The DOI matches its Crossref record; 97 of the 101 references it cites were found in a registry or an index.
Oral appliances and functional orthopaedic appliances for obstructive sleep apnoea in children
Open accessAbstract
BACKGROUND: Apnoea is a breathing disorder marked by the absence of airflow at the nose or mouth. In children, risk factors include adenotonsillar hypertrophy, obesity, neuromuscular disorders and craniofacial anomalies. The most common treatment for obstructive sleep apnoea syndrome (OSAS) in childhood is adeno-tonsillectomy. This approach is limited by its surgical risks, mostly in children with comorbidities and, in some patients, by recurrence that can be associated with craniofacial problems. Oral appliances and functional orthopaedic appliances have been used for patients who have OSAS and craniofacial anomalies because they hold the lower jaw (mandible) forwards which potentially enlarges the upper airway and increases the upper airspace, improving the respiratory function. OBJECTIVES: To assess the effects of oral appliances or functional orthopaedic appliances for obstructive sleep apnoea in children. SEARCH METHODS: We searched the following electronic databases: Cochrane Oral Health's Trials Register (to 7 April 2016); Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 3) in the Cochrane Library (searched 7 April 2016); MEDLINE Ovid (1946 to 7 April 2016); Embase Ovid (1980 to 7 April 2016); LILACS BIREME (from 1982 to 7 April 2016); BBO BIREME (from 1986 to 7 April 2016) and SciELO Web of Science (from 1997 to 7 April 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials on 7 April 2016. We placed no restrictions on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: All randomised or quasi-randomised controlled trials comparing all types of oral and functional orthopaedic appliances with placebo or no treatment, in children 15 years old or younger. PRIMARY OUTCOME: reduction of apnoea to less than one episode per hour. SECONDARY OUTCOMES: dental and skeletal relationship, sleep parameters improvement, cognitive and phonoaudiological function, behavioural problems, quality of life, side effects (tolerability) and economic evaluation. DATA COLLECTION AND ANALYSIS: Two review authors screened studies and extracted data independently. Authors were contacted for additional information. We calculated risk ratios with 95% confidence intervals for all important dichotomous outcomes. We assessed the quality of the evidence of included studies using GRADEpro software. MAIN RESULTS: The initial search identified 686 trials. Only one trial, reporting the results from a total of 23 children and comparing an oral appliance to no treatment, was suitable for inclusion in the review. The trial assessed apnoea-hypopnoea, daytime symptoms (sleepiness, irritability, tiredness, school problems, morning headache, thirstiness in the morning, oral breathing and nasal stuffiness) and night-time symptoms (habitual snoring, restless sleep and nightmares measured by questionnaire). Results were inconsistent across outcomes measures and time points. The evidence was considered very low quality. AUTHORS' CONCLUSIONS: There is insufficient evidence to support or refute the effectiveness of oral appliances and functional orthopaedic appliances for the treatment of obstructive sleep apnoea in children. Oral appliances or functional orthopaedic appliances may be considered in specified cases as an auxiliary in the treatment of children who have craniofacial anomalies which are risk factors for apnoea.
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In the citing paper
“A 2016 Cochrane systematic review compared the course of OSA in children following the use of personalized OAs versus no intervention; however, evidence of OA for treating OSA was insufficient [8].”
From Airway morphology, hyoid position, and serum inflammatory markers of obstructive sleep apnea in children treated with modified twin-block appliances (2025) · cites this paper as [8]
In the citing paper
“In the other 3 studies, 17 20 21 a reduction of at least 50% in the AHI was observed, which was considered as therapeutic success, even if the scores were not within the normal range.”
From Mandibular Advancement Appliances in Pediatric Obstructive Sleep Apnea: An Umbrella Review (2023) · cites this paper as [20]
In the citing paper
“A significant number of children do not respond to adenotonsillectomy, which is still the primary treatment for OSA, and most of them do not tolerate CPAP therapy.”
