The Efficacy of Device Designs (Mono-block or Bi-block) in Oral Appliance Therapy for Obstructive Sleep Apnea Patients: A Systematic Review and Meta-Analysis

Hiroyuki Ishiyama, Daichi Hasebe, Kazumichi Sato, Yuki Sakamoto, Akifumi Furuhashi, Eri Komori and Hidemichi Yuasa
Additional contact information
Hiroyuki Ishiyama: Orofacial Pain Management, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima Bunkyo-ku, Tokyo 1138510, Japan
Daichi Hasebe: Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-Dori, Cyuo-ku, Nigata-shi, Nigata 9518514, Japan
Kazumichi Sato: Department of Oral Medicine, Oral and Maxillofacial Surgery, Tokyo Dental College, 5-11-13 Sugano Ichikawa-shi, Chiba 2728513, Japan
Yuki Sakamoto: Department of Oral Surgery, Hironokogen Hospital, 3-1-1 Kitayamadai Nishi-ku Kobe-shi, Hyogo 6512215, Japan
Akifumi Furuhashi: Department of Oral and Maxillofacial Surgery, Aichi Medical University, 1-1 Yazakokarimata Nagakute-shi, Aichi 4801103, Japan
Eri Komori: Division of Medicine for Function and Morphology of Sensor Organ, Dentistry and Oral Surgery, Osaka Medical College, 2-7 Daigaku-machi Takatsuki-shi, Osaka 5698686, Japan
Hidemichi Yuasa: Department of Oral and Maxillofacial Surgery, National Hospital Organization Toyohashi Medical Center, 50 Imure-chou Aza Hamamichi-Ue, Toyohashi-shi, Aichi 4408510, Japan

IJERPH, 2019, vol. 16, issue 17, 1-15

Abstract: Oral appliance (OA m ) therapy has demonstrated efficacy in treating obstructive sleep apnea (OSA). The aim of this systematic review was to clarify the efficacy of device designs (Mono-block or Bi-block) in OA m therapy for OSA patients. We performed a meta-analysis using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. Two studies (Mono-block OA m versus Bi-block OA m ) remained eligible after applying the exclusion criteria. When comparing Mono-block OA m and Bi-block OA m , Mono-block OA m significantly reduced the apnea–hypopnea index (2.92; 95% confidence interval (95%CI), 1.26 to 4.58; p = 0.0006), and patient preference for Mono-block OA m was significantly higher (2.06; 95%CI, 1.44 to 2.06; p < 0.0001). Lowest SpO 2 , arousal index, non-REM stage 3, sleep efficiency, Epworth Sleepiness Scale (ESS), Snoring Scale, and side effects were not significantly different between the two groups (lowest SpO 2 : −11.18; 95%CI, −26.90 to 4.54; p = 0.16, arousal index: 4.40; 95%CI, −6.00 to 14.80; p = 0.41, non-REM stage 3: −2.00; 95%CI, −6.00 to 14.80; p = 0.41, sleep efficiency: −1.42, 95%CI, −4.71 to 1.86; p = 0.40, ESS: 0.12; 95%CI, −1.55 to 1.79; p = 0.89, Snoring Scale: 0.55; 95%CI, −0.73 to 1.83, p = 0.55, side effects: 1.00, 95%CI, 0.62 to 1.61, p = 1.00). In this systematic review, the use of Mono-block OA m was more effective than Bi-block OA m for OSA patients.

Keywords: obstructive sleep apnea; oral appliance; systematic review; mono-block; bi-block (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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