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Table 1 Prediction of treatment response with oral appliance

From: Practical considerations for effective oral appliance use in the treatment of obstructive sleep apnea: a clinical review

Authors, year of publication Number of patients Type of titration tray Titration criteria AHI or RDI (/h) baseline AHI(/h) titration PSG AHI(/h) OA Type of OA OA jaw position Prediction of treatment responder (%) Treatment success with OA Criterion of success Remark
Sensitivity Specificity Positive predictive value Negative predictive value
Raphaelson et al. 1998 6 N/A      Silencer   N/A N/A N/A N/A    Case report
Dort et al. 2006 33 RCMP Until obstructive events and snoring were eliminated 26.9 ± 18.3 N/A N/A Klearway Evaluated position by titration 75 82.4 80 77.8 49% RDI < 15/h and RDI
reduction of <30%
 
Kuna et al. 2006 21 EMA-T ・Snoring, apnea, hypopnea, were eliminated
・Maximum tolerated advancement
33.5 ± 18.3 16.4 ± 13.0 24.6 ± 17.1(titration position)
24.9 ± 18.8(final position)
Klearway ・Evaluated position by titration
・Additional advancement (final)
0 (AHI < 10)
75
(50%reduction)
55 (AHI < 10)
46
(50%reduction)
0 (AHI < 10)
46.1
(50%reduction)
92 (AHI < 10)
75
(50%reduction)
47 AHI < 15/h and
>50% reduction
inAHI
 
Tsai et al. 2004 19 RCMP Elimination of majority of obstructive sleep apnea, hypopnea and oxygen desaturation 34.0 ± 4.88 N/A 17 ± 4.7 Klearway Used conventional procedure 90 89 90 89 53 AHI < 15/h and AHI
reduction of >30%
and a subjective
improvement in
symptoms
 
Petelle et al. 2002 7 temporary appliance ・Significant reduction of the incidence of sleep disordered breathing
・Reaching position of maximum advancement of system
・Position causing discomfort or pain
66.9 ± 32.4 26.1 ± 20.7 19.6 ± 20.2 Herbst Evaluated position by titration 0 (AHI < 10)
60 (AHI < 20)
100 (AHI < 10)
100 (AHI < 20)
N/A (AHI < 10)
100 (AHI < 20)
57 (AHI < 10)
50 (AHI < 20)
42.9 (AHI < 10)
68.9 (AHI < 20)
AHI < 10/h
AHI < 20/h
 
Zhou and Liu 2012 16 temporary appliance Until the maximum AHI reduction was achieved 26.38 ± 4.13 N/A 6.58 ± 2.28 (monoblock)
9.87 ± 2.88 (SILENT NITE)
monoblock
SILENTNITE
Evaluated position by titration N/A N/A N/A N/A 68.9 (monoblock)
56.3 (SILENT NITE)
AHI < 10 and >50%
reduction in AHI
 
Remmers et al. 2013 67 RCMP Elimination of majority of respiratory events in REM and NREM sleep in both the supine and lateral position 25.2 ± 14.8 N/A N/A SomnoDent ・Predicted effective target jaw position
・70% of A-P range of motion for predicted failure
86 92 94 83 58 AHI < 10 and >50%
reduction in AHI
 
  1. AHI apnea–hypopnea index, RDI respiratory disturbance index, RCMP remotely controlled mandibular protrusion