Mandibular advancement device for obstructive sleep apnea and its relationship with Temporomandibular Disorders
Dispositivos de avance mandibular para Apnea obstructiva del sueño y su relación con Trastornos Temporomandibulares
Author
Flores Cortés, Eduardo
Muga Massai, Macarena
Ugalde Flores, Andrés
Abstract
Objective: To analyze the state of the art of Mandibular advancement device (MAD) and its relationship with the presence of Temporomandibular Disorders (TMD). Materials and Methods: A search was made using PubMed, Lilacs, Cochrane, and Scielo databases using the terms "mandibular advancement device", "mandibular advancement splints", "Obstructive sleep apnea" , and "temporomandibular disorders". Inclusion criteria were articles published in the last 5 years on humans, language (English / Spanish). Exclusion criteria: Articles that did not address TMDs, Studies conducted on children.Results: 17 articles were found, 2 were duplicates, and 7 were eliminated by manual review of titles and abstracts; of the remaining 8, 3 were excluded by PRISMA regimen and the selection criteria, obtaining 5 studies. For the analysis, the parameters were: type of study, sample, percentage of mandibular protrusion, TMD presence, and conclusions. Conclusion: MADs prove to be safe for the treatment of OSAHS, despite generating fatigue and muscle pain in the initial period. Statistically, significant evidence is lacking to associate them with TMD. Moreover, protocols that standardize MAD and the percentage of mandibular advancement are lacking. Objetivo: Analizar el estado del arte del dispositivo de avance mandibular (DAM) y su relación con la aparición de transtornos temporomandibulares (TTM). Objetivos específicos: Identificar el porcentaje de protrusión mandibular y su relación con TTM, y determinar el TTM más frecuente asociado a DAM. Materiales y Método: Se realizó una búsqueda en los motores PubMed, Lilacs, Cochrane y Scielo con los términos "mandibular advancement device", "mandibular advancement splints", "Obstructive sleep apnea" y "temporomandibular disorders". Criterios de inclusión: 5 años, Humanos, Tipo de estudio, Idioma (Inglés/Español). Criterios de exclusión: No aborda TTM, Estudios en niños. Resultados: La búsqueda arrojó 17 artículos, donde se eliminaron 2 duplicados y 7 por revisión manual de títulos y abstracts; de los 8 restantes, 3 se excluyeron por pauta PRISMA y los criterios de selección, obteniendo 5 estudios en total. Para el análisis, se determinaron los parámetros: Tipo de estudio, muestra, porcentaje de protrusión mandibular, presencia de TTM y conclusiones. Conclusión: Los DAM demuestran ser seguros para el tratamiento de SAHOS, pese a generar fatiga y dolor muscular en el periodo inicial. Falta evidencia estadísticamente significativa que los asocie a TTM. A su vez, faltan protocolos que estandaricen los DAM y el porcentaje de avance mandibular.
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