Jurel Sunit Kumar, Bakrolwala Husbana Altaf, Chand Pooran, Singh Raghuwar Dayal, Bhujbal Rushikesh Bhau, Singh Balendra Pratap
Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India.
J Indian Prosthodont Soc. 2024 Oct 1;24(4):311-319. doi: 10.4103/jips.jips_216_24. Epub 2024 Oct 15.
Improvement in outcomes of obstructive sleep apnea (OSA) could answer the question of whether nocturnal wearing of removable complete dentures is beneficial.
To evaluate the available literature that compares nocturnal wearing of removable complete dentures or overdentures in patients diagnosed with OSA on the Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), quality of sleep (Pittsburgh Sleep Quality Index [PSQI]) and other outcomes.
Registration of the proposed protocol was done in an open-source registry. Databases (Medline, Embase, and Cochrane Central Register of Controlled Trials) were searched until August 2024. All the reports were screened by reading the abstracts and full texts by two independent reviewers and conflicts were resolved by the third reviewer in Covidence. Data extraction and risk of bias assessment as per the Risk of Bias 1.0 tool (RoB 1.0) were done in Covidence. Mean difference and risk ratios were used as effect measures for continuous and dichotomous outcomes. Statistical analysis was performed using a fixed effect model. The certainty of evidence was judged by the GRADE approach.
Out of 2428 available reports, three randomized controlled trials were included for statistical analyses involving a total of 123 participants. The pooled estimate for AHI showed no evidence of any difference with and without nocturnal wear of removable complete dentures (MD: 2.88; 95% confidence interval [CI]: 0.94 to 6.70; 246 participants). No evidence of any difference was found for PSQI (MD: 0.20; 95% CI: -0.97 to 1.37; 138 participants) and for ESS (MD: 0.20; 95% CI: -1.60 to 1.20; 138 participants).
The review found insufficient evidence to judge that nocturnal wearing of removable complete dentures was effective in patients with OSA measured by Apnea Hypopnea Index, PSQI, and Epworth sleepiness scale.
阻塞性睡眠呼吸暂停（OSA）治疗效果的改善可能会解答夜间佩戴可摘全口义齿是否有益这一问题。
评估现有文献，这些文献比较了被诊断为OSA的患者夜间佩戴可摘全口义齿或覆盖义齿对呼吸暂停低通气指数（AHI）、爱泼华嗜睡量表（ESS）、睡眠质量（匹兹堡睡眠质量指数[PSQI]）及其他指标的影响。
在一个开源注册库中对拟定方案进行注册。检索数据库（Medline、Embase和Cochrane对照试验中心注册库）直至2024年8月。由两名独立审阅者通过阅读摘要和全文对所有报告进行筛选，Covidence中的第三名审阅者解决冲突。在Covidence中根据偏倚风险1.0工具（RoB 1.0）进行数据提取和偏倚风险评估。均值差和风险比用作连续和二分结果的效应量度。使用固定效应模型进行统计分析。证据的确定性通过GRADE方法判断。
在2428篇可用报告中，纳入三项随机对照试验进行统计分析，共涉及123名参与者。AHI的合并估计显示，夜间佩戴与不佩戴可摘全口义齿之间没有差异的证据（均值差：2.88；95%置信区间[CI]：0.94至6.70；246名参与者）。PSQI（均值差：0.20；95%CI：-0.97至1.37；138名参与者）和ESS（均值差：0.20；95%CI：-1.60至1.20；138名参与者）均未发现有差异的证据。
该综述发现，依据呼吸暂停低通气指数、PSQI和爱泼华嗜睡量表衡量，没有足够证据判断夜间佩戴可摘全口义齿对OSA患者有效。
