Effectiveness of mandibular advancement appliances in treating obstructive sleep apnea syndrome: A systematic review

Serra-Torres, Sara; Bellot-Arcís, Carlos; Montiel-Company, José María; Marco-Algarra, Jaime; Almerich‐Silla, José Manuel

doi:10.1002/lary.25505

Cited by 83 publications

(63 citation statements)

References 44 publications

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“…Third, a systematic review comparing adjustable with fixed devices or custom‐made devices with prefabricated ones showed that in both cases the former were more effective …”

Section: Discussionmentioning

confidence: 99%

“…Third, a systematic review comparing adjustable with fixed devices or custom-made devices with prefabricated ones showed that in both cases the former were more effective. 51 Finally, there is a notable disparity with respect to some variables such as the time of follow-up, type of We have considered all of these factors when comparing our results with other studies in moderate-to-severe OSA patients.…”

Section: Effect Of the Mad On Polysomnographic Variablesmentioning

confidence: 98%

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Impact of an oral appliance on obstructive sleep apnea severity, quality of life, and biomarkers

et al. 2017

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“…Third, a systematic review comparing adjustable with fixed devices or custom‐made devices with prefabricated ones showed that in both cases the former were more effective …”

Section: Discussionmentioning

confidence: 99%

Section: Effect Of the Mad On Polysomnographic Variablesmentioning

confidence: 98%

Impact of an oral appliance on obstructive sleep apnea severity, quality of life, and biomarkers

et al. 2017

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“…They also presented the results grouped by grade of severity and noted that in mild OSA, the effects of the two types of appliances were similar. In a systematic review, Serra-Torres et al [5] concluded that adjustable and custom-made mandibular advancement appliances give better results than fixed and prefabricated appliances, and that monobloc appliances give rise to more adverse events. Objective polygraphic registrations are crucial as described by Marklund et al [14] who evaluated fixed OAs incrementally advanced in response to the clinical observation.…”

Section: Discussionmentioning

confidence: 99%

“…These results are in contrast to the findings of a retrospective study by Lettieri et al [4], who found significant advantages in AHI reduction with adjustable compared with fixed appliances. In a systematic review, Serra-Torres et al [5] also concluded that adjustable and custom-made mandibular advancement appliances give better results than fixed and prefabricated appliances, and that monobloc appliances give rise to more adverse events.…”

Section: Introductionmentioning

confidence: 99%

Obstructive sleep apnea treated with custom-made bibloc and monobloc oral appliances: a retrospective comparative study

Isacsson¹,

Fodor²,

Sturebrand³

2016

Sleep Breath

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PurposeThe primary purpose of this hypothesis-generating retrospective study was to compare the effect of monobloc and bibloc (Narval™) appliances on the apnea–hypopnea index (AHI) and the total cost of treatment during the first year of treatment.MethodsObstructive sleep apnea (OSA) subjects treated with a monobloc or bibloc during two different time periods were identified from medical records and data were extracted. Subjects treated with either of the appliances passed the same primary examination, follow-up visits, and follow-up polygraphic examination. A 1-year clinical follow-up was made on the bibloc group.ResultsThe study analysis included 110 monobloc- and 55 bibloc-treated subjects with baseline mean AHI of 23 and 22, respectively. AHI responders (AHI < 10 and/or a ≥50 % reduction of baseline AHI) were seen at follow-up in 61 % of the monobloc group and 56 % of the bibloc group. The improvement of the AHI value was similar in the two groups, with mean declines of 12.7 and 13.8, respectively. The ODI (oxygen desaturation index), lowest SpO2, longest apnea, and the mean Epworth sleepiness scale (ESS) score were significantly reduced by 3.1 (monobloc) and 2.2 (bibloc), i.e., at the same level for both groups. The total direct cost of treatment for a 1-year treatment was 17 % higher for the bibloc-treated subjects than for the monobloc-treated subjects.ConclusionsThe results indicate that the monobloc and bibloc appliances are equally effective but the cost of treatment over 1 year was higher with the bibloc. However, prospective randomized controlled trials are needed to adequately test the assumption that the two treatment modalities are equally effective.

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“…The articles were classified as being of high, medium or low quality according to the CONSORT criteria (11) adapted by Mattos et al (12) and used by Fernández-Ferrer et al and Serra-Torres et al (13,14). The quality of the systematic reviews was assessed in accordance with the PRISMA guidelines (10).…”

Section: Methodsmentioning

confidence: 99%

Impact of functional mandibular advancement appliances on the temporomandibular joint - a systematic review

Ivorra-Carbonell¹,

Montiel-Company²,

Almerich‐Silla³

et al. 2016

Med Oral

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BackgroundAlthough many orthodontists have no doubts about the effectiveness of functional appliances for mandibular advancement, the impact on the temporomandibular joint (TMJ) is still in dispute. The objective of this systematic review is to examine the main effects on the TMJ of using functional appliances, both in healthy patients and in patients with a pre-existing disorder.Material and MethodsA systematic review of the literature was conducted in accordance with the PRISMA guidelines. Only systematic reviews, meta-analyses, randomized clinical trials (RCTs), case-control studies and cohort studies were included. A detailed language-independent electronic search was conducted in the Pubmed, Scopus, Cochrane Library and Embase databases. All studies published between 2000 and 2015 were included.ResultsA total of 401 articles were identified. Of these, 159 were duplicates and were excluded. On reading the title and abstract, 213 articles were excluded because they did not answer the research question, leaving a total of 29 articles. These articles were read and assessed. Following critical reading of the full text, eight articles were excluded: seven because they were considered of low quality and one because it published redundant data. As a result, 21 articles were included.ConclusionsAfter treatment with functional appliances, the condyle was found to be in a more advanced position, with remodelling of the condyle and adaptation of the morphology of the glenoid fossa. No significant adverse effects on the TMJ were observed in healthy patients and the appliances could improve joints that initially presented forward dislocation of the disk. Key words:Temporomandibular joint, TMJ, orthodontic appliances, functional, mandibular advancement, herbst appliance, bionator.

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Effectiveness of mandibular advancement appliances in treating obstructive sleep apnea syndrome: A systematic review

Abstract: NA.

Cited by 83 publications

References 44 publications

Impact of an oral appliance on obstructive sleep apnea severity, quality of life, and biomarkers

Impact of an oral appliance on obstructive sleep apnea severity, quality of life, and biomarkers

Obstructive sleep apnea treated with custom-made bibloc and monobloc oral appliances: a retrospective comparative study

Impact of functional mandibular advancement appliances on the temporomandibular joint - a systematic review

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