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- Title
Efficacy of two mandibular advancement appliances in the treatment of obstructive sleep apnea-hypopnea syndrome: A systematic review.
- Authors
Marina, M.; Ariga, Padma; Ganapathy, Dhanraj M.; Mallikarjuna, Arunasree Vadaguru
- Abstract
Introduction: Obstructive sleep apnea (OSA) is a potentially life threatening and highly prevalent breathing disorder. In practice, the prevalence of OSA seems to be underreported, as roughly 85% of patients with OSA are usually undiagnosed. The treatment of OSA depends on the severity of symptoms, magnitude of clinical complications, and the etiology of upper airway obstruction. It is recommended that the first line of treatment should be conservative due to the questionable prognosis of surgical interventions. Concerning nonsurgical methods, oral appliances offer several advantages over other therapeutic choices, although the cost of oral appliances varies, compared to the health-care costs of untreated sleep apnea and high compliance rates associated with their use, the overall cost is very low, they are non-invasive, easy to fabricate, and reversible and are acceptable for most patients. Aim: The aim of this study was to systematically investigate the efficacy of two mandibular advancement appliances (MDAs) in the treatment of mild-moderate OSA. Selection Criteria: Clinical trials in which nocturnal wear of two types of MDA were evaluated for apnea-hypopnea index (AHI), oxyhemoglobin saturation level, and Epworth Sleepiness Scale (ESS). Data Collection and Analysis: An electronic search was conducted for scholarly articles about comparing two types of oral appliance used to treat OSA written listed with PubMed, Science Direct, and Google Scholar databases. The search methodology applied was a combination of Medical Subject Headings terms and suitable keywords. Results: Of the 20 articles obtained from electronic search, 12 were excluded on examination of title and abstract and three were excluded on the basis of core data. One article was handpicked and a total of six articles were reviewed. Conclusion: According to the articles reviewed, it can be concluded that both MDAs significantly improve sleep and its associated disorders such as snoring frequency, breathing pause, oxygen saturation, ESS, and AHI. The MAD enlarges and stabilizes the airway space by advancing the mandible and stretching the attached soft tissue, particularly tongue. The MDAs have been well tolerated by the patients. It can be used to treat patients with mild-to-moderate OSA and in severe OSA patients also.
- Subjects
GOOGLE Scholar (Web resource); MEDICAL subject headings; META-analysis; EPWORTH Sleepiness Scale; SLEEP apnea syndromes; ELECTRONIC information resource searching; DATA collection platforms
- Publication
Drug Invention Today, 2019, Vol 11, Issue 3, p698
- ISSN
0975-7619
- Publication type
Article