Vol. 15 No. 1 (2023)
Revisión sistemática

Efectos secundarios de los dispositivos de avance mandibular en pacientes adultos con apnea obstructiva del sueño: Revisión sistemática de revisiones sistemáticas.

PDF (Español (España))
  • María de Jesús Castro Salazar,
  • Valentina Fuenmayor Macrobio
María de Jesús Castro Salazar
Ortodoncista, practica privada
Valentina Fuenmayor Macrobio
Ortodoncista, practica privada

Published 2023-12-23

Keywords

  • Mandibular advancement device,
  • Obstructive sleep apnea,
  • Orthodontic appliances,
  • Corrective orthodontics,
  • Mandibular thruster

How to Cite

Castro Salazar, M. de J., & Fuenmayor Macrobio, V. (2023). Efectos secundarios de los dispositivos de avance mandibular en pacientes adultos con apnea obstructiva del sueño: Revisión sistemática de revisiones sistemáticas. IDental, 15(1). Retrieved from https://revistas.ulacit.ac.cr/index.php/iDental/article/view/102

Copyright (c) 2023 iDental

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Downloads

Download data is not yet available.

Abstract

Objective: Mandibular advancement devices are widely used for the treatment of obstructive sleep apnea; therefore, it is important to know all the possible side effects they may generate. The aim of this study is to perform a systematic review of systemic reviews investigating the main dental, skeletal, TMJ and wear-related side effects caused by mandibular advancement devices used to treat obstructive sleep apnea in adult patients.

Methods: A search was performed in Pubmed and Scopus databases, between 2012 and 2022, in Spanish and English. The PICOT research strategy was (P) adult patients diagnosed with OSA using (I) Mandibular Advancement Devices as a form of treatment for OSA, (C) no treatment or placebo, (O) dental, skeletal, TMJ and wearing adverse effects, (T) systematics reviews and metanalysis. The quality classification tool used was AMSTAR2.

Results: Six systematic reviews were included, four of which were of medium quality and two of low quality. Three corresponded to systematic reviews and meta-analyses, and three to systematic reviews. The total number of participants was 49,983. Among the main findings the most studied were the side effects at the dental level, being proinclination of lower incisors.

Conclusion: The most common side effects at the dental level were proinclination of the lower incisors, reduction of the vertical and horizontal overbite, and at the skeletal level, reduction of the ANB angle.

PDF (Español (España))

