对阻塞性睡眠呼吸暂停患者使用不同下部推进装置的副作用进行比较:系统性审查和元分析
Xi Wang1, Hui Chen2, Shaohua Ge1
1Department of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Shandong, China.
概括
针对阻塞性睡眠呼吸暂停 (OSA) 的可调节下推进装置 (MAD) 与非可调节类型相比,对关节和肌的副作用较少. 然而,这两种设计都没有为所有副作用提供普遍优越的结果.
科学领域:
- 牙科 睡眠医学 睡眠医学
- 矯正牙科 矯正牙科是一種矯正牙科.
- 面外科手术 面外科手术
背景情况:
- 部推进装置 (MAD) 是CPAP的常见替代品,用于治疗阻塞性睡眠呼吸暂停 (OSA).
- MAD与各种副作用有关,促使对设计特异性影响进行调查.
- 本系统性审查解决了对可调节和不可调节的MAD设计之间副作用的比较数据的需求.
研究的目的:
- 系统地比较与OSA治疗的可调和不可调的MAD相关的副作用的类型和严重程度.
- 为临床医生提供基于证据的指导,根据患者特定的副作用概况选择最合适的MAD设计