{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T01:23:21Z","timestamp":1785461001051,"version":"3.56.0"},"reference-count":26,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001349","name":"National Medical Research Council","doi-asserted-by":"publisher","award":["CSASI18may-0005"],"award-info":[{"award-number":["CSASI18may-0005"]}],"id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Dent Res"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    Severe obstructive sleep apnea (OSA) is linked to adverse cardiovascular outcomes. While continuous positive airway pressure (CPAP) is the standard treatment, mandibular advancement devices (MADs) offer an alternative. This substudy of a randomized trial compared the effectiveness of MADs versus CPAP on 24-h ambulatory blood pressure (BP), sleep-related quality of life, myocardial remodeling, ambulatory heart rhythm, and biomarkers in severe OSA. A total of 144 participants were randomized to MAD (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200973) or CPAP (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200971) for 12\u2009mo. Median nightly usage was 5.4 (2.9\u20136.5) h for the MAD group (\u22656\u2009h\/night: 56.1%) and 4.9 (4.0\u20136.0) h for the CPAP group (\u22656\u2009h\/night: 28.3%). The apnea-hypopnea index at baseline and 6\u2009mo was 44.0 (37.6\u201359.2) and 20.9 (11.7\u201331.9) events\/h in the MAD group and 50.7 (40.7\u201359.8) and 2.1 (1.2\u20133.4) events\/h in the CPAP group, respectively. MAD treatment reduced asleep mean BP (\u22124.7\u2009mm Hg, 95% confidence interval [CI]: \u22128.3 to \u22124.0,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.015), asleep systolic BP (\u22122.0\u2009mm Hg, 95% CI: \u221210.0 to \u22124.0,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.047), and asleep diastolic BP (\u22124.0\u2009mm Hg, 95% CI: \u22129.0 to \u22123.0,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.007), whereas CPAP showed no significant changes. The between-group differences favored MAD in asleep mean BP (\u22123.70\u2009mm Hg, 95% CI: \u22127.40 to 0.00,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.050) and asleep systolic BP (\u22124.78\u2009mm Hg, 95% CI: \u22129.51 to 0.04,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.048). Both improved sleep-related quality of life, although CPAP had a slightly greater effect on the Epworth Sleepiness Scale (\u03941.63, 95% CI: 0.45 to 2.81,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.007). No significant changes were observed in cardiac magnetic resonance imaging parameters, ambulatory heart rhythm, or biomarkers. Adverse effects included jaw pain (14.8%) and teeth discomfort (8.2%) with MAD, whereas CPAP users reported dry mouth (50.8%), nasal congestion (23.0%), and air leakage (29.5%). In conclusion, these findings suggested MAD could be an acceptable and effective treatment for patients with severe OSA and hypertension. The study was registered at Clinicaltrials.gov (NCT04119999).\n                  <\/jats:p>","DOI":"10.1177\/00220345251361796","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T09:05:22Z","timestamp":1756717522000},"page":"112-119","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Mandibular Advancement Device versus CPAP in Severe Obstructive Sleep Apnea"],"prefix":"10.1177","volume":"105","author":[{"given":"J.T.","family":"Colpani","sequence":"first","affiliation":[{"name":"Discipline of Endodontics, Operative Dentistry and Prosthodontics, Faculty of Dentistry, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.-H.","family":"Ou","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.M.","family":"Kosasih","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.K.F.","family":"Lee","sequence":"additional","affiliation":[{"name":"Discipline of Endodontics, Operative Dentistry and Prosthodontics, Faculty of Dentistry, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.-P.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National University Heart Centre, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.H.","family":"Tan","sequence":"additional","affiliation":[{"name":"Discipline of Endodontics, Operative Dentistry and Prosthodontics, Faculty of Dentistry, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8877-1584","authenticated-orcid":false,"given":"R.C.W.","family":"Wong","sequence":"additional","affiliation":[{"name":"Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.W.","family":"Chin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Heart Centre Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.A.","family":"Cistulli","sequence":"additional","affiliation":[{"name":"Sleep Research Group, Charles Perkins Centre &amp; Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia"},{"name":"Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8777-2705","authenticated-orcid":false,"given":"C.-H.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"Department of Cardiology, National University Heart Centre, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(15)00416-6"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.124.2.594"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsaf022"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.23747"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.158.2.9712036"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-023-02958-2"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy475"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2018.01.003"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.103.1.30"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/19.suppl_9.S111"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034519885644"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.1464"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-025-03249-8"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-06413-5_22"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-072853"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2024.03.359"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00837-2024"},{"key":"e_1_3_3_19_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201212-2223OC"},{"key":"e_1_3_3_20_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.4858"},{"key":"e_1_3_3_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsab015"},{"key":"e_1_3_3_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2015.05.020"},{"key":"e_1_3_3_23_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.9308"},{"key":"e_1_3_3_24_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.3946"},{"issue":"10","key":"e_1_3_3_25_1","first-page":"835","article-title":"An instrument to measure functional status outcomes for disorders of excessive sleepiness","volume":"20","author":"Weaver TE","year":"1997","unstructured":"Weaver TE, Laizner AM, Evans LK, Maislin G, Chugh DK, Lyon K, Smith PL, Schwartz AR, Redline S, Pack AI, et al. 1997. An instrument to measure functional status outcomes for disorders of excessive sleepiness. Sleep. 20(10):835\u2013843.","journal-title":"Sleep"},{"key":"e_1_3_3_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2021-217714"},{"key":"e_1_3_3_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.9811"}],"container-title":["Journal of Dental Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00220345251361796","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00220345251361796","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00220345251361796","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T21:09:33Z","timestamp":1777496973000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00220345251361796"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1177\/00220345251361796"],"URL":"https:\/\/doi.org\/10.1177\/00220345251361796","relation":{},"ISSN":["0022-0345","1544-0591"],"issn-type":[{"value":"0022-0345","type":"print"},{"value":"1544-0591","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]}}}