A carregar...
Publicação
Indicações clínicas e efeitos adversos dos DAM utilizados na SAOS : revisão sistemática
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| 619.29 KB | Adobe PDF |
Autores
Orientador(es)
Resumo(s)
Introdução: A Síndrome de Apneia Obstrutiva do Sono (SAOS) é um distúrbio do sono com elevada prevalência e impacto significativo na saúde geral e na qualidade de vida dos indivíduos afetados. Os Dispositivos de Avanço Mandibular (DAM) constituem uma opção terapêutica para os casos de SAOS leve ou moderada. Esta revisão sistemática tem como principais objetivos: aferir a eficácia clínica destes dispositivos e identificar potenciais efeitos adversos de uma utilização a longo prazo. Material e Métodos: A pesquisa de artigos foi realizada em 3 bases de dados <br/>(PubMed/MEDLINE®, Web of Science® e Cochrane®), tendo por base a questão de investigação PICO: “Os DAM (I) utilizados em pacientes com SAOS (P), quando comparados com outras formas de tratamento (C), apresentam efeitos adversos superiores e indicações clínicas específicas (O)?”. Definidos os critérios de inclusão/exclusão, e seguindo as diretrizes PRISMA, a seleção dos artigos foi realizada por 2 investigadores independentes cuja concordância foi determinada pelo coeficiente Kappa de Cohen. O protocolo de investigação foi registado no PROSPERO (CRD420261394928) e a qualidade dos artigos incluídos no estudo foi aferida pela checklist de Downs and Black. Recolheram-se dados referentes à data de realização dos estudos, população envolvida (idade, género, tamanho da amostra), tipo de DAM e grupo controlo, eficácia e efeitos adversos reportados. Os principais resultados e as principais conclusões de cada estudo foram analisados de forma comparativa. Resultados: Dos 588 artigos identificados inicialmente, apenas 9 foram elegíveis para análise com elevado índice de concordância entre examinadores e baixo risco de viés. Os estudos analisados são concordantes quanto à eficácia dos DAM no tratamento da SAOS promovendo uma redução significativa do índice de apneia-hipopneia. No entanto, efeitos adversos são relatados por alguns autores quer a nível musculosquelético quer a nível dentário e oclusal. Conclusão: Os DAM constituem uma opção terapêutica eficaz para pacientes com SAOS leve a moderada e pacientes intolerantes à terapia com CPAP. Apesar da sua eficácia inequívoca, os efeitos adversos não devem ser menosprezados e devem ser considerados na tomada de decisão relativamente a este tipo de tratamento para a SAOS. Estes resultados realçam a necessidade de uma monitorização clínica regular.
Introduction: Obstructive Sleep Apnea Syndrome (OSAS) is a highly prevalent sleep disorder with substantial implications for general health and quality of life. Mandibular Advancement Devices (MAD) constitute an established therapeutic option for patients with mild to moderate OSAS. This systematic review aims to evaluate the clinical effectiveness of MADs and to identify potential adverse effects associated with long-term use. <br/>Material and Methods: A literature search was conducted across three databases (PubMed/MEDLINE®, Web of Science®, and Cochrane®), based on the PICO research question: “Do MAD (I), used in patients with OSAS (P), when compared with other treatment modalities (C), present greater adverse effects and specific clinical indications (O)?” Inclusion and exclusion criteria were predefined, and study selection followed PRISMA guidelines. Two independent reviewers screened the studies, with inter-rater agreement assessed using Cohen’s Kappa coefficient. The protocol was registered in PROSPERO (CRD420261394928). Study quality was assessed using the Downs and Black checklist. Extracted data included study date, population characteristics (age, sex, sample size), type of MAD and control intervention, treatment effectiveness, and reported adverse effects. The main outcomes and conclusions of each study were comparatively analyzed. Results: Of the 588 articles initially identified, only 9 met the eligibility criteria, showing high inter-examiner agreement and low risk of bias. The included studies consistently support the effectiveness of MADs in treating OSAS, demonstrating a significant reduction in the apnea–hypopnea index. However, some authors report adverse effects at both musculoskeletal and dental levels. Conclusion: MADs represent an effective therapeutic option for patients with mild to moderate OSAS and for patients intolerant to CPAP. Despite the clear effectiveness of MAD in the management of OSAS, adverse effects (dental, occlusal, and musculoskeletal) should not be underestimated and must be considered when selecting this treatment modality. These findings highlight the need for regular clinical monitoring.
Introduction: Obstructive Sleep Apnea Syndrome (OSAS) is a highly prevalent sleep disorder with substantial implications for general health and quality of life. Mandibular Advancement Devices (MAD) constitute an established therapeutic option for patients with mild to moderate OSAS. This systematic review aims to evaluate the clinical effectiveness of MADs and to identify potential adverse effects associated with long-term use. <br/>Material and Methods: A literature search was conducted across three databases (PubMed/MEDLINE®, Web of Science®, and Cochrane®), based on the PICO research question: “Do MAD (I), used in patients with OSAS (P), when compared with other treatment modalities (C), present greater adverse effects and specific clinical indications (O)?” Inclusion and exclusion criteria were predefined, and study selection followed PRISMA guidelines. Two independent reviewers screened the studies, with inter-rater agreement assessed using Cohen’s Kappa coefficient. The protocol was registered in PROSPERO (CRD420261394928). Study quality was assessed using the Downs and Black checklist. Extracted data included study date, population characteristics (age, sex, sample size), type of MAD and control intervention, treatment effectiveness, and reported adverse effects. The main outcomes and conclusions of each study were comparatively analyzed. Results: Of the 588 articles initially identified, only 9 met the eligibility criteria, showing high inter-examiner agreement and low risk of bias. The included studies consistently support the effectiveness of MADs in treating OSAS, demonstrating a significant reduction in the apnea–hypopnea index. However, some authors report adverse effects at both musculoskeletal and dental levels. Conclusion: MADs represent an effective therapeutic option for patients with mild to moderate OSAS and for patients intolerant to CPAP. Despite the clear effectiveness of MAD in the management of OSAS, adverse effects (dental, occlusal, and musculoskeletal) should not be underestimated and must be considered when selecting this treatment modality. These findings highlight the need for regular clinical monitoring.
Descrição
Palavras-chave
Síndrome da apneia obstrutiva do sono, SAOS Dispositivo de avanço mandibular DAM Efeitos adversos Revisão sistemática Obstructive sleep apnea syndrome OSAS Mandibular advancement devices MAD Adverse effects Systematic review
Contexto Educativo
Citação
Editora
Licença CC
Sem licença CC