| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 1.8 MB | Adobe PDF |
Authors
Abstract(s)
Introdução: A Síndrome da Apneia Obstrutiva do Sono consiste num distúrbio
respiratório relacionado com o sono, classificado através do Índice de
Apneia/Hipopneia. Um dos tratamentos preconizado para as formas leve e
moderada desta patologia são os Dispositivos de Avanço Mandibular. O objetivo
desta revisão sistemática consiste na avaliação qualitativa da eficácia e dos
efeitos adversos dos Dispositivos de Avanço Mandibular no tratamento de
Síndrome da Apneia Obstrutiva do Sono ao longo do tempo.
Materiais e Métodos: Esta revisão sistemática teve como base as guidelines
PRISMA. Foi realizada uma pesquisa nas bases de dados PubMed/MEDLINE®,
Cochrane® e Web of Science - MEDLINE®, até 15 de abril de 2021. Dois
investigadores realizaram, a seleção dos estudos. A qualidade dos estudos foi
avaliada através da checklist de Downs e Black e a concordância entre
examinadores foi avaliada através do coeficiente de kappa de Cohen.
Resultados: Através da pesquisa foram identificados 2011 artigos. Depois da
eliminação dos duplicados e triplicados foi analisado o título de 662 artigos,
destes, 339 foram analisados pelo resumo e 62 pela leitura integral. No final,
foram elegíveis para análise 16 artigos.
Conclusões: Os Dispositivos de Avanço Mandibular aumentam a área das vias
aéreas através da deslocação da mandíbula anterior e inferiormente, deslocação
do palato mole, da língua e do osso hioide anteriormente e ativação dos
músculos masséter e submentonianos. Estes efeitos causam a uma diminuição
do Índice de Apneia/Hipopneia, aumento da saturação de oxigénio no sangue e
melhoria dos sintomas da Síndroma da Apneia Obstrutiva do Sono, sendo então
eficazes no seu tratamento. No entanto, devido à sua colocação intraoral vão
causar efeitos secundários que, apesar de não serem considerados
contraindicação ao tratamento, não devem ser negligenciados, como a
diminuição do trespasse vertical e horizontal, a posição posteroinferior da
mandíbula e o desconforto articular.
Introduction: Obstructive Sleep Apnea Syndrome is a sleep-related respiratory disorder, classified by the Apnea/Hypopnea Index. One of the treatments recommended for the mild and moderate forms of this pathology are the Mandibular Advancement Devices. Thus, the aim of this systematic review is to qualitatively assess the efficacy and the adverse effects of Mandibular Advancement Devices in the treatment of Obstructive Sleep Apnea Syndrome over time. Materials and Methods: This systematic review was written using the PRISMA guidelines. A search was carried out in the PubMed / MEDLINE®, Cochrane® and Web of Science - MEDLINE® databases, until April 15th, 2021. Two researchers selected the studies independently. The quality of the papers was assessed using the Downs and Black checklist and the agreement between examiners was measured using the Cohen's kappa coefficient. Results: Through the research, 2011 articles were identified. After removing duplicates and triplicates, the title of 662 articles was analyzed. Among these, 339 were examined by abstract and 62 by full reading. After this selection, 16 articles were eligible for analysis. Conclusion: Mandibular Advancement Devices increase the area of the airways through displacement of the mandible anteriorly and inferiorly, displacement of the soft palate, tongue and hyoid bone anteriorly and activation of the masseter and submentonian muscles. These effects cause a decrease in Apnea/Hypopnea Index, an increase in oxygen saturation and an improvement in the symptoms of Obstructive Sleep Apnea Syndrome, thus being effective in its treatment. However, due to their intraoral placement, they will cause side effects, despite not being considered a contraindication to treatment, should not be neglected. Possible side effects include reduced overjet and overbite, posteroinferior position of the mandible and joint discomfort.
Introduction: Obstructive Sleep Apnea Syndrome is a sleep-related respiratory disorder, classified by the Apnea/Hypopnea Index. One of the treatments recommended for the mild and moderate forms of this pathology are the Mandibular Advancement Devices. Thus, the aim of this systematic review is to qualitatively assess the efficacy and the adverse effects of Mandibular Advancement Devices in the treatment of Obstructive Sleep Apnea Syndrome over time. Materials and Methods: This systematic review was written using the PRISMA guidelines. A search was carried out in the PubMed / MEDLINE®, Cochrane® and Web of Science - MEDLINE® databases, until April 15th, 2021. Two researchers selected the studies independently. The quality of the papers was assessed using the Downs and Black checklist and the agreement between examiners was measured using the Cohen's kappa coefficient. Results: Through the research, 2011 articles were identified. After removing duplicates and triplicates, the title of 662 articles was analyzed. Among these, 339 were examined by abstract and 62 by full reading. After this selection, 16 articles were eligible for analysis. Conclusion: Mandibular Advancement Devices increase the area of the airways through displacement of the mandible anteriorly and inferiorly, displacement of the soft palate, tongue and hyoid bone anteriorly and activation of the masseter and submentonian muscles. These effects cause a decrease in Apnea/Hypopnea Index, an increase in oxygen saturation and an improvement in the symptoms of Obstructive Sleep Apnea Syndrome, thus being effective in its treatment. However, due to their intraoral placement, they will cause side effects, despite not being considered a contraindication to treatment, should not be neglected. Possible side effects include reduced overjet and overbite, posteroinferior position of the mandible and joint discomfort.
Description
Keywords
Síndrome da Apneia Obstrutiva do Sono Tratamento Dispositivo de avanço mandibular Revisão sistemática Obstructive Sleep Apnea Syndrome Mandibular advancement device Treatment Systematic review