Oral appliance therapy in obstructive sleep apnea and snoring - systematic review and new directions of development.

ABSTRACT

Objective: Oral appliance therapy is a non-invasive treatment that offers a wide variety of oral devices for the treatment of obstructive sleep apnea (OSA). The present review focuses on the effectiveness of mandibular advancement devices for the treatment of OSA.Methods: A systematic review based on the PRISMA checklist was carried out. A detailed electronic database search was conducted using "Obstructive sleep apnea" AND "Oral appliance" AND "Dentistry" as keywords.Results: The initial search in the electronic databases resulted in a total of 262 papers. After the title and abstract analysis and full-text review, the number of eligible papers was reduced to 15.Conclusion: The mandibular advancement device is an effective treatment, improving the Apnea Hypopnea Index and the symptoms of patients with OSA in 92% of the subjects from all the investigated studies. The future may include the integration of a biosensor for the diagnosis and follow-up.Abbreviations OSA Obstructive sleep apnea; MADs Mandibular advancement devices; CPAP Continuous positive airway pressure; OAT Oral appliance therapy; MRD Mandibular repositioning devices; MAS Mandibular advancement splints; MAA Mandibular advancement appliances; OA Oral appliances; AASM American Academy of Sleep Medicine; AHI Apnea-hypopnea index; EEG Sleep-related breathing disorder SRBD; Electroencephalogram; EOG Electrooculogram; ECG Electrocardiogram; QOL Quality of life; TMJ Temporomandibular joint.