Side effects of mandibular advancement splints for the treatment of snoring and obstructive sleep apnea: a systematic review

Detalhes bibliográficos
Autor(a) principal: Martins,Olivia de Freitas Mendes
Data de Publicação: 2018
Outros Autores: Chaves Junior,Cauby Maia, Rossi,Rowdley Robert Pereira, Cunali,Paulo Afonso, Dal-Fabbro,Cibele, Bittencourt,Lia
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Dental Press Journal of Orthodontics
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2176-94512018000400045
Resumo: ABSTRACT Introduction: Occlusal side effects or development of pain and/or functional impairment of the temporomandibular complex are potential reasons for poor compliance or abandonment of mandibular advancement splints treatment for snoring and obstructive sleep apnea. Objective: This study aimed at providing a comprehensive review evaluating the craniofacial side effects of oral appliance therapy for snoring and obstructive sleep apnea. Methods: An electronic search was systematically conducted in PubMed and Virtual Health Library from their inception until October 2016. Only Randomized Controlled Trials whose primary aim was to measure objectively identified side effects on craniofacial complex of a custom-made oral appliance for treating primary snoring or obstructive sleep apnea were included. Studied patients should be aged 20 or older. The risk of bias in the trials was assessed in accordance with the recommendations of The Cochrane Risk of Bias criteria. Results: A total of 62 full-text articles were assessed for eligibility. After the review process, only 6 met all the inclusion criteria. All studies were rated as having a high risk of bias. The most uniformly reported mandibular advancement splint side effects were predominantly of dental nature and included a decrease in overjet and overbite. The risk of developing pain and function impairment of the temporomandibular complex appeared limited with long-term mandibular advancement splint use. Conclusion: The limited available evidence suggests that mandibular advancement splint therapy for snoring and obstructive sleep apnea results in changes in craniofacial morphology that are predominantly dental in nature, specially on a long-term basis. Considering the chronic nature of obstructive sleep apnea and that oral appliance use might be a lifelong treatment, a thorough customized follow-up should therefore be undertaken to detect possible side effects on craniofacial complex. It is also important to provide adequate information to the patients regarding these possible changes, especially to those in whom larger occlusal changes are to be expected or in whom they are unfavorable. Long-term assessments of adverse effects of oral appliance therapy, with larger study samples and recruitment of homogenous patient population are still required.
id DPI-1_36d062847f22f6ad3182c0ed58396ef3
oai_identifier_str oai:scielo:S2176-94512018000400045
network_acronym_str DPI-1
network_name_str Dental Press Journal of Orthodontics
repository_id_str
spelling Side effects of mandibular advancement splints for the treatment of snoring and obstructive sleep apnea: a systematic reviewObstructive seep apneaAdverse effectsMandibular advancement splintsSystematic reviewABSTRACT Introduction: Occlusal side effects or development of pain and/or functional impairment of the temporomandibular complex are potential reasons for poor compliance or abandonment of mandibular advancement splints treatment for snoring and obstructive sleep apnea. Objective: This study aimed at providing a comprehensive review evaluating the craniofacial side effects of oral appliance therapy for snoring and obstructive sleep apnea. Methods: An electronic search was systematically conducted in PubMed and Virtual Health Library from their inception until October 2016. Only Randomized Controlled Trials whose primary aim was to measure objectively identified side effects on craniofacial complex of a custom-made oral appliance for treating primary snoring or obstructive sleep apnea were included. Studied patients should be aged 20 or older. The risk of bias in the trials was assessed in accordance with the recommendations of The Cochrane Risk of Bias criteria. Results: A total of 62 full-text articles were assessed for eligibility. After the review process, only 6 met all the inclusion criteria. All studies were rated as having a high risk of bias. The most uniformly reported mandibular advancement splint side effects were predominantly of dental nature and included a decrease in overjet and overbite. The risk of developing pain and function impairment of the temporomandibular complex appeared limited with long-term mandibular advancement splint use. Conclusion: The limited available evidence suggests that mandibular advancement splint therapy for snoring and obstructive sleep apnea results in changes in craniofacial morphology that are predominantly dental in nature, specially on a long-term basis. Considering the chronic nature of obstructive sleep apnea and that oral appliance use might be a lifelong treatment, a thorough customized follow-up should therefore be undertaken to detect possible side effects on craniofacial complex. It is also important to provide adequate information to the patients regarding these possible changes, especially to those in whom larger occlusal changes are to be expected or in whom they are unfavorable. Long-term assessments of adverse effects of oral appliance therapy, with larger study samples and recruitment of homogenous patient population are still required.Dental Press International2018-08-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S2176-94512018000400045Dental Press Journal of Orthodontics v.23 n.4 2018reponame:Dental Press Journal of Orthodonticsinstname:Dental Press International (DPI)instacron:DPI10.1590/2177-6709.23.4.045-054.oarinfo:eu-repo/semantics/openAccessMartins,Olivia de Freitas MendesChaves Junior,Cauby MaiaRossi,Rowdley Robert PereiraCunali,Paulo AfonsoDal-Fabbro,CibeleBittencourt,Liaeng2018-09-18T00:00:00Zoai:scielo:S2176-94512018000400045Revistahttp://www.scielo.br/dpjoONGhttps://old.scielo.br/oai/scielo-oai.phpartigos@dentalpress.com.br||davidnormando@hotmail.com2177-67092176-9451opendoar:2018-09-18T00:00Dental Press Journal of Orthodontics - Dental Press International (DPI)false
