Mandibular advancement for obstructive sleep apnoea – ADA-EBD critical summary


This new ADA-EBD critical summary looks at a 2011 systematic review by Pirklbauer et al.   The review compared maxillomandibular advancement (MMA) surgery to conventional continuous positive airway pressure (CPAP) ventilation therapy for reducing signs and symptoms of obstructive sleep apnea syndrome (OSAS)

The summariser highlights that although 39 studies and 1213 patients in total were included there was only one randomised controlled trial. They also considered that this was a review with significant limitations, e.g. only a single database was searched and low quality high bias studies were included.

While the review suggested that MMA is effective the quality of the evidence is poor and short term in nature. There have been previous reviews of this area, including a Cochrane review last updated in 2005 (Dental Elf 26th Oct 2011) and while the summariser noted two more recent studies although both the Varghese and Boyd papers cited are retrospective.


ADA-EBD summary -More research needed on the role of maxillomandibular advancement in the treatment of obstructive sleep apnea syndrome

Pirklbauer K, Russmueller G, Stiebellehner L, Nell C, Sinko K, Millesi G, Klug C. Maxillomandibular advancement for treatment of obstructive sleep apnea syndrome: a systematic review. J Oral Maxillofac Surg. 2011 Jun;69(6):e165-76. doi: 10.1016/j.joms.2011.01.038. Review. PubMed PMID: 21605790.

Dental Elf 26th Oct 2011- Maxillomandibular advancement surgery may be an effective treatment for patients with obstructive sleep apnoea

Varghese R, Adams NG, Slocumb NL, Viozzi CF, Ramar K, Olson EJ. Maxillomandibular advancement in the management of obstructive sleep apnea. Int J Otolaryngol. 2012;2012:373025. doi: 10.1155/2012/373025. Epub 2012 Jan 29. PubMed PMID: 22518154; PubMed Central PMCID: PMC3299305.

Boyd SB, Walters AS, Song Y, Wang L. Comparative effectiveness of maxillomandibular advancement and uvulopalatopharyngoplasty for the treatment of  moderate to severe obstructive sleep apnea. J Oral Maxillofac Surg. 2013 Apr;71(4):743-51. doi: 10.1016/j.joms.2012.10.003. Epub 2012 Dec 6. PubMed PMID:  23219145; PubMed Central PMCID: PMC3604163.

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