{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:19:25Z","timestamp":1773965965075,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Oral Rehabilitation"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mandibular advancement devices (MADs) are established alternatives to continuous positive airway pressure (CPAP) for obstructive sleep apnea syndrome (OSAS), particularly valued for better patient compliance. Traditional contraindications include insufficient healthy teeth for retention, affecting a significant portion of patients due to global edentulism rates of up to 37.8% in ageing populations. Despite emerging reports challenging this, no synthesis exists on MAD efficacy in edentulous or partially edentulous patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This PRISMA\u2010compliant systematic review (PROSPERO: CRD420251078741) searched Embase, PubMed, Cochrane, Web of Science, and LILACS from inception to June 25, 2025. OSAS patients with insufficient teeth, treated with modified MADs (over edentulous ridges, teeth\/mucosa, or dentures) were included. Patients are excluded if they had surgical treatment (i.e., dental implants) as part of their care. Outcomes assessed include: apnea\u2010hypopnea index (AHI), oxygen saturation and patient\u2010reported outcome measures (PROMs). Risk of bias was assessed using the JBI checklist and ROBINS\u2010I.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighteen studies (3 prospective cohort studies, 15 case reports;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200949 patients) were included. In general, modified MADs were effective in treating OSAS when evaluating AHI, lowest oxygen saturation and PROMs. The mean AHI reduced from 22.39\u2009\u00b1\u200912.08\u2009events\/h to 5.55\u2009\u00b1\u20093.60\u2009events\/h after treatment (75.2% reduction). Similar efficacy was noted when comparing patients with bimaxillary edentulous ridge, edentulous ridge in only 1 arch and patients with bimaxillary partial edentulism. The same finding was observed when comparing MADs over teeth\/mucosa and over dentures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Modified MADs appeared effective in traditionally contraindicated patients, challenging prior guidelines and offering options for CPAP\u2010intolerant individuals with insufficient teeth. Larger RCTs are needed for confirmation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/joor.70061","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T06:59:36Z","timestamp":1758869976000},"page":"246-256","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Modified Mandibular Advancement Device Is Effective in Patients With Insufficient Teeth: A Systematic Review"],"prefix":"10.1111","volume":"53","author":[{"given":"Chee Weng","family":"Yong","sequence":"first","affiliation":[{"name":"Faculty of Dentistry National University Centre for Oral Health, National University of Singapore  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernadette","family":"Quah","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry National University Centre for Oral Health, National University of Singapore  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qi\u2010Yan","family":"Chung","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry National University Centre for Oral Health, National University of Singapore  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mei Na","family":"Tan","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry National University Centre for Oral Health, National University of Singapore  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank Kong Fei","family":"Lee","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry National University Centre for Oral Health, National University of Singapore  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8877-1584","authenticated-orcid":false,"given":"Raymond Chung Wen","family":"Wong","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry National University Centre for Oral Health, National University of Singapore  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.3008"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201212\u20102223OC"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/00220345251361796"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.4696"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2008167"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325\u2010013\u20100886\u20104"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.11626"},{"key":"e_1_2_10_9_1","volume-title":"Oral Health Surveillance Report: Dental Caries, Tooth Retention, and Edentulism, United States, 2017\u2013March 2020","author":"Centers for Disease Control and Prevention","year":"2024"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph111111308"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s41782\u2010024\u201000289\u20100"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100501.2007.01343.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cden.2019.02.004"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jormas.2024.101759"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003878.pub5"},{"key":"e_1_2_10_16_1","first-page":"1","article-title":"Sleep Apnoea in Patients With Stable Congestive Heart Failure an Intervention Study With a Mandibular Advancement Device","volume":"168","author":"Eskafi M.","year":"2004","journal-title":"Swedish Dental Journal. 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