Mandibular advancement splint (MAS) therapy for obstructive sleep apnoea—an overview and quality assessment of systematic reviews
Abstract
Background To conduct an overview of existing systematic reviews concerning management of obstructive sleep apnoea-hypopnoea syndrome (OSAHS) with mandibular advancement splint (MAS) and assess their methodological quality.Method PubMed and relevant Cochrane Library databases (CDSR, DARE, HTA) searches were performed (09.13) to identify systematic reviews investigating the response of adults with OSAHS to MAS therapy. The methodological quality of the included systematic reviews was assessed using AMSTAR, a validated tool for assessing quality.Results Eight systematic reviews, four incorporating meta-analyses, were identified evaluating both objective and subjective outcome measures. The effectiveness of MAS therapy was compared to no treatment (n = 1), non-active appliance (n = 6), continuous positive airway pressure (CPAP; n = 5), surgical intervention (n = 3) and a different MAS intervention (n = 4). The quality of the reviews was variable (median = 7, range = 3 to 11), with only two of higher quality (AMSTAR scores >10), one of them a Cochrane review. In this high quality and current review, the overall (pooled) effects for comparison of MAS therapy with inactive appliances, revealed significant benefits of MAS therapy in terms of both daytime sleepiness and objective apnoea-hypopnoea index (AHI) outcomes.Conclusion In general, the results from the higher quality reviews concerning the effectiveness of MAS therapy for OSAHS highlight the ability of the intervention to improve OSAHS. Current reporting guidelines for systematic reviews (e.g. PRISMA) and sources of high-quality existing reviews should be closely followed to enhance the validity and relevance of future reviews.
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Johal et al. evaluated eight reviews/clinical practice guidelines comparing oral appliances with different modalities including no treatment and reported variable quality with only two of the systematic reviews being of high quality.
“Johal et al. 16 evaluated eight reviews/clinical practice guidelines comparing OAs with different modalities including no treatment.They reported variable quality with only two of the SRs being of high quality.”
From Quality assessment of systematic reviews on the efficacy of oral appliance therapy for adult and pediatric sleep-disordered breathing (2016) · cites this paper as [16]
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Al-Jewair, T. S., Gaffar, B. O., & Flores-Mir, C. (2016) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.6062 · Cited by 10 · see citing works
- Authors
- Johal, A., Fleming, P. S., Manek, S., & Marinho, V. C. C.
- Affiliations
- Queen Mary University of London (GB)
- Corresponding author
- Johal, Ama
- Venue
- Sleep and Breathing
- Published
- 2015-03-17
- Volume
- 19
- Issue
- 3
- Pages
- 1101-1108
- ISSN
- 1520-9512 (ISSN-L)
- 1522-1709
- OpenAlex
- W1977227406
- Cited by
- 15
- References
- 28
- Citations by year
- 2025: 1 · 2023: 1 · 2022: 1 · 2019: 2 · 2018: 4 · 2017: 2 · 2016: 4
- FWCI
- 0.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Sleep And Breathing (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- mandibular advancement device, obstructive sleep apnea, sleep apnea treatment, oral appliance therapy, methodological quality of systematic reviews, AMSTAR, continuous positive airway pressure, apnea-hypopnea index, daytime sleepiness, reporting guidelines
- MeSH terms
- Adult, Humans, Disorders of Excessive Somnolence, Occlusal Splints, Polysomnography, Mandibular Advancement, Sleep Apnea, Obstructive
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