ArticleThorax1999
Mandibular advancement oral appliance therapy for obstructive sleep apnoea: effect on awake calibre of the velopharynx.
Article in Thorax, 1999. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
52 citing papers in PubMed, 235 citations in OpenAlex.
- Comparisons of the effects of two types of titratable mandibular advancement devices on respiratory parameters and upper airway dimensions in patients with obstructive sleep apnea: a randomized controlled trial.Clinical oral investigations · 2023Trial
- Functional imaging improves patient selection for mandibular advancement device treatment outcome in sleep-disordered breathing: a prospective study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Trial
- Efficacy of uvulopalatopharyngoplasty combined with oral appliance in treatment of obstructive sleep apnea-hypopnea syndrome.Irish journal of medical science · 2015Trial
- A promising concept of combination therapy for positional obstructive sleep apnea.Sleep & breathing = Schlaf & Atmung · 2015Trial
- Effects of varying mandibular protrusion and degrees of vertical opening on upper airway dimensions in apneic dentate subjects.Journal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie · 2015Trial
- Trial
- Objective measurement of compliance during oral appliance therapy for sleep-disordered breathing.Thorax · 2013Trial
- Comparative effects of two oral appliances on upper airway structure in obstructive sleep apnea.Sleep · 2011Trial
- Mandibular advancement splint titration in obstructive sleep apnoea.Sleep & breathing = Schlaf & Atmung · 2009Trial
- The efficacy of a mandibular advancement splint in relation to cephalometric variables.Sleep & breathing = Schlaf & Atmung · 2002Trial
- Unpredictable results of laser assisted uvulopalatoplasty in the treatment of obstructive sleep apnoea.Thorax · 2000Trial
- Clinical Effectiveness of a Separated-Type Oral Appliance for Obstructive Sleep Apnea in Japanese Patients.Dentistry journal · 2026Article
- Posterior airway changes during and after Herbst appliance treatment.Clinical oral investigations · 2025Article
- Effectiveness of Narval CC™ device in the treatment of obstructive sleep apnea.Sleep medicine: X · 2023Article
- The role of oral appliance therapy in obstructive sleep apnoea.European respiratory review : an official journal of the European Respiratory Society · 2023Review
- Impact of occlusal reconstruction positions on airway dimensions in patients with edentulism and long centric occlusion.BMC oral health · 2023Article
- Oral appliance therapy for obstructive sleep apnea in multiple system atrophy with floppy epiglottis: a case series of three patients.Sleep & breathing = Schlaf & Atmung · 2023Article
- Mandibular advancement reduces pharyngeal collapsibility by enlarging the airway rather than affecting velopharyngeal compliance.Physiological reports · 2023Article
- Multimodal phenotypic labelling using drug-induced sleep endoscopy, awake nasendoscopy and computational fluid dynamics for the prediction of mandibular advancement device treatment outcome: a prospective study.Journal of sleep research · 2022Article
- Mandibular Torus as a New Index of Success for Mandibular Advancement Devices.International journal of environmental research and public health · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe mechanisms of action of oral appliance therapy in obstructive sleep apnoea are poorly understood. Videoendoscopy of the upper airway was used during wakefulness to examine whether the changes in pharyngeal dimensions produced by a mandibular advancement oral appliance are related to the improvement in the severity of obstructive sleep apnoea.
methodsFifteen patients with mild to moderate obstructive sleep apnoea (median (range) apnoea index (AI) 4(0-38)/h, apnoea-hypopnoea index (AHI) 28(9-45)/h) underwent overnight polysomnography and imaging of the upper airway before and after insertion of the oral appliance. Images were obtained in the hypopharynx, oropharynx, and velopharynx at end tidal expiration during quiet nasal breathing in the supine position. The cross sectional area and diameters of the upper airway were measured using image processing software with an intraluminal catheter as a linear calibration.
resultsAI decreased to a median (range) value of 0 (0-6)/h (p<0.01) and AHI to 8 (1-28)/h (p<0.001) following insertion of the oral appliance. The median (95% confidence interval) cross sectional area of the upper airway increased by 18% (3 to 35) (p<0.02) in the hypopharynx and by 25% (11 to 69) (p<0.005) in the velopharynx, but not significantly in the oropharynx. Although in general the shape of the pharynx did not change following insertion of the oral appliance, the lateral diameter of the velopharynx increased to a greater extent than the anteroposterior diameter. Following insertion of the oral appliance the reduction in AHI was related to the increase in cross sectional area of the velopharynx (p = 0.01).
conclusionsA mandibular advancement oral appliance increases the cross sectional area of the upper airway during wakefulness, particularly in the velopharynx. Assuming this effect on upper airway calibre is not eliminated by sleep, mandibular advancement oral appliances may reduce the severity of obstructive sleep apnoea by maintaining patency of the velopharynx, particularly in its lateral dimension.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.