{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:53:30Z","timestamp":1788872010330,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2014,3,21]],"date-time":"2014-03-21T00:00:00Z","timestamp":1395360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"The Japanese Academy of Dental Sleep Medicine"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Oral Rehabilitation"],"published-print":{"date-parts":[[2014,7]]},"abstract":"Summary<\/jats:title>\n \n Oral appliances (\n OA<\/jats:styled-content>\n s) have demonstrated efficacy in treating obstructive sleep apnea (\n OSA<\/jats:styled-content>\n ), but many different\n OA<\/jats:styled-content>\n devices are available. The Japanese Academy of Dental Sleep Medicine supported the use of\n OA<\/jats:styled-content>\n s that advanced the mandible forward and limited mouth opening and suggested an evaluation of their effects in comparison with untreated or\n CPAP<\/jats:styled-content>\n . A systematic search was undertaken in 16 April 2012. The outcome measures of interest were as follows: Apnea Hypopnea Index (\n AHI<\/jats:styled-content>\n ), lowest SpO\n 2<\/jats:sub>\n , arousal index, Epworth Sleepiness Scale (\n ESS<\/jats:styled-content>\n ), the\n SF<\/jats:styled-content>\n \u201036 Health Survey. We performed this meta\u2010analysis using the Grading of Recommendations, Assessment, Development and Evaluation (\n GRADE<\/jats:styled-content>\n ) system. Five studies remained eligible after applying the exclusion criteria. Comparing\n OA<\/jats:styled-content>\n and control appliance,\n OA<\/jats:styled-content>\n significantly reduced the weighted mean difference (\n WMD<\/jats:styled-content>\n ) in both\n AHI<\/jats:styled-content>\n and the arousal index (favouring\n OA<\/jats:styled-content>\n ,\n AHI<\/jats:styled-content>\n : \u22127\u00b705 events\u00a0h\n \u22121<\/jats:sup>\n ; 95%\n CI<\/jats:styled-content>\n , \u221212\u00b707 to \u22122\u00b703;\n P<\/jats:italic>\n \u00a0=\u00a00\u00b7006, arousal index: \u22126\u00b795 events\u00a0h\n \u22121<\/jats:sup>\n ; 95%\n CI<\/jats:styled-content>\n , \u221211\u00b775 to \u22122\u00b715;\n P<\/jats:italic>\n \u00a0=\u00a00\u00b7005).\n OA<\/jats:styled-content>\n s were significantly less effective at reducing the\n WMD<\/jats:styled-content>\n in\n AHI<\/jats:styled-content>\n and improving lowest SpO\n 2<\/jats:sub>\n and\n SF<\/jats:styled-content>\n \u201036 than\n CPAP<\/jats:styled-content>\n , (favouring\n OA<\/jats:styled-content>\n ,\n AHI<\/jats:styled-content>\n : 6\u00b711 events\u00a0h\n \u22121<\/jats:sup>\n ; 95%\n CI<\/jats:styled-content>\n , 3\u00b724 to 8\u00b798;\n P<\/jats:italic>\n \u00a0=\u00a00\u00b70001, lowest SpO\n 2<\/jats:sub>\n : \u22122\u00b752%; 95%\n CI<\/jats:styled-content>\n , \u22124\u00b781 to \u22120\u00b723;\n P<\/jats:italic>\n \u00a0=\u00a00\u00b703,\n SF<\/jats:styled-content>\n \u201036: \u22121\u00b780; 95%\n CI<\/jats:styled-content>\n , \u22123\u00b717 to \u2212042;\n P<\/jats:italic>\n \u00a0=\u00a00\u00b701). Apnea Hypopnea Index and arousal index were significantly improved by\n OA<\/jats:styled-content>\n relative to the untreated disease. Apnea Hypopnea Index, lowest SpO\n 2<\/jats:sub>\n and\n SF<\/jats:styled-content>\n \u201036 were significantly better with\n CPAP<\/jats:styled-content>\n than with\n OA<\/jats:styled-content>\n . The results of this study suggested that\n OA<\/jats:styled-content>\n s improve\n OSA<\/jats:styled-content>\n compared with untreated.\n CPAP<\/jats:styled-content>\n appears to be more effective in improving\n OSA<\/jats:styled-content>\n than\n OA<\/jats:styled-content>\n s.\n <\/jats:p>","DOI":"10.1111\/joor.12162","type":"journal-article","created":{"date-parts":[[2014,3,21]],"date-time":"2014-03-21T03:14:25Z","timestamp":1395371665000},"page":"542-554","source":"Crossref","is-referenced-by-count":39,"title":["The effect of oral appliances that advanced the mandible forward and limited mouth opening in patients with obstructive sleep apnea: A systematic review and meta\u2010analysis of randomised controlled trials"],"prefix":"10.1111","volume":"41","author":[{"given":"K.","family":"Okuno","sequence":"first","affiliation":[{"name":"Division for Oral and Facial Disorders Osaka University Dental Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Sato","sequence":"additional","affiliation":[{"name":"Oral Cancer Center Tokyo Dental College Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Arisaka","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine, Oral and Maxillofacial Surgery Tokyo Dental College Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Hosohama","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine, Oral and Maxillofacial Surgery Tokyo Dental College Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Gotoh","sequence":"additional","affiliation":[{"name":"Second Department of Oral and Maxillofacial Surgery Osaka Dental University Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Taga","sequence":"additional","affiliation":[{"name":"Dentistry and Oral Surgery JR Tokyo General Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Sasao","sequence":"additional","affiliation":[{"name":"Center for Oral Functional Disorders Sasao Dental Clinic Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Hamada","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Kinki University Faculty of Medicine Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,3,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta13040"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200808-1341OC"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.94.1.9"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/29.2.240"},{"key":"e_1_2_8_6_1","first-page":"1","article-title":"Oral appliances for obstructive sleep apnea: an evidence\u2010based analysis","volume":"9","author":"Health Quality Ontario","year":"2009","journal-title":"Ont Health Technol Assess Ser"},{"key":"e_1_2_8_7_1","first-page":"CD004435","article-title":"Oral appliances for obstructive sleep apnoea","volume":"25","author":"Lim J","year":"2006","journal-title":"Cochrane Database Syst 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