ReviewDeutsches Arzteblatt international2018
Oral Interventions for Obstructive Sleep Apnea.
Review in Deutsches Arzteblatt international, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Extraction of premolars in orthodontic treatment does not negatively affect upper airway volume and minimum cross-sectional area: a systematic review with meta-analysis.European journal of orthodontics · 2025Pooled it
- Are there benefits from using bone-borne maxillary expansion instead of tooth-borne maxillary expansion? A systematic review with meta-analysis.Progress in orthodontics · 2019Pooled it
- Chinese Guidelines for the Diagnosis and Surgical Treatment of Adult Obstructive Sleep Apnea (2024).World journal of otorhinolaryngology - head and neck surgery · 2026Article
- Non-dental Effects of Rapid Maxillary Expansion in Growing Children: A Literature Review.Cureus · 2025Review
- Airway morphology, hyoid position, and serum inflammatory markers of obstructive sleep apnea in children treated with modified twin-block appliances.BMC oral health · 2025Article
- Obstructive Sleep Apnea in Pregnancy and its Impact on Maternal-Fetal Health: A Hidden Threat - Narrative Review.The open respiratory medicine journal · 2025Review
- Obstructive Sleep Apnea and Stroke: Determining the Mechanisms Behind their Association and Treatment Options.Translational stroke research · 2024Review
- Pediatric Obstructive Sleep Apnea Syndrome: Emerging Evidence and Treatment Approach.TheScientificWorldJournal · 2021Review
- Orthopedic Treatment for Class II Malocclusion with Functional Appliances and Its Effect on Upper Airways: A Systematic Review with Meta-Analysis.Journal of clinical medicine · 2020Review
- Update on oral appliance therapy.European respiratory review : an official journal of the European Respiratory Society · 2019Review
- Obstructive sleep apnea in adults.Dental press journal of orthodontics · 2019Review
- False Comparison, and Interdisciplinary Approach Is Lacking.Deutsches Arzteblatt international · 2018Article
- In Reply.Deutsches Arzteblatt international · 2018Article
Corrections and comments
- Commented on by
- Commented on byIn Reply.2018
Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe effectiveness of intraoral appliances (IOA), maxillary expansion (ME), and maxillomandibular advancement (MMA) in the treatment of children and adults with obstructive sleep apnea (OSA) has not yet been adequately assessed.
methodsAn umbrella review was performed based on established guidelines for evidence-based medicine. Data synthesis was performed only from randomized controlled trials with Paule-Mandel random-effects meta-analyses / meta-regressions using mean differences (MDs) and 95% confidence intervals (CIs) and was followed by the qualitative evaluation of the meta-evidence.
results29 systematic reviews were included, 7 of which provided quantitative data. IOA were effective in improving apnea hypopnea index (AHI) compared to both, placebo appliances (12 trials; 525 patients; MD = -11.70; 95% CI: [-15.38; -8.01]; p<0.001) and no treatment (1 trial; 24 patients; MD = -14.30; [-21.59; -7.01]; p<0.001). Only the former comparison was supported by robust meta-evidence. Effectiveness of IOA as measured by the Epworth Sleepiness Scale, on the other hand, was not supported by robust meta-evidence. No randomized or prospective controlled trials were found on the effectiveness of ME (conventional or surgically assisted) and MMA.
conclusionIntraoral appliances are effective in reducing AHI and their use is substantiated by robust evidence. There is no evidence from high-quality research to support treatment with ME (conventional or surgically assisted) or MMA in patients with OSA.
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.