Dental and skeletal long-term side effects of mandibular advancement devices in obstructive sleep apnea patients: a systematic review with meta-regression analysis

Objective: The aim of this study is to identify the craniofacial changes of long term use of Mandibular Advancement Devices (MAD) for Obstructive Sleep Apnea (OSA) treatment trough a systematic review of the literature. Materials and methods: A systematic review was performed assessing the following electronic databases: PubMed, EBSCOhost, The Cochrane Library and EMBASE,between January 2000 and May 2014, human studies and english language. Inclusion and exclusion criteria were applied to the results. Selected articles were evaluated with the use of an international check list related to the type of the study (CONSORT). A classification of the level of evidence and the degree of recommendation were performed trough the SORT strategy. Results: 1383 articles were identified after the initial search. After applying the criteria selection and complete the check list selected (CONSORT) only 1 study fulfilled the inclusion criteria. A classification of the level of evidence and grade of recommendation were performed by using the SORT strategy to the selected article. Conclusions: No enough body of evidence were found in this study to identify the craniofacial changes with the long term use of Mandibular Advancement Devices for the treatment of Obstructive Sleep Apnea.

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Long-term manifestations and modifiers of prevalence estimates of the post-COVID-19 syndrome: A systematic review and meta-analysis.

10.1101/2021.10.17.21265123 ◽

2021 ◽

Author(s):

Daniel De-la-Rosa-Martínez ◽

Marco Antonio Delaye-Martínez ◽

Omar Yaxmehen Bello-Chavolla ◽

Alejandro Sicilia-Andrade ◽

Isaac David Juárez-Cruz ◽

...

Keyword(s):

Systematic Review ◽

Regression Analysis ◽

Meta Analysis ◽

Population Characteristics ◽

Published Data ◽

System Disease ◽

Prevalence Estimates ◽

Meta Regression ◽

Meta Regression Analysis

Background: Post-acute COVID-19 syndrome (PACS) is a multi-system disease comprising persistent symptomatology after the acute phase of infection. Long-term PACS effects significantly impact patient outcomes, but their incidence remains uncharacterized due to high heterogeneity between studies. Therefore, we aimed to summarize published data on PACS, characterizing the clinical presentation, prevalence, and modifiers of prevalence estimates. Method: In this systematic review and meta-analysis, we research MEDLINE for original studies published from January 1st, 2020, to January 31st, 2021, that reported proportions of PACS manifestations. Studies were eligible for inclusion if they included patients aged ≥18 years with confirmed COVID-19 by RT-PCR or antigen testing and a minimum follow-up of 21 days. The prevalence of individual manifestations across studies was pooled using random-effects meta-analysis. For evaluating determinants of heterogeneity, meta-regression analysis was performed. This study was registered in PROSPERO (CRD42019125025). Results: After screening 1,235 studies, we included 29 reports for analysis. Twenty-seven meta-analyses were performed, and 61 long-term manifestations were described. The pooled prevalence of PACS was 56% (95%CI 45-66%), with the most common manifestations being diminished health status, fatigue, asthenia, dyspnea, myalgias, hyposmia and dysgeusia. Most of the included studies presented high heterogeneity. After conducting the meta-regression analysis, we identified that age, gender, number of comorbidities, and reported symptoms significantly modify the prevalence estimation of PACS long-term manifestations. Conclusion: PACS is inconsistently reported between studies, and population characteristics influence the prevalence estimates due to high heterogeneity. A systematized approach for the study of PACS is needed to characterize its impact adequately.

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Dropout and adherence of obstructive sleep apnea patients to mandibular advancement device therapy: a systematic review of randomized controlled trials with meta‐analysis and meta‐regression

Journal of Oral Rehabilitation ◽

10.1111/joor.13290 ◽

2021 ◽

Author(s):

Francesco Bortolotti ◽

Giulia Corazza ◽

Maria Lavinia Bartolucci ◽

Serena Incerti Parenti ◽

Corrado Paganelli ◽

...

Keyword(s):

Systematic Review ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Meta Analysis ◽

Mandibular Advancement ◽

Controlled Trials ◽

Device Therapy ◽

Randomized Controlled ◽

Obstructive Sleep ◽

Meta Regression

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Use of mandibular advancement devices for the treatment of primary snoring with or without obstructive sleep apnea (OSA): A systematic review

Sleep Medicine Reviews ◽

10.1016/j.smrv.2020.101407 ◽

2021 ◽

Vol 56 ◽

pp. 101407

Author(s):

Micheline M.D. De Meyer ◽

Olivier M. Vanderveken ◽

Sonia De Weerdt ◽

Luc A.M. Marks ◽

Bernadita A. Cárcamo ◽

...

Keyword(s):

Systematic Review ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Mandibular Advancement ◽

Primary Snoring ◽

Obstructive Sleep ◽

Mandibular Advancement Devices

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The Most Effective Amount of Forward Movement for Oral Appliances for Obstructive Sleep Apnea: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16183248 ◽

2019 ◽

Vol 16 (18) ◽

pp. 3248 ◽

Cited By ~ 3

Author(s):

Yuki Sakamoto ◽

Akifumi Furuhashi ◽

Eri Komori ◽

Hiroyuki Ishiyama ◽

Daichi Hasebe ◽

...

Keyword(s):

Systematic Review ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Side Effects ◽

Sleep Stage ◽

Mandibular Advancement ◽

Apnea Hypopnea Index ◽

Oral Appliances ◽

Forward Movement ◽

Obstructive Sleep

This systematic review clarifies the amount of effective protrusion in mandibular advancement devices of oral appliances required for obstructive sleep apnea (OSA). The systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Review Manager 5 and GRADEpro were used to combine trials and analyze data. The present review included three studies. In mild to moderate OSA cases, measured using the apnea–hypopnea index (AHI), 50% protrusion was more effective than 75% protrusion. However, 75% protrusion was more effective for severe cases. Sleep stage, Epworth Sleepiness Scale (ESS), snoring index, and side effects significantly differed between the groups. Additionally, 75% protrusion was more effective (AHI: 0.38, 95% CI: −0.89 to 1.65, p = 0.56; sleep stage 3: −1.20, 95% CI: 9.54–7.14, p = 0.78; ESS: 1.07, 95% CI: −0.09 to 2.24, p = 0.07; snoring index: 0.09, 95% CI: 0.05–0.13, p < 0.05; side effects: RR: 1.89, 95% CI: 0.36–9.92, p = 0.45). As per the AHI, 75% protrusion was effective in severe cases, whereas 50% protrusion was effective in moderate cases. Analysis of different surrogate outcomes indicated that 75% protrusion was more effective. Further, well-designed, larger trials should determine the benefits for patients. Additionally, investigations of adherence and side effects with long-term follow-up are needed.

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