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CC BY-NC-ND 4.0 · Sleep Sci 2023; 16(04): e468-e475
DOI: 10.1055/s-0043-1776747
Review Article

Mandibular Advancement Appliances in Pediatric Obstructive Sleep Apnea: An Umbrella Review

Carolina Cozzi-Machado 
1   Postgraduate Program in Surgical Sciences, Department of Otorhinolaryngology, Head and Neck Surgery, Faculdade de Ciências Médicas (FCM), Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
,
Fátima Rosana Albertini
2   Postgraduate Program in Child and Adolescent Health, Centro de Investigação em Pediatria (CIPED), Faculdade de Ciências Médicas (FCM), Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
,
Silvana Silveira
1   Postgraduate Program in Surgical Sciences, Department of Otorhinolaryngology, Head and Neck Surgery, Faculdade de Ciências Médicas (FCM), Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
,
Almiro José Machado-Júnior
3   Department of Otorhinolaryngology, Head and Neck Surgery, Faculdade de Ciências Médicas (FCM), Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil; Institute of Science and Technology, Universidade Estadual de São Paulo (UNESP), São José dos Campos, SP, Brazil
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Abstract

Introduction Obstructive sleep apnea (OSA) is defined as intermittent partial or complete collapse of the upper airway during sleep. It is a common condition in childhood, with an incidence ranging from 1.2% to 5.7%, and it can harm several aspects of children's life, such as cognitive, metabolic and cardiovascular functions, among others.

There are treatment options, such as adenotonsillectomy, myofunctional therapy, mandibular advancement appliances (MAAs), rapid maxillary expansion, and positive airway pressure devices, but there is still doubt about which method is more suitable for the treatment of OSA in children.

Objective To analyze the effectiveness of MAAs in the treatment of pediatric OSA.

Materials and Methods The search was conducted in August 2021 in different electronic databases, such as PubMed, EBSCO (Dentistry & Oral Sciences Source), LILACS, Ovid, SciELO, Web of Science, EMBASE BIREME, BBO BIREME, and the Cochrane Library.

Results Only three systematic reviews and two meta-analyses were included in the present study. All studies showed improvement in the score on the apnea-hypopnea index after using MAAs in the treatment of pediatric OSA.

Conclusion Although more randomized studies are needed, based on the present umbrella review, MAAs must be considered part of the multidisciplinary treatment for pediatric OSA.

Keywords

mandibular advancement - obstructive sleep apnea - children


Publication History

Received: 16 May 2022

Accepted: 31 January 2023

Article published online:
22 November 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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