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MANDIBULAR ADVANCEMENT APPLIANCES IN PEDIATRIC OBSTRUCTIVE SLEEP APNEA: AN UMBRELLA REVIEW
Pediatric obstructive sleep apnea (OSA) is defined as intermittent partial or complete collapse of the upper airway during sleep.
It’s a common condition in childhood with an incidence from 1,2% to 5,7% and that can harm several aspects of children’s life such as cognitive, metabolic and cardiovascular functions, among others.
There are some treatment options such as adenotonsillectomy, myofunctional therapy, mandibular advancement appliances, 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.
The main goal of this umbrella review was to analyze the effectiveness of mandibular advancement appliances (MAA) in obstructive sleep apnea (OSA) treatment in children.
The search was conducted in August 2021 and used several electronic databases, such as: PubMed, EBSCO (Dentistry & Oral Sciences Source), LILACS Ovid, SciELO Web of Science, EMBASE Bireme, BBO Bireme electronic databases and Cochrane Library.
Only three systematic reviews and two meta-analysis were included in this study. All studies showed improvements not only in the airway space, but also in the apnea-hypopnea index (AHI) score, by using MAA in the treatment of OSA in children.
Although there is the need of more randomized studies with larger sample sizes and specific inclusion and exclusion criteria to establish accurate treatment protocols, from this umbrella review, the mandibular advancement appliances must be considered as part of a multidisciplinary treatment for children with OSA.
mandibular advancement, obstructive sleep apnea, children
Unicamp - São Paulo - Brasil
Carolina Cozzi Machado, Fátima Rosana Albertini, Almiro José Machado Junior