From Mandibular Advancement Appliances in Pediatric Obstructive Sleep Apnea: An Umbrella Review (2023) · cites this paper as [20]
In the citing paper
“Therefore, functional orthopedic appliances, if correctly prescribed, are well tolerated and are able to increase airway space during sleep, reduce airway collapsibility, and improve muscle tone. 18 20”
From Mandibular Advancement Appliances in Pediatric Obstructive Sleep Apnea: An Umbrella Review (2023) · cites this paper as [20]
In the citing paper
“Many adults begin snoring and experiencing other respiratory disturbances, such as OSA, in childhood; hence, the relevance of early diagnosis and treatment to prevent long-term complications in adult life. These measures also contribute to reduce costs to the healthcare system and improve quality of life. 20”
From Mandibular Advancement Appliances in Pediatric Obstructive Sleep Apnea: An Umbrella Review (2023) · cites this paper as [20]
In the citing paper
“They are able to increase upper airway space, reduce airway collapsibility, and improve muscle tone. 18 20”
From Mandibular Advancement Appliances in Pediatric Obstructive Sleep Apnea: An Umbrella Review (2023) · cites this paper as [20]
In the citing paper
“Although adenotonsillectomy is widely performed to treat pediatric OSA around the world, recurrence is very common, particularly in children with skeletal deformities, such as mandibular retrognathia, maxillary constriction, or both. 20”
From Mandibular Advancement Appliances in Pediatric Obstructive Sleep Apnea: An Umbrella Review (2023) · cites this paper as [20]
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Citations
Cites
1 retracted
Guilleminault, C., Quo, S. D., Huynh, N. T., & Li, K. K. (2008) · SLEEP · doi:10.5665/sleep/31.7.953 · Cited by 56
RetractedThe Measurement of Observer Agreement for Categorical Data
Landis, J. R., & Koch, G. G. (1977) · Biometrics · doi:10.2307/2529310 · Cited by 81,148
Bias in meta-analysis detected by a simple, graphical test
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997) · BMJ · doi:10.1136/bmj.315.7109.629 · Cited by 56,722
Moher, D., Schulz, K. F., & Altman, D. G. (2001) · The Lancet · doi:10.1016/s0140-6736(00)04337-3 · Cited by 5,373
Improving the Quality of Reporting of Randomized Controlled Trials: The CONSORT Statement
Begg, C. (1996) · JAMA · doi:10.1001/jama.1996.03540080059030 · Cited by 3,127
Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome
Marcus, C. L., Brooks, L. J., Draper, K. A., Gozal, D., Halbower, A. C., Jones, J., Schechter, M. S., Sheldon, S. H., Spruyt, K., Ward, S. D., et al. (2012) · Pediatrics · doi:10.1542/peds.2012-1671 · Cited by 2,432
Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome
Marcus, C. L., Brooks, L. J., Ward, S. D., Draper, K. A., Gozal, D., Halbower, A. C., Jones, J. E., Lehmann, C. U., Schechter, M. S., Sheldon, S. H., et al. (2012) · PEDIATRICS · doi:10.1542/peds.2012-1672 · Cited by 1,710
Published by John Wiley & Sons Ltd
Modarresi, O. A. F., & Shakibaie, M. M. M. R. (2015) · Cited by 1,111
Clinical Practice Guideline: Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome
Pulmonology, S. O. P. (2002) · PEDIATRICS · doi:10.1542/peds.109.4.704 · Cited by 930
Normal Polysomnographic Values for Children and Adolescents
Marcus, C. L., Omlin, K. J., Basinki, D. J., Bailey, S. L., Rachal, A. B., von Pechmann, W. S., Keens, T. G., & Ward, S. L. D. (1992) · American Review of Respiratory Disease · doi:10.1164/ajrccm/146.5_pt_1.1235 · Cited by 808
Flagged first, then by citations
4 of the 101 references couldn’t be matched to a known paper.
Research works printed but not linked: 4
- Nunes Junior, 2011, Snoring children treatment with orthodontic and orthopedic appliance - randomized clinical trial, Sleep & Breathing, 15, 257
- Bell, 2001, Skeletal advancement for the treatment of obstructive sleep apnea, The Cleft Palate-Craniofacial Journal, 38, 147, 10.1597/1545-1569_2001_038_0147_saftto_2.0.co_2 · DOI
- Carrol, 1995, Obstructive sleep apnea syndrome in infants and children: diagnosis and management, 193
- Guilleminault, 2008, Orthodontic expansion treatment and adenotonsillectomy in the treatment of obstructive sleep apnea in prepubertal children, Sleep, 31, 953-7 [Erratum
Cited by
Sorted by citations
Items 101–126 of 126
CPAP Adherence in Children with Special Health-Care Needs
McLaren-Barnett, A., & Narang, I. (2022) · Springer eBooks · doi:10.1007/978-3-030-93146-9_26 · Cited by 1
Ramirez, K. J. D. F., Koecklin, K. H. U., Dulanto-Vargas, J. A., & Carranza-Samanez, K. M. (2025) · Journal of international oral health · doi:10.4103/jioh.jioh_159_24 · Cited by 1
