Use of intraoral devices for treatment of obstructive sleep apnea syndrome
https://doi.org/10.51922/2074-5044.2025.2.88
Abstract
The article presents an analysis of literature data on the use and efficacy of intraoral devices in the treatment of obstructive sleep apnea syndrome. The use of intraoral applicators is currently one of the standard techniques, recommended for the conservative treatment of obstructive sleep disordered breathing during sleep. There are two fundamentally different types of intraoral devices by their mechanism of action: acting on the position of the mandible or fixing the tongue. If in the first case, increasing the lumen of the upper airway is achieved by extending the lower jaw, in the second case prevents tongue retraction during sleep. Intraoral devices are characterized by high compliance and patient adherence. Currently, mandibular advancement devices are considered a possible alternative to CIPAP therapy or surgical treatment and are the method of choice for mild to moderate obstructive sleep apnea syndrome. To identify relevant studies we searched in Pubmed, Medline and Cochrane Library, Elibrary, Google Academy databases using key terms related to intraoral devices.Using key terms related to intraoral devices in obstructive sleep apnea syndrome.
About the Authors
N. I. GrebenBelarus
V. L. Chekan
Belarus
G. V. Gudny
Belarus
A. A. Nidelko
Belarus
References
1. Fleetham, J. Ayas, N. Bradley, D. et al. CTS Sleep Disordered Breathing Committee. Canadian Thoracic Society guidelines: diagnosis and treatment of sleep disordered breathing in adults. Can Respir J. 2006 Oct;13(7):387–92.
2. Azarbarzin, A., Sands, S. A., Stone, K. L. et al. The hypoxic burden of sleep apnoea predicts cardiovascular disease-related mortality: the Osteoporotic Fractures in Men Study and the Sleep Heart Health Study. Eur Heart J. 2019 Apr 07;40(14):1149–1157.
3. Mehrtash, M., Bakker, J. P., Ayas, N. Predictors of Continuous Positive Airway Pressure Adherence in Patients with Obstructive Sleep Apnea. Lung. 2019 Apr;197(2):115–121.
4. Ramar, K., Dort, L. C., Katz, S. G. et al. Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015. J Clin Sleep Med. 2015 Jul 15;11(7):773–827.
5. Ferraz, P. D., Francisco, I., Borges, M. I. et al. Pharyngeal Airspace Alterations after Using the Mandibular Advancement Device in the Treatment of Obstructive Sleep Apnea Syndrome. Life (Basel). 2022 Jun 2;12(6):835.
6. Guarda-Nardini, L., Manfredini, D., Mion, M. et al. Anatomically Based Outcome Predictors of Treatment for Obstructive Sleep Apnea with Intraoral Splint Devices: A Systematic Review of Cephalometric Studies. J Clin Sleep Med. 2015 Nov 15;11(11):1327–34.
7. Buzunov, R. V., Legejda, I. V., Careva, E. V. Hrap i sindrom obstruktivnogo apnoje sna u vzroslyh i detej.Prakticheskoe rukovodstvo dlja vrachej. Moscow, 2012.128 p. (In Russ.)
8. Agaltsov, M. V. Ispol’zovanie vnutrirotovyh ustrojstv pri lechenii obstruktivnogo apnoje vo sne i ih vlijanie na serdechno-sosudistuju sistemu. Arterial Hypertension. 2018;24(4):396–405. (In Russ.)
9. Rubnikovich, S. P., Denisova, Ju. L., Baradina, I. N. et al. Primenenie stomatologicheskih vnutrirotovyh ustrojstv dlja lechenija sindroma obstruktivnogo apnoje sna. Stomatologist.2020; 2:8–13. (In Russ.)
10. Nabavi, S, Bhadra, S. Smart Mandibular Advancement Device for Intraoral Monitoring of Cardiorespiratory Parameters and Sleeping Postures. IEEE Trans Biomed Circuits Syst. 2021 Apr;15(2): 248–258.
11. Nikolopoulou, M., Aarab, G., Ahlberg, J. et al. Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnea: A randomized, placebo-controlled trial on temporomandibular side-effects. Clin Exp Dent Res. 2020 Aug;6(4):400–406.
12. Op de Beeck, S., Dieltjens, M., Verbruggen A. E. et al. Phenotypic Labelling Using Drug-Induced Sleep Endoscopy Improves Patient Selection for Mandibular Advancement Device Outcome: A Prospective Study. J Clin Sleep Med. 2019 Aug 15; 15(8):1089–1099.
13. Aarab, G., Nikolopoulou, M., Ahlberg, J. et al. Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnea: a randomized, placebo-controlled trial on psychological distress. Clin Oral Investig. 2017 Sep;21(7): 2371–2378.
14. Doff, M. H., Hoekema, A., Wijkstra, P. J. et al. Oral appliance versus continuous positive airway pressure in obstructive sleep apnea syndrome: a 2-year follow-up. Sleep. 2013; 36:1289–1296.
15. Sharples, L., Glover, M., Clutterbuck-James A. et al. Clinical effectiveness and cost-effectiveness results from the randomised controlled trial of oral mandibular advancement devices for obstructive sleep apnoea-hypopnoea (TOMADO) and long-term economic analysis of oral devices and continuous positive airway pressure. Health Technol Assess. 2014; 18:1–296.
16. Mehta, A., Qian, J., Petocz, P. et al. A randomized, controlled study of a mandibular advancement splint for obstructive sleep apnea. Am J Respir Crit Care Med. 2001;163:1457–61.
17. Hoekema, A., Doff, M. H., de Bont, L. G. et al. Predictors of obstructive sleep apnea-hypopnea treatment outcome. J Dent Res. 2007; 86:1181–6.
18. Liu, Y., Lowe, A. A., Fleetham, J. A., Park, Y. C. Cephalometric and physiologic predictors of the efficacy of an adjustable oral appliance for treating obstructive sleep apnea. Am J Orthod Dentofac Orthop. 2001; 120:639–47.
19. Sutherland, K., Schwab, R. J., Maislin, G. et al. Facial phenotyping by quantitative photography reflects craniofacial morphology measured on magnetic resonance imaging in Icelandic sleep apnea patients. Sleep. 2014;37:959–68.
Review
For citations:
Greben N.I., Chekan V.L., Gudny G.V., Nidelko A.A. Use of intraoral devices for treatment of obstructive sleep apnea syndrome. Military Medicine. 2025;(2):88-96. (In Russ.) https://doi.org/10.51922/2074-5044.2025.2.88
JATS XML