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Management of sleep apnea: a critical look at intra‐oral appliances
Author(s) -
Conley R. S.
Publication year - 2015
Publication title -
orthodontics and craniofacial research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.664
H-Index - 55
eISSN - 1601-6343
pISSN - 1601-6335
DOI - 10.1111/ocr.12071
Subject(s) - oral appliance , medicine , obstructive sleep apnea , intensive care medicine , narrative review , sleep apnea , randomized controlled trial , systematic review , medline , dentistry , surgery , anesthesia , political science , law
With so many disciplines of both medicine and dentistry involved in the treatment of obstructive sleep apnea ( OSA ), several forms of therapy are available. The orthodontist is rarely considered when the diagnosis of chronic obstructive sleep apnea ( OSA ) is delivered. However, the scope of orthodontic care today is much broader than the mere alignment of teeth. While the current gold standard for OSA care remains continuous positive air pressure ( CPAP ), the patient may be given a prescription for an intra‐oral sleep appliance. When orthodontists work in concert with their medical colleagues to provide a sleep appliance, several considerations must be made including the evidence regarding oral appliance efficacy. For some patients, oral appliances are highly successful; however, even for responsive patients, there are risks associated with oral appliance therapy. The aim of the paper was to present a critical review of the current level of evidence for the use of oral appliances in the treatment of OSA . A substantial number of publications ranging from case reports, uncontrolled and controlled case series, prospective randomized studies, and even a small number of systematic reviews were available. The existing systematic reviews were based on either a limited number of prospective studies with limited numbers of patients or in some cases were based on subjective data only. As a result, a narrative review of the literature was performed that discusses objective clinically testable criteria and recent developments that may aid future research investigations.