About oral appliances

 

Thanks to a wealth of clinical research, oral appliances, also known as mandibular repositioning devices (MRDs) have gained recognition over the last decade as an effective solution to snoring, as well as an alternative to CPAP treatment in cases of mild to moderate obstructive sleep apnoea (OSA).1,2,3

In these latter cases, the Mean Disease Alleviation of MRD treatment, which factors in both AHI reduction and compliance, is 51.1%, which is similar to what is generally reported for CPAP (50%).4 These results fit the hypothesis that MRD treatment, despite being inferior to CPAP in terms of AHI reduction, might translate into a similar adjusted AHI and effectiveness because of a higher compliance.4

 

Narval CC MRD* has high compliance rates

At ResMed, we are conducting a five-year study ­— the largest of its kind — among 369 users, and found the regular use of ResMed’s Narval CC™ MRD led to a full disappearance of loud snoring in almost 8 of 10 users.5 It also reduced OSA levels by 50% in almost 8 of 10 users.5

 

Two types of MRDs: custom and off-the-shelf

There are two types of MRDs on the market: custom-made ones like Narval CC, and thermoplastic ones that patients need to fit themselves. A recent comparative study demonstrated that a custom-made oral appliance is twice as effective in reducing snoring than non-custom, thermo-plastic MRDs3. It has a higher compliance rate – 94% over 69%4 – and patients are more likely to prefer it (82%).4

 

References

  • 01

    Practice Parameters for the Treatment of Snoring and Obstructive Sleep Apnea with Oral Appliances: An Update for 2005, AASM report, Sleep 2006;29(2): 240-243, US Guidelines

  • 02

    Non-CPAP therapies in obstructive sleep apnoea, ERS task force. Eur Respir J. 2011 May;37(5):1000-28, Systematic Review. Recommendations (European)

  • 03

    B. Fleury et al. OSAHS treatment with mandibular advancement oral appliance. Rev Mal Respir. 2010 Oct;27 Suppl 3:S146-56. Systematic Review. Recommendations (France)

  • 04

    Vanderveken OM. Objective measurement of compliance during oral appliance therapy for sleep-disordered breathing. Thorax. 2013 Jan;68(1):91-6.

  • 05

    Vecchierini MF & al. A custom-made mandibular repositioning device for obstructive sleep apnoea-hypopnoea syndrome: the ORCADES study. Sleep Med. 2016 Mar;19:131-40. doi: 10.1016. Two-year follow-up results.

* This product may not be available in all countries.

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