A systematic review on the effectiveness of titratable over nontitratable mandibular advancement appliances for sleep apnea
Background: Mandibular advancement appliances are being tested for use in patients with obstructive sleep apnea (OSA). However, the effectiveness of titration of these appliances does not have conclusive evidence. Systematic reviews help us to compile all available clinical evidence using statistica...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2017-01-01
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| Series: | The Journal of Indian Prosthodontic Society |
| Subjects: | |
| Online Access: | http://www.j-ips.org/article.asp?issn=0972-4052;year=2017;volume=17;issue=4;spage=319;epage=324;aulast=Sivaramakrishnan |
| _version_ | 1818179030037299200 |
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| author | Gowri Sivaramakrishnan Kannan Sridharan |
| author_facet | Gowri Sivaramakrishnan Kannan Sridharan |
| author_sort | Gowri Sivaramakrishnan |
| collection | DOAJ |
| description | Background: Mandibular advancement appliances are being tested for use in patients with obstructive sleep apnea (OSA). However, the effectiveness of titration of these appliances does not have conclusive evidence. Systematic reviews help us to compile all available clinical evidence using statistical principles. Hence, the aim of this systematic review is to identify the effectiveness of titratable over nontitratable mandibular advancement appliances in patients with mild to moderate OSA. This review objective is to identify if titration of these appliances produce significant benefits over fixed appliances.
Materials and Methodology: Electronic databases were searched to identify eligible studies based on set inclusion criteria. Data extraction form was created and the data were extracted. The participants were mild to moderate OSA patients who received mandibular advancement appliances. Studies included a comparison between titratable and nontitratable mandibular advancement appliance.
Results: Of the five included studies, three were observational and two were a randomized trial. All these studies were conducted in adults. The outcome attributes were polysomnographic readings and apnea-hypopnea index (AHI). A significant heterogeneity was seen between the eligible studies and hence a meta-analysis could not be performed.
Conclusion: The results from this systematic review did not show significant advantages of titratable appliances, although titratable appliances performed better from individual studies as regards to reduction in AHI and polysomnography. The reason is the lack of sufficient clinical trials on the same. More high quality randomized controlled trials comparing titratable and fixed appliances have to be initiated to get to conclusive evidence. |
| first_indexed | 2024-12-11T20:57:23Z |
| format | Article |
| id | doaj.art-729c0586e6024183a5d7d9a62c30371d |
| institution | Directory Open Access Journal |
| issn | 0972-4052 1998-4057 |
| language | English |
| last_indexed | 2024-12-11T20:57:23Z |
| publishDate | 2017-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | The Journal of Indian Prosthodontic Society |
| spelling | doaj.art-729c0586e6024183a5d7d9a62c30371d2022-12-22T00:51:05ZengWolters Kluwer Medknow PublicationsThe Journal of Indian Prosthodontic Society0972-40521998-40572017-01-0117431932410.4103/jips.jips_115_17A systematic review on the effectiveness of titratable over nontitratable mandibular advancement appliances for sleep apneaGowri SivaramakrishnanKannan SridharanBackground: Mandibular advancement appliances are being tested for use in patients with obstructive sleep apnea (OSA). However, the effectiveness of titration of these appliances does not have conclusive evidence. Systematic reviews help us to compile all available clinical evidence using statistical principles. Hence, the aim of this systematic review is to identify the effectiveness of titratable over nontitratable mandibular advancement appliances in patients with mild to moderate OSA. This review objective is to identify if titration of these appliances produce significant benefits over fixed appliances. Materials and Methodology: Electronic databases were searched to identify eligible studies based on set inclusion criteria. Data extraction form was created and the data were extracted. The participants were mild to moderate OSA patients who received mandibular advancement appliances. Studies included a comparison between titratable and nontitratable mandibular advancement appliance. Results: Of the five included studies, three were observational and two were a randomized trial. All these studies were conducted in adults. The outcome attributes were polysomnographic readings and apnea-hypopnea index (AHI). A significant heterogeneity was seen between the eligible studies and hence a meta-analysis could not be performed. Conclusion: The results from this systematic review did not show significant advantages of titratable appliances, although titratable appliances performed better from individual studies as regards to reduction in AHI and polysomnography. The reason is the lack of sufficient clinical trials on the same. More high quality randomized controlled trials comparing titratable and fixed appliances have to be initiated to get to conclusive evidence.http://www.j-ips.org/article.asp?issn=0972-4052;year=2017;volume=17;issue=4;spage=319;epage=324;aulast=SivaramakrishnanMandibular advancement devicemechanical appliancesleep apnea |
| spellingShingle | Gowri Sivaramakrishnan Kannan Sridharan A systematic review on the effectiveness of titratable over nontitratable mandibular advancement appliances for sleep apnea The Journal of Indian Prosthodontic Society Mandibular advancement device mechanical appliance sleep apnea |
| title | A systematic review on the effectiveness of titratable over nontitratable mandibular advancement appliances for sleep apnea |
| title_full | A systematic review on the effectiveness of titratable over nontitratable mandibular advancement appliances for sleep apnea |
| title_fullStr | A systematic review on the effectiveness of titratable over nontitratable mandibular advancement appliances for sleep apnea |
| title_full_unstemmed | A systematic review on the effectiveness of titratable over nontitratable mandibular advancement appliances for sleep apnea |
| title_short | A systematic review on the effectiveness of titratable over nontitratable mandibular advancement appliances for sleep apnea |
| title_sort | systematic review on the effectiveness of titratable over nontitratable mandibular advancement appliances for sleep apnea |
| topic | Mandibular advancement device mechanical appliance sleep apnea |
| url | http://www.j-ips.org/article.asp?issn=0972-4052;year=2017;volume=17;issue=4;spage=319;epage=324;aulast=Sivaramakrishnan |
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