References

  1. Alessandri-Bonetti, G., D’Antò, V., Stipa, C., Rongo, R., Incerti-Parenti, S., & Michelotti, A. (2017). Dentoskeletal effects of oral appliance wear in obstructive sleep apnoea and snoring patients. European Journal of Orthodontics, 39(5), 482–488. https://doi.org/10.1093/ejo/cjw078
  2. Bartolucci, M. L., Bortolotti, F., Corazza, G., Incerti Parenti, S., Paganelli, C., & Alessandri Bonetti, G. (2021). Effectiveness of different mandibular advancement device designs in obstructive sleep apnoea therapy: A systematic review of randomised controlled trials with meta-analysis. Journal of Oral Rehabilitation, 48(4), 469–486. https://doi.org/10.1111/joor.13077
  3. Bartolucci, M. L., Bortolotti, F., Martina, S., Corazza, G., Michelotti, A., & Alessandri-Bonetti, G. (2019). Dental and skeletal long-term side effects of mandibular advancement devices in obstructive sleep apnea patients: a systematic review with meta-regression analysis. European Journal of Orthodontics, 41(1), 89–100. https://doi.org/10.1093/ejo/cjy036
  4. Bartolucci, M. L., Bortolotti, F., Raffaelli, E., D’Antò, V., Michelotti, A., & Alessandri Bonetti, G. (2016). The effectiveness of different mandibular advancement amounts in OSA patients: a systematic review and meta-regression analysis. Sleep & Breathing = Schlaf & Atmung, 20(3), 911–919. https://doi.org/10.1007/s11325-015-1307-7
  5. Dispositivos de avance mandibular (DAM) en el tratamiento del SAHS. (2005). Archivos de Bronconeumología, 41, 68–74. https://doi.org/10.1016/S0210-5705(09)71003-9
  6. Fritsch, K. M., Iseli, A., Russi, E. W., & Bloch, K. E. (2001). Side effects of mandibular advancement devices for sleep apnea treatment. American Journal of Respiratory and Critical Care Medicine, 164(5), 813–818. https://doi.org/10.1164/ajrccm.164.5.2003078
  7. Gao, Y.-N., Wu, Y.-C., Lin, S.-Y., Chang, J. Z.-C., & Tu, Y.-K. (2019). Short-term efficacy of minimally invasive treatments for adult obstructive sleep apnea: A systematic review and network meta-analysis of randomized controlled trials. Journal of the Formosan Medical Association = Taiwan Yi Zhi, 118(4), 750–765. https://doi.org/10.1016/j.jfma.2018.02.008
  8. Guimarães, T. M., Poyares, D., Oliveira E Silva, L., Luz, G., Coelho, G., Dal Fabbro, C., Tufik, S., & Bittencourt, L. (2021). The treatment of mild OSA with CPAP or mandibular advancement device and the effect on blood pressure and endothelial function after one year of treatment. Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine, 17(2), 149–158. https://doi.org/10.5664/jcsm.8822
  9. Incerti Parenti, S., Aroni, E., Laffranchi, L., Paganelli, C., & Alessandri-Bonetti, G. (2020). The effectiveness of mandibular advancement devices in the treatment of obstructive sleep apnoea in adults: a methodological quality assessment of systematic reviews. European Journal of Orthodontics, 42(5), 483–493. https://doi.org/10.1093/ejo/cjz065
  10. Jonas, D. E., Amick, H. R., Feltner, C., Weber, R. P., Arvanitis, M., Stine, A., Lux, L., & Harris, R. P. (2017). Screening for Obstructive Sleep Apnea in Adults: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA, 317(4), 415–433. https://doi.org/10.1001/jama.2016.19635
  11. Liu, S. Y.-C., Huon, L.-K., Powell, N. B., Riley, R., Cho, H. G., Torre, C., & Capasso, R. (2015). Lateral Pharyngeal Wall Tension After Maxillomandibular Advancement for Obstructive Sleep Apnea Is a Marker for Surgical Success: Observations From Drug-Induced Sleep Endoscopy. Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons, 73(8), 1575–1582. https://doi.org/10.1016/j.joms.2015.01.028
  12. Martins, O. de F. M., Chaves Junior, C. M., Rossi, R. R. P., Cunali, P. A., Dal-Fabbro, C., & Bittencourt, L. (2018). Side effects of mandibular advancement splints for the treatment of snoring and obstructive sleep apnea: a systematic review. Dental Press Journal of Orthodontics, 23(4), 45–54. https://doi.org/10.1590/2177-6709.23.4.045-054.oar
  13. Oral appliances for obstructive sleep apnea: an evidence-based analysis. (2009). Ontario Health Technology Assessment Series, 9(5), 1–51.
  14. Patel, S., Rinchuse, D., Zullo, T., & Wadhwa, R. (2019). Long-term dental and skeletal effects of mandibular advancement devices in adults with obstructive sleep apnoea: A systematic review. International Orthodontics, 17(1), 3–11. https://doi.org/10.1016/j.ortho.2019.01.004
  15. Shea, B. J., Reeves, B. C., Wells, G., Thuku, M., Hamel, C., Moran, J., Moher, D., Tugwell, P., Welch, V., Kristjansson, E., & Henry, D. A. (2017). AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ (Online), 358, 1–9. https://doi.org/10.1136/bmj.j4008
  16. Sivaramakrishnan, G., & Sridharan, K. (2017). A systematic review on the effectiveness of titratable over nontitratable mandibular advancement appliances for sleep apnea. Journal of Indian Prosthodontic Society, 17(4), 319–324. https://doi.org/10.4103/jips.jips_115_17
  17. Tsolakis, I. A., Palomo, J. M., Matthaios, S., & Tsolakis, A. I. (2022). Dental and Skeletal Side Effects of Oral Appliances Used for the Treatment of Obstructive Sleep Apnea and Snoring in Adult Patients-A Systematic Review and Meta-Analysis. Journal of Personalized Medicine, 12(3). https://doi.org/10.3390/jpm12030483