Breakage-Related Remanufacture of Mandibular Advancement Devices in Patients With Obstructive Sleep Apnea: A Retrospective Study of 219 Patients
- 1Department of Oral and Maxillofacial Surgery, Kanazawa Medical University, Uchinada, JPN
- 2Department of Physical and Cognitive Rehabilitation Technology, Kanazawa Medical University Hospital, Uchinada, JPN
- 3Department of Pathology Ⅱ, Kanazawa Medical University, Uchinada, JPN
Abstract
Introduction: Mandibular advancement devices (MADs) are used for obstructive sleep apnea (OSA), but the frequency of new-device fabrication following breakage during treatment is uncertain.
Methods: We analyzed 219 patients treated with a custom-made fixed-type MAD at a single center. The endpoint was the first documented new-device fabrication due to device breakage, across successive appliances if necessary, measured from the initial recorded fabrication date. The record term “repair” denoted new-device fabrication, whereas adjustment of an existing device was not an event. Dental-treatment and loss-related replacements did not end patient-level observation. For patients without a documented breakage event, absence of a return visit was assumed to mean no recorded event through March 31, 2025.
Results: Fifty-eight of 219 patients (26.5%) had a first breakage-related remanufacture; 161 were administratively censored. Two patients had an intervening new device for a non-device reason: one later had a breakage event and one did not. Median analytic observation time was 45.9 months (IQR 18.4-77.3; range 0.3-180.7). Estimated event-free survival at one and three years was 91.6% (95% CI 87.0-94.6) and 81.1% (95% CI 74.8-86.0), respectively. Actual last-contact dates and loss to clinical follow-up could not be determined.
Conclusion: Breakage-related new-device fabrication was documented during MAD treatment. These patient-level estimates depend on an unverified assumption that patients who did not return had no recorded event; they do not describe the physical lifespan of a single appliance or treatment efficacy.
Related
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BibTeX
@article{kakuda2026breakagerelated,
title = {{Breakage-Related Remanufacture of Mandibular Advancement Devices in Patients With Obstructive Sleep Apnea: A Retrospective Study of 219 Patients}},
author = {Shintaro Kakuda and Shuto Ito and Yasuhisa Sawai and Yota Yamauchi and Fukunori Toukai and Satoshi Wada and Takanobu Takata and Eiji Mitate and Hiroyuki Nakano},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.117448},
url = {https://doi.org/10.7759/cureus.117448},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Breakage-Related Remanufacture of Mandibular Advancement Devices in Patients With Obstructive Sleep Apnea: A Retrospective Study of 219 Patients
AU - Shintaro Kakuda
AU - Shuto Ito
AU - Yasuhisa Sawai
AU - Yota Yamauchi
AU - Fukunori Toukai
AU - Satoshi Wada
AU - Takanobu Takata
AU - Eiji Mitate
AU - Hiroyuki Nakano
PY - 2026
DA - 2026/10/04
JO - Cureus
DO - 10.7759/cureus.117448
UR - https://doi.org/10.7759/cureus.117448
AB - Introduction: Mandibular advancement devices (MADs) are used for obstructive sleep apnea (OSA), but the frequency of new-device fabrication following breakage during treatment is uncertain. Methods: We analyzed 219 patients treated with a custom-made fixed-type MAD at a single center. The endpoint was the first documented new-device fabrication due to device breakage, across successive appliances if necessary, measured from the initial recorded fabrication date. The record term “repair” denoted new-device fabrication, whereas adjustment of an existing device was not an event. Dental-treatment and loss-related replacements did not end patient-level observation. For patients without a documented breakage event, absence of a return visit was assumed to mean no recorded event through March 31, 2025. Results: Fifty-eight of 219 patients (26.5%) had a first breakage-related remanufacture; 161 were administratively censored. Two patients had an intervening new device for a non-device reason: one later had a breakage event and one did not. Median analytic observation time was 45.9 months (IQR 18.4-77.3; range 0.3-180.7). Estimated event-free survival at one and three years was 91.6% (95% CI 87.0-94.6) and 81.1% (95% CI 74.8-86.0), respectively. Actual last-contact dates and loss to clinical follow-up could not be determined. Conclusion: Breakage-related new-device fabrication was documented during MAD treatment. These patient-level estimates depend on an unverified assumption that patients who did not return had no recorded event; they do not describe the physical lifespan of a single appliance or treatment efficacy.
SN - 2168-8184
ER -