Mandibular Exercises For The Prevention Of Temporomandibular Disorder During Mandibular Advancement Device Therapy In Obstructive Sleep Apnea Patients: A Randomized Controlled Trial


  • Thais de Moura Guimarães
  • Camila Dinis Tavares
  • Fernanda R Almeida
  • Paulo Afonso Cunali
  • Otávio Ferraz
  • Cibele Dal Fabbro
  • Cauby Maia Chaves Jr Federal University of Ceará
  • Rowdley Rossi
  • Sergio Tufik
  • Lia Bittencourt



Objective: This study aimed to evaluate the efficacy of mandibular exercises for the prevention of temporomandibular disorder (TMD) during Obstructive Sleep Apnea (OSA) treatment with mandibular advancement device (MAD) in patients without TMD symptoms.

Material and methods: Nineteen subjects with mild to moderate OSA were included. Patients were randomized into two groups: a control group and a support therapy group. Both groups received the MAD at 75% of their maximum protrusion. The support therapy group was instructed to perform mandibular exercises two times per day. Pain was assessed by an analogical pain scale during progressive protrusion at the 4th, 12th and 16th week. The Research Diagnostic Criteria for Temporomandibular disorders (RDC-TMD) were applied at the initial evaluation and at 16th week. Student’s t-test, paired t-test, ANOVA, Friedman’s ANOVA and chi-square were performed for statistics analyses.

Results: A total of 19 subjects, 10 in the support therapy group and 9 in the control group completed the protocol. According to the analogical pain scale and the RDC-TMD, none of the patients from either group experienced temporomandibular pain.

Conclusion: Both groups did not develop TMD symptoms, mandible exercise as support therapy did not influence the prevention of TMD.







Dental Medicine

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