Keywords
Key points
- •The concept in oral appliances for obstructive sleep apnea (OSA) management is protrusion of the mandible and/or tongue for structural effects on the upper airway.
- •The upper airway is a muscular tube and its dimensions are enlarged with mandibular and tongue advancement.
- •Protrusion of the mandible and tongue stretches the muscles, thereby reducing upper airway collapsibility with airway shape change and increase in muscle tone.
- •Oral appliances are effective and evidence-based options in managing OSA.
Types of oral appliances



Oral appliance effects on airway
Cross-Sectional Area
Other Effects
Collapsibility
Oral appliance effects on obstructive sleep apnea compared with continuous positive airway pressure
Apnea-Hypopnea Index
Oxygenation
Compliance
Subjective Sleepiness
Function and Quality of Life
Cardiovascular Effects
Mortality
Oral appliance adverse effects
Dental Effects
Craniofacial Changes
Temporomandibular Joint Disorders
Other Effects
Predicting and improving oral appliance treatment response
American Sleep Assocociation | sleep apnea oral appliances - research & treatments | 2018. Available at: https://www.sleepassociation.org/sleep-disorders/sleep-apnea/oral-appliance-for-sleep-apnea/. Accessed July 22, 2018.
National Institutes of Health, United States National Library of Medicine, ClinicalTrials.gov. 2018. Available at: https://clinicaltrials.gov/ct2/show/record/NCT01532050. Accessed 26 July, 2018.
Cephalometry
Mandibular Advancement Device Design
Customized versus noncustomized
Titratable versus nontitratable
Therapeutic Diagnosis
Visualizing airway response
Mandibular advancement device titration using polysomnography
Remote-controlled mandibular positioners
- Kastoer C.
- Dieltjens M.
- Oorts E.
- et al.
Combination Therapy
Mandibular advancement device and tongue-stabilizing devices
Mandibular advancement device and continuous positive airway pressure
Practice recommendations
Indications
Contraindications
Appliance Selection
Clinical Follow-up
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Disclosure Statement: The authors declare no conflicts of interest and no funding was received in the preparation of this article.
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