Treatment of Obstructive Sleep Apnea with Orthodontic Oral a | 89104

Journal of Research in Medical and Dental Science
eISSN No. 2347-2367 pISSN No. 2347-2545

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Treatment of Obstructive Sleep Apnea with Orthodontic Oral appliances: Systematic Review

Author(s): Nasir H AlHamlan*, Lujain A AlGhrairy, Waad E AlSaadi, Khaled W AlBawardi, Rana A AlOlaiq and Afnan T AlZomaili


Objective: This systematic review study aims to determine the treatment success in patients with obstructive sleep apnea syndrome in different orthodontic treatment method. Methods: A systematic search to identify all relevant randomized control trials was conducted in PubMed databases. A supplemental manual search was performed by reviewing the reference lists of the related articles. The key words used to conduct the research were; obstructive sleep apnoea, oral appliance, orthodontic therapy, snoring, treatment success. Study selected to be included is in English language, within twenty past years. No exclusions were made based on ethnicity, age, or gender. Results: In terms of MAD comparing to inactive control devices, four RCT studies conclude that the mandibular advancement splint (MAS) resulted in significant improvements in AHI and Oxygen Desaturation Index (p<0.001). Moreover, two studies designed to compare oral appliance against no treatment. It concludes that all treated subjects had significantly lower apnea index, AHI (p<0.001) and hypopnea index values (p<0.001), whereas in untreated control subjects these values remained almost unchanged. Additionally, five studies compared one of the MRA with another design of MRA. One of these studies concludes that both devices (MAS and TSD) had a similar efficacy in AHI reduction, yet, improvements in snoring, quality of sleep and better compliance were reported by the patients for MAS than TSD. Another study results in significant reduction in AHI, AI and improvement in ESS and SS in both SILENT NITE and a one-piece Monoblock appliance despite the patients' preference for Monoblock appliance. Furthermore, a study was conducted to determine if the design of MRA can affect the end treatment result of OSA. Despite similar outcome of both appliances, there was a significant preference of the minimal coverage of teeth and palate MRA design. Similarly, A custom-made MRA is statistically more effective in the management of OSA and also in patients’ preference and compliance. Finally, in evaluating the effectiveness of MAS to control SDB in children, there were an overall clinical reduction of AHI, snoring time with active MAS wearing, and improvement of quality of life and behavior with active MAS than sham MAS. Conclusion: Many studies resulting in an overall improvement of AHI, hypopnea index values, snoring reduction, quality of sleep, quality of life and neuro-cognitive functions. These outcomes intensify the importance of multidisciplinary management of OSAS. Other important health outcomes related to OSAS.

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