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mandibular advance device

Indications: - obstructive sleep apnea (OSA) Procedure: - advancement of tongue or mandible anteriorly Clinical significance: - objective benefit in 50% of patients with moderate OSA - greater patient satisfaction than CPAP - almost as effective as CPAP [1] - often better tolerated than CPAP [2] - CPAP & mandibular advance devices affer similar reductions in blood pressure systolic BP (-2.5 mm Hg), diastolic BP (-2.0 mm Hg) [4] - reduction in the apnea-hypopnea index [5]

General

device (medical device)

References

  1. Holley AB et al. Efficacy of an adjustable oral appliance and comparison with continuous positive airway pressure for the treatment of obstructive sleep apnea syndrome. Chest 2011 Dec; 140:1511 PMID: 21636666
  2. Phillips CL et al. Health outcomes of continuous positive airway pressure versus oral appliance treatment for obstructive sleep apnea: A randomized controlled trial. Am J Respir Crit Care Med 2013 Apr 15; 187:879 PMID: 23413266
  3. Qaseem A et al Management of Obstructive Sleep Apnea in Adults: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. Published online 24 September 2013 PMID: 24061345 http://annals.org/article.aspx?articleid=1740756
  4. Bratton DJ et al CPAP vs Mandibular Advancement Devices and Blood Pressure in Patients With Obstructive Sleep ApneaA Systematic Review and Meta-analysis. JAMA. 2015;314(21):2280-2293 PMID: 26624827 http://jama.jamanetwork.com/article.aspx?articleid=2473494
  5. Zaghi S et al. Maxillomandibular advancement for treatment of obstructive sleep apnea: A meta-analysis. JAMA Otolaryngol Head Neck Surg 2015 Nov 25 PMID: 26606321