What is the role of mandibular repositioning in oral appliance (OA) therapy for obstructive sleep apnea (OSA)?

Updated: Sep 15, 2020
  • Author: Himanshu Wickramasinghe, MD, MBBS; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Treatment success with mandibular repositioners (and with OAs in general) appears to be inversely related to the initial RDI. A growing body of evidence now suggests that the severity of OSA is predictive of the response to OAs.

Most studies that have examined the efficacy of OAs have used mandibular repositioners. However, a 2009 study investigated the effect of TRDs on OSA severity. [189] If ideal treatment is an AHI lower than 5 and no snoring, few patients met that goal. If ideal treatment is an AHI lower than 10, then 31% met that goal. Response variation was wide, with a standard deviation for AHI of 19.5. Two predictors of response were found using multiple regression: age and protrusion distance (mean protrusion, approximately 7±1.5 mm).


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