-0.70°, p=0.012) and at 5 years a widening of the hard palate (1.55°, p=0.038). Vestibuloversion of the mandibular incisors was observed (1.78°, p=0.033 and 2.29°, p=0.023, at 2 and 5 years respectively) as well as mesioversion of the first molar at 2 years (2.29°, p=0.030). A rotation of the occlusal plane (+6.71°, p=0.011) and reduction of the incisor overbite were observed at 5 years (-1.08 mm, p=0.013). No correlation was found between the different dental classes and dentoskeletal changes or reported side effects. No correlation between LCR variables changes and MAD compliance or tolerance.

Conclusion:study data showed clinically insignificant skeletal and dentoalveolar changes. Regular dental FU is recommended throughout the course of MAD therapy.