Is maxillomandibular advancement an effective treatment for obstructive sleep apnea? Systematic literature review and meta-analysis

Trindade, Paulo Alceu Kiemle; Nogueira, Vânia dos Santos Nunes; Weber, Silke Anna Theresa

doi:10.1016/j.bjorl.2023.02.007

Cited by 2 publications

(1 citation statement)

References 34 publications

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“…They found that OAT improves the quality of life of POSA patients [31]. Trindade et al [32] included four studies with 83 adult patients and compared their results before and after OAT. They reported that OAT achieved a 79.5% reduction in AHI and a decrease in respiratory obstruction.…”

Section: Discussionmentioning

confidence: 99%

Oral appliance therapy vs. positional therapy for managing positional obstructive sleep apnea; a systematic review and meta-analysis of randomized control trials

Mohamed,

Mohammed,

Liu

et al. 2024

BMC Oral Health

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Aim To assess the efficacy of positional therapy and oral appliance therapy for the management of positional obstructive sleep apnea. Methods We searched PubMed, Web of Science, Cochrane, and SCOPUS for relevant clinical trials. Quality assessment of the included trials was evaluated according to Cochrane’s risk of bias tool. We included the following outcomes: The apnea-hypopnea index (AHI), AHI non-supine, AHI supine, sleep efficiency, percentage of supine sleep, Adherence (≥ 4 h/night, ≥ 5 days/week), Oxygen desaturation Index, Arousal Index, Epworth Sleepiness Scale score (ESS), Mean SpO2, and Functional Outcomes of Sleep Questionnaire. Results The AHI non-supine and the ESS scores were significantly lower in the OAT cohort than in the PT cohort. The PT cohort was associated with a significantly decreased percentage of supine sleep than the OAT cohort (MD= -26.07 [-33.15, -19.00], P = 0.0001). There was no significant variation between PT cohort and OAT cohort regarding total AHI, AHI supine, ODI, sleep efficiency, arousal index, FOSQ, adherence, and mean SpO2. Conclusion Both Positional Therapy and Oral Appliance Therapy effectively addressed Obstructive Sleep Apnea. However, Oral Appliance Therapy exhibited higher efficiency, leading to increased supine sleep percentage and more significant reductions in the Apnea Hypopnea Index during non-supine positions, as well as lower scores on the Epworth Sleepiness Scale.

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Section: Discussionmentioning

confidence: 99%

Oral appliance therapy vs. positional therapy for managing positional obstructive sleep apnea; a systematic review and meta-analysis of randomized control trials

Mohamed,

Mohammed,

Liu

et al. 2024

BMC Oral Health

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The Incidence of Obstructive Sleep Apnea in Patients with Dento-Skeletal Malformation

D’Amato,

Todaro,

Saponaro

et al. 2024

Dentistry Journal

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Purpose: The aim of this article is to analyze the incidence of undiagnosed obstructive sleep apnea (OSA) in patients affected by dento-skeletal malformation. We also evaluated the patterns most affected by the condition and calculated the post surgical changes. Methods: We conducted a retrospective cohort study on 71 patients including 35 men and 36 women. The patients studied were affected by dento-skeletal class II and III malformations and underwent bimaxillary orthognathic surgery in all cases. Patients were evaluated with polysomnography before surgery and at least 6 months after surgery to assess any improvement or worsening of the apnea hypopnea index (AHI) index. Regarding AHI evaluation criteria, an AHI > 5 was considered indicative of OSA, 4 < AHI < 5 was considered borderline and AHI < 4 was considered indicative of non-OSA. We also considered demographic variables like age at the time of intervention and gender, and anatomical variables like the pattern of the dento-skeletal deformity and the presence or absence of maxillary hypoplasia. Qualitative variables were described as absolute and relative frequencies, while quantitative variables were summarized as mean and standard deviation. To quantitatively express the relationship between two variables, the correlation coefficient was calculated. The covariance array was used to evaluate multiple correlations. Results: Our study shows that there is a significant percentage (33%) of patients who undergo orthognathic surgery with an AHI > 5 and also a percentage of patients (11%) who can be considered to be “borderline.” It emerges that the pattern most at risk is the one characterized by retruded maxilla and patients with dento-skeletal class II. Considering the post surgical period, the statistical analysis shows that after surgery, only 8% of malformed patients present an AHI > 5, compared to the 20.5% described in the Italian population. Conclusions: In patients who receive orthognathic surgery, the presence of obstructive sleep apnea is significantly higher than in the general population. When planning the surgical correction of a dento-skeletal malformation, the surgeon must aim not only for the esthetics results, but also for proper stomatognathic and respiratory function; this cannot be achieved without taking polysomnography information into account.

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Is maxillomandibular advancement an effective treatment for obstructive sleep apnea? Systematic literature review and meta-analysis

Cited by 2 publications

References 34 publications

Oral appliance therapy vs. positional therapy for managing positional obstructive sleep apnea; a systematic review and meta-analysis of randomized control trials

Oral appliance therapy vs. positional therapy for managing positional obstructive sleep apnea; a systematic review and meta-analysis of randomized control trials

The Incidence of Obstructive Sleep Apnea in Patients with Dento-Skeletal Malformation

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