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Cited by 127Obstructive Sleep Apnea ResearchOrthodontics and Dentofacial OrthopedicsTemporomandibular Joint Disorders

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

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Carvalho, Fernando R, Lentini-Oliveira, Débora A, Prado, Lucila BF, Prado, Gilmar F, Carvalho, Luciane BC·2016·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd005520.pub3PMC PMC6458031
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Abstract

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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Research works printed but not linked: 4

  1. Nunes Junior, 2011, Snoring children treatment with orthodontic and orthopedic appliance - randomized clinical trial, Sleep & Breathing, 15, 257
  2. 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
  3. Carrol, 1995, Obstructive sleep apnea syndrome in infants and children: diagnosis and management, 193
  4. Guilleminault, 2008, Orthodontic expansion treatment and adenotonsillectomy in the treatment of obstructive sleep apnea in prepubertal children, Sleep, 31, 953-7 [Erratum

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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
ORCID
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
DOI
10.1002/14651858.cd005520.pub3
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
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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