Systematic Review of Oral Appliances in the Treatment of Pediatric Obstructive Sleep Apnea

Objectives: (1) To conduct a systematic review to evaluate the quality of the existing literature and research on oral appliances to treat children with obstructive sleep apnea, and (2) to perform a meta-analysis on this research to summarize the highest quality evidence on the efficacy of such appliances. Methods: Covidence^TM software was utilized to import a total of 2278 references from 8 databases including Cochrane, DOSS, Embase, Google Scholar, Ovid MEDLINE, PubMed, Scopus, and Web of Science in August 2023^43. Studies were screened for population (children and adolescents up to 18 years old) treated and intervention (mandibular oral appliances or nonsurgical treatments). Duplicate studies were excluded as well as those involving adult patients (>18 years of age), and patients treated with surgical therapy. All abstracts were screened by three independent reviewers. Data extraction was completed on 63 articles. Types of articles included in the review were systematic reviews and meta-analyses, randomized and nonrandomized clinical trials, and cohort studies. Studies that satisfy the inclusion criteria underwent quality assessment, using the JBI Critical Appraisal tools and checklists. An assessment for risk bias was conducted using Risk of Bias Visualization Tool (Robvis). Statistical analysis of apnea hypopnea index (AHI) and oxygen saturation (SaO2) and a meta-analysis of eligible studies were conducted using SPSS software. Results: Ten clinical studies (cohort/RCT/NRCT) and seven systematic reviews were included in the review and satisfied the inclusion criteria. A cohort study by Remy et al in 2022 showed that AHI significantly decreased, with a greater proportion in the younger age group (6-7). All experimental groups of the existing studies in the analysis demonstrated a decrease in AHI (-0.77) compared to the control group (0.31), except Machado et al (2016), and an overall increase in SaO2 (0.18) with the use of oral appliances. Conclusion: Oral appliances are a viable treatment option for children with OSA. Literature in the topic is limited by the number of high-quality studies, with small sample sizes. Further clinical research needs to be conducted to produce quality studies that support the use of oral appliances in children.

Name thesis:degree_name

Master of Science

Discipline thesis:degree_discipline

Oral Biology

Grantor

Texas A&M University

Year dc:date.issued

2025

Author dc:creator

• Newton, Margaret Erin 1995-

Advisor dc:contributor.advisor

• Schneiderman, Emet

Committee member dc:contributor.committeemember

• Kesterke, Matthew

• Health Sciences, Dentistry

Language dc:language.iso

English

Handle dc:identifier.uri

https://hdl.handle.net/1969.1/1599064

OAI record oai:identifier

https://oaktrust.library.tamu.edu/server/oai/request?verb=GetRecord&metadataPrefix=dim&identifier=oai%3Aoaktrust.library.tamu.edu%3A1969.1%2F1599064