Prerequisites for the permanent use of a Protrusionsschiene are sufficient anchorage units and parodontal healthy teeth. Removable dentures and unilateral Freiendsituationen, which provide no sufficient retention, represent contraindications for a Protrusionsschiene. Reduced anchorage units, implants can increase the conditions for use of the Rails (33). Two European studies have shown that there is a contraindication for a permanent use of the Rails at approximately 30% of patients who ask for a treatment, because of lack of dental retention options (24 and 34). Through the permanent relocation of the mandible in the bedroom, reciprocal forces are transferred to the stomatognathe system, which a regular application can cause tooth position changes. These are rather small and clinically not flashy, in some cases but clinically relevant changes in occlusion can occur (35).
Important parameters for the occurrence of dental side effects is the duration of the application, the longer the rails are worn, the more experience dental side effects. Patients with a deep bite, a retro-molar of lower jaw position and a horizontal face skull design develop dental less side effects than patients with scarce Overbite and a vertical facial structure (36). Potential anomalies of tooth position are a palatal maxillary anterior tilt and a distal tilt of the maxillary posterior teeth, a labial tilt of the mandibular incisors and a mesial tilt of mandibular posterior teeth, a lateral open bite and a reduction of the sagittal and vertical uberbisses in the front. Permanently carried the rails and are mostly hard materials used, can also intrusions in the area of the posterior teeth occur. This can lead to the lifting of the approximal contact points in the posterior region. Currently, yet no study was conducted, which looked at the reactions of the periodontium a regular use of the Rails. Clinical notes talk sure that increased especially in the lower jaw front vertical bone loss is observed.