Table 1 Prediction of treatment response with oral appliance
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 | |