dc.title.none.fl_str_mv Side effects of mandibular advancement splints for the treatment of snoring and obstructive sleep apnea: a systematic review
title Side effects of mandibular advancement splints for the treatment of snoring and obstructive sleep apnea: a systematic review
spellingShingle Side effects of mandibular advancement splints for the treatment of snoring and obstructive sleep apnea: a systematic review
Martins,Olivia de Freitas Mendes
Obstructive seep apnea
Adverse effects
Mandibular advancement splints
Systematic review
title_short Side effects of mandibular advancement splints for the treatment of snoring and obstructive sleep apnea: a systematic review
title_full Side effects of mandibular advancement splints for the treatment of snoring and obstructive sleep apnea: a systematic review
title_fullStr Side effects of mandibular advancement splints for the treatment of snoring and obstructive sleep apnea: a systematic review
title_full_unstemmed Side effects of mandibular advancement splints for the treatment of snoring and obstructive sleep apnea: a systematic review
title_sort Side effects of mandibular advancement splints for the treatment of snoring and obstructive sleep apnea: a systematic review
author Martins,Olivia de Freitas Mendes
author_facet Martins,Olivia de Freitas Mendes
Chaves Junior,Cauby Maia
Rossi,Rowdley Robert Pereira
Cunali,Paulo Afonso
Dal-Fabbro,Cibele
Bittencourt,Lia
author_role author
author2 Chaves Junior,Cauby Maia
Rossi,Rowdley Robert Pereira
Cunali,Paulo Afonso
Dal-Fabbro,Cibele
Bittencourt,Lia
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Martins,Olivia de Freitas Mendes
Chaves Junior,Cauby Maia
Rossi,Rowdley Robert Pereira
Cunali,Paulo Afonso
Dal-Fabbro,Cibele
Bittencourt,Lia
dc.subject.por.fl_str_mv Obstructive seep apnea
Adverse effects
Mandibular advancement splints
Systematic review
topic Obstructive seep apnea
Adverse effects
Mandibular advancement splints
Systematic review
description ABSTRACT Introduction: Occlusal side effects or development of pain and/or functional impairment of the temporomandibular complex are potential reasons for poor compliance or abandonment of mandibular advancement splints treatment for snoring and obstructive sleep apnea. Objective: This study aimed at providing a comprehensive review evaluating the craniofacial side effects of oral appliance therapy for snoring and obstructive sleep apnea. Methods: An electronic search was systematically conducted in PubMed and Virtual Health Library from their inception until October 2016. Only Randomized Controlled Trials whose primary aim was to measure objectively identified side effects on craniofacial complex of a custom-made oral appliance for treating primary snoring or obstructive sleep apnea were included. Studied patients should be aged 20 or older. The risk of bias in the trials was assessed in accordance with the recommendations of The Cochrane Risk of Bias criteria. Results: A total of 62 full-text articles were assessed for eligibility. After the review process, only 6 met all the inclusion criteria. All studies were rated as having a high risk of bias. The most uniformly reported mandibular advancement splint side effects were predominantly of dental nature and included a decrease in overjet and overbite. The risk of developing pain and function impairment of the temporomandibular complex appeared limited with long-term mandibular advancement splint use. Conclusion: The limited available evidence suggests that mandibular advancement splint therapy for snoring and obstructive sleep apnea results in changes in craniofacial morphology that are predominantly dental in nature, specially on a long-term basis. Considering the chronic nature of obstructive sleep apnea and that oral appliance use might be a lifelong treatment, a thorough customized follow-up should therefore be undertaken to detect possible side effects on craniofacial complex. It is also important to provide adequate information to the patients regarding these possible changes, especially to those in whom larger occlusal changes are to be expected or in whom they are unfavorable. Long-term assessments of adverse effects of oral appliance therapy, with larger study samples and recruitment of homogenous patient population are still required.
publishDate 2018
dc.date.none.fl_str_mv 2018-08-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2176-94512018000400045
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2176-94512018000400045
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/2177-6709.23.4.045-054.oar
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Dental Press International
publisher.none.fl_str_mv Dental Press International
dc.source.none.fl_str_mv Dental Press Journal of Orthodontics v.23 n.4 2018
reponame:Dental Press Journal of Orthodontics
instname:Dental Press International (DPI)
instacron:DPI
instname_str Dental Press International (DPI)
instacron_str DPI
institution DPI
reponame_str Dental Press Journal of Orthodontics
collection Dental Press Journal of Orthodontics
repository.name.fl_str_mv Dental Press Journal of Orthodontics - Dental Press International (DPI)
repository.mail.fl_str_mv artigos@dentalpress.com.br||davidnormando@hotmail.com
_version_ 1754122398115823616