Cambios en índices de apnea-hipopnea y saturación de oxígeno en pacientes SAHOS con dispositivo de avance mandibular. Una revisión de revisiones

Abstract

Introduction: obstructive sleep apnea (OSAH) affects breathing due to the obliteration of the airways. Mandibular Advancement Devices (MAD) could release the respiratory obstruction. Studies have tried to verify the effectiveness of MAD to improve the condition of OSAH, however, the results generate discussion. Objective: To evaluate changes in oxygen saturation and the AHI apnea-hypopnea index after the use of MAD in adult patients with mild, moderate and severe OSAH based on the published literature. Materials and methods: A review of reviews was carried out, based on publications in health sciences databases such as EMBASE, COCHRANE, PUBMED, DENTISTRY AND WEB OF SCIENCE, taking into account the inclusion criteria such as systematic review studies and meta-analysis published during the last 10 years, in the languages of Spanish, English, Portuguese that evaluate changes in AHI and oxygen saturation, through a descriptive analysis performed in Excel. The project was endorsed by the research committee of the dental school. Results: 20 articles were included that met the selection criteria. All published in English. The countries with the most publications were China, the United States, Italy, and Japan. All indicated improvement in apnea-hypopnea and oxygen saturation indices after MAD. Conclusions: The use of MAD in adult patients with mild, moderate, or severe OSAH improves AHI and oxygen saturation, regardless of the percentage of mandibular advancement or the design of the MAD. The reviews presented a high degree of validity measured with the ROBIS tool, generating reliability in the results. It is recommended in future studies to evaluate other variables of sleep architecture contained in polysomnography.