Trial reportSleep & breathing = Schlaf & Atmung2020
A stepwise titration protocol for oral appliance therapy in positional obstructive sleep apnea patients: proof of concept.
Trial report in Sleep & breathing = Schlaf & Atmung, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06612008 (Superimposition of Intra-oral Scans in Mandibular Advancement Device), which is not on this map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Superimposition of Intra-oral Scans in Mandibular Advancement Device (MAD) Therapy for Obstructive Sleep Apnea
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Mandibular advancement devices decrease systolic pressure during the day and night in patients with obstructive sleep apnea: A systematic review and meta-analysis.Sleep & breathing = Schlaf & Atmung · 2024Pooled it
- 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
- The South Texas Oral Health Network Study of Practitioners' Approaches to Oral Appliance Therapy Titration for Obstructive Sleep Apnea and Their Impact on Patient Outcomes (PAOSA): Protocol for a Prospective Observational Study.JMIR research protocols · 2026Article
- Mandibular advancement devices in obstructive sleep apnea: diagnostic predictors for treatment response and clinical implications : A retrospective pilot cohort study.Journal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie · 2025Article
- Most Custom Oral Appliances for Obstructive Sleep Apnea Do Not Meet the Definition of Custom.Bioengineering (Basel, Switzerland) · 2025Review
- Different Oral Appliance Designs Demonstrate Different Rates of Efficacy for the Treatment of Obstructive Sleep Apnea: A Review Article.Bioengineering (Basel, Switzerland) · 2025Review
- The development of a novel bidirectional fine-tuning mandibular advancement device.BMC oral health · 2024Article
- Factors associated with treatment adherence to mandibular advancement devices: a scoping review.Sleep & breathing = Schlaf & Atmung · 2023Article
- A Multicenter Prospective Study on the Use of a Mandibular Advancement Device in the Treatment of Obstructive Sleep Apnea.Dentistry journal · 2023Article
- Starting Mandibular Advancement Device Therapy in Patients with Good Protrusive Capacity: A Randomized Pilot Study.Turkish journal of orthodontics · 2023Article
- Innovations in mandibular advancement splint therapy for obstructive sleep apnoea.Frontiers in sleep · 2023Review
- Mandibular Advancement Devices for OSA: An Alternative to CPAP?Pulmonary therapy · 2021Review
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 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIn patients with positional obstructive sleep apnea (POSA), oral appliance therapy (OAT) is among the first-line treatments. The aim of this study was to evaluate the effects of a new standardized stepwise titration protocol for OAT in a group of patients with POSA.
methodsThis was an observational intervention trial. Patients who were previously randomized to the OAT intervention arm of a comparison study comprised the subjects for this study. These patients, who had mild to moderate POSA, were assessed after 3 and 12 months for treatment efficacy, objective adherence by temperature microsensor, and side effects. The titration of OAT was performed using a standardized stepwise titration protocol including advancement levels of 60%, 75%, and 90% of the maximum mandibular protrusion. The optimal advancement level per individual was based on a weighted compromise between efficacy and side effects.
resultsIn total, 36 patients were included and all completed the titration protocol after 3 months. At baseline, the OAT was set at 60% of the maximal mandibular protrusion position. At a 3-month evaluation, the advancement remained at 60% in 16 patients (44%) and reached 75% advancement in 20 patients (56%). Mean apnea-hypopnea index decreased from 12.9 events per hour (9.1-16.7) to 6.9 (3.7-10.3) (P < 0.001), and median objective adherence was 97.4 (61.4-100.00) after 3 months. The 12-month analysis showed consistent results and good OAT tolerance. Six patients (16.7%) terminated OAT and one patient (2.8%) was lost to follow-up.
conclusionsThis standardized stepwise titration protocol for OAT showed good efficacy, good OAT tolerance, and good objective adherence in patients with mild to moderate POSA. Therefore, the protocol is recommended in research projects to improve standardization of methods between studies and in clinical practice for its practical feasibility.
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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.