Guilleminault, C., Hervy-Auboiron, M., Huang, Y., Li, K. K., & Amat, P. (2019) · L Orthodontie Française · doi:10.1051/orthodfr/2019038 · Cited by 1
Wijk, L. Z. (2008) · Figshare · Cited by 1
Unveiling and Managing Upper Airway Problems in the Orthodontic Patient
Yow, M., Koh, H. L., & Loh, S. R. H. (2023) · Wiley eBooks · doi:10.1002/9781119870081.ch11 · Cited by 1
Martínez-Font, J., Segarra, I. S., & de Luxán, S. A. (2011) · Revista española de ortodoncia
Obstruktive Schlafapnoe bei Kindern und Jugendlichen
Rose, E. C. (2015) · wissen kompakt · doi:10.1007/s11838-015-0006-3
Atkins, C. S. (2013) · UKnowledge (University of Kentucky)
Obstructive Sleep Apnea: Orthodontic Strategies to Establish and Maintain a Patent Airway
Yow, M., & Weng, E. L. K. (2012) · Wiley eBooks · doi:10.1002/9781118702901.ch13
Les revues systématiques Cochrane en orthodontie
Delière, M., Yan-Vergnes, W., Hamel, O., Marchal-Sixou, C., & Vergnes, J. (2010) · International Orthodontics · doi:10.1016/j.ortho.2010.07.013
Obstructive sleep apnoea syndrome in children
Maltrana-García, J. A., Uali-Abeida, M. E., Pérez-Delgado, L., Leza, I. A., Vicente-González, E. A., & García, A. O. (2009) · Acta Otorrinolaringologica (English Edition) · doi:10.1016/s2173-5735(09)70130-9
Obstruktive Schlafapnoe bei Kindern und Jugendlichen
Jung, B. (2015)
Ventilator Support in Children with Obstructive Sleep Apnea Syndrome
Nandalike, K., & Arens, R. (2016) · Respiratory medicine · doi:10.1007/978-1-4939-3749-3_13
Dentofacial Morphology in Obese and Non-Obese Children With and Without Obstructive Sleep Apnea
Simone, D. J. (2016) · TSpace (University of Toronto)
Georgiou, A. N., Cameron, A. C., & Balasubramaniam, R. (2018) · Springer eBooks · doi:10.1007/978-3-319-28100-1_25-1
American Thoracic Society 2019 Pediatric Core Curriculum
Moore, P. E., Boyer, D. M., Perkins, R. C., Katz, E. S., Castro‐Codesal, M. L., MacLean, J. E., Akil, N., Esther, C. R., Kaslow, J. A., Lewis, T. C., et al. (2019) · Pediatric Pulmonology · doi:10.1002/ppul.24482
de Jong-Verhoeff, J., Neven, A. K., Eekhof, J. A., & Kemper, J. (2010) · Huisarts en Wetenschap · doi:10.1007/s12445-010-0066-8
Neven, A. K., & Kruis, A. L. (2021) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-368-2739-3_85
Diagnosis and treatment of obstructive sleep apnea
Salamah, F. S. B., Alfayez, H. M. A., & Melibary, R. T. (2022) · International Journal of Community Medicine and Public Health · doi:10.18203/2394-6040.ijcmph20220016
(2018) · Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie · doi:10.1007/s00056-018-0152-2
Xu, Z., & Wu, Y. (2022) · Springer eBooks · doi:10.1007/978-981-19-5791-8_7
Obstructive sleep apnea in adolescents
Teplitzky, T. B. (2024) · Elsevier eBooks · doi:10.1016/b978-0-323-99653-2.00032-8
Treatment of Children with Obstructive Sleep Apnea Syndrome
Perez, I. A., & Ward, S. D. (2024) · Elsevier eBooks · doi:10.1016/b978-0-323-75566-5.00034-4
Treatment of Pediatric Sleep Apnea, a Critical Look at the Problem (literature review)
Дрогомирецька, М. С., & Gergel, I. (2025) · SUCHASNA STOMATOLOHIYA · doi:10.33295/1992-576x-2025-1-95
Kortge, X., Collaro, A., Idris, G., Slee, N., Phua, Y. S., & Chawla, J. (2025) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000011375
Metadata
- Authors
- Carvalho, F. R., Lentini-Oliveira, D. A., Prado, L. B., Prado, G. F., & Carvalho, L. B.
- Affiliations
- Universidade Federal de São Paulo (BR)
- Universidade Federal de São Paulo; Department of Neurology; Rua Claudio Rossi,394 São Paulo São Paulo Brazil 01547-000
- Venue
- Cochrane Database of Systematic Reviews
- Publisher
- Wiley
- Published
- 2016-10-04
- Volume
- 2016
- Issue
- 11
- Pages
- CD005520-CD005520
- ISSN
- 1361-6137 (ISSN-L)
- 1465-1858
- PMC
- PMC6458031
- OpenAlex
- W1572240561
- Cited by
- 127
- References
- 101
- Citations by year
- 2025: 8 · 2024: 7 · 2023: 8 · 2022: 13 · 2021: 13 · 2020: 3 · 2019: 13 · 2018: 8 · 2017: 5 · 2016: 10
- FWCI
- 1.41
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cochrane Database of Systematic Reviews (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Health Sciences › Dentistry › Orthodontics › Orthodontics and Dentofacial Orthopedics
- Health Sciences › Dentistry › Oral Surgery › Temporomandibular Joint Disorders
- Keywords
- obstructive sleep apnea, children, oral appliances, mandibular advancement, craniofacial anomalies, adenotonsillar hypertrophy, sleep parameters, cognitive function, behavioral problems, quality of life, treatment tolerability, economic evaluation, conservative treatment, adenotonsillectomy
- MeSH terms
- Adolescent, Child, Humans, Orthodontic Appliances, Orthotic Devices, Randomized Controlled Trials as Topic, Sleep Apnea, Obstructive
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