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Article: A systematic review of the efficacy of oral appliance design in the management of obstructive sleep apnoea

TitleA systematic review of the efficacy of oral appliance design in the management of obstructive sleep apnoea
Authors
Issue Date2011
PublisherOxford University Press. The Journal's web site is located at http://ejo.oxfordjournals.org/
Citation
European Journal Of Orthodontics, 2011, v. 33 n. 3, p. 318-324 How to Cite?
AbstractOral appliances (OAs) are increasingly advocated as a treatment option for obstructive sleep apnoea (OSA). However, it is unclear how their different design features influence treatment efficacy. The aim of this research was to systematically review the evidence on the efficacy of different OAs on polysomnographic indices of OSA. A MeSH and text word search were developed for Medline, Embase, Cinahl, and the Cochrane library. The initial search identified 1475 references, of which 116 related to studies comparing OAs with control appliances. Among those, 14 were randomized controlled trials (RCTs), which formed the basis of this review. The type of OA investigated in these trials was mandibular advancement devices (MADs), which were compared with either inactive appliances (six studies) or other types of MADs with different design features.Compared with inactive appliances, all MADs improved polysomnographic indices, suggesting that mandibular advancement is a crucial design feature of OA therapy for OSA. The evidence shows that there is no one MAD design that most effectively improves polysomnographic indices, but that efficacy depends on a number of factors including severity of OSA, materials and method of fabrication, type of MAD (monobloc/twin block), and the degree of protrusion (sagittal and vertical).These findings highlight the absence of a universal definition of treatment success. Future trials of MAD designs need to be assessed according to agreed success criteria in order to guide clinical practice as to which design of OAs may be the most effective in the treatment of OSA. © 2010 The Author.
Persistent Identifierhttp://hdl.handle.net/10722/134852
ISSN
2015 Impact Factor: 1.44
2015 SCImago Journal Rankings: 1.090
ISI Accession Number ID
Funding AgencyGrant Number
General Research Fund, Hong KongHKU 772809M
Funding Information:

General Research Fund, Hong Kong (project no. HKU 772809M).

References
Grants

 

DC FieldValueLanguage
dc.contributor.authorAhrens, Aen_HK
dc.contributor.authorMcGrath, Cen_HK
dc.contributor.authorHägg, Uen_HK
dc.date.accessioned2011-07-21T07:22:15Z-
dc.date.available2011-07-21T07:22:15Z-
dc.date.issued2011en_HK
dc.identifier.citationEuropean Journal Of Orthodontics, 2011, v. 33 n. 3, p. 318-324en_HK
dc.identifier.issn0141-5387en_HK
dc.identifier.urihttp://hdl.handle.net/10722/134852-
dc.description.abstractOral appliances (OAs) are increasingly advocated as a treatment option for obstructive sleep apnoea (OSA). However, it is unclear how their different design features influence treatment efficacy. The aim of this research was to systematically review the evidence on the efficacy of different OAs on polysomnographic indices of OSA. A MeSH and text word search were developed for Medline, Embase, Cinahl, and the Cochrane library. The initial search identified 1475 references, of which 116 related to studies comparing OAs with control appliances. Among those, 14 were randomized controlled trials (RCTs), which formed the basis of this review. The type of OA investigated in these trials was mandibular advancement devices (MADs), which were compared with either inactive appliances (six studies) or other types of MADs with different design features.Compared with inactive appliances, all MADs improved polysomnographic indices, suggesting that mandibular advancement is a crucial design feature of OA therapy for OSA. The evidence shows that there is no one MAD design that most effectively improves polysomnographic indices, but that efficacy depends on a number of factors including severity of OSA, materials and method of fabrication, type of MAD (monobloc/twin block), and the degree of protrusion (sagittal and vertical).These findings highlight the absence of a universal definition of treatment success. Future trials of MAD designs need to be assessed according to agreed success criteria in order to guide clinical practice as to which design of OAs may be the most effective in the treatment of OSA. © 2010 The Author.en_HK
dc.languageeng-
dc.publisherOxford University Press. The Journal's web site is located at http://ejo.oxfordjournals.org/en_HK
dc.relation.ispartofEuropean Journal of Orthodonticsen_HK
dc.titleA systematic review of the efficacy of oral appliance design in the management of obstructive sleep apnoeaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0141-5387&volume=33&issue=3&spage=318&epage=324&date=2011&atitle=A+systematic+review+of+the+efficacy+of+oral+appliance+design+in+the+management+of+obstructive+sleep+apnoea-
dc.identifier.emailMcGrath, C:mcgrathc@hkucc.hku.hken_HK
dc.identifier.emailHägg, U:euohagg@hkusua.hku.hken_HK
dc.identifier.authorityMcGrath, C=rp00037en_HK
dc.identifier.authorityHägg, U=rp00020en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1093/ejo/cjq079en_HK
dc.identifier.pmid21239397-
dc.identifier.scopuseid_2-s2.0-79957794530en_HK
dc.identifier.hkuros186308-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79957794530&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume33en_HK
dc.identifier.issue3en_HK
dc.identifier.spage318en_HK
dc.identifier.epage324en_HK
dc.identifier.isiWOS:000291064000016-
dc.publisher.placeUnited Kingdomen_HK
dc.relation.projectA randomized clinical trial of the treatment of obstructive sleep apnoea using oral appliances-
dc.identifier.scopusauthoridAhrens, A=37021149400en_HK
dc.identifier.scopusauthoridMcGrath, C=7102335507en_HK
dc.identifier.scopusauthoridHägg, U=7006790279en_HK
dc.identifier.citeulike9432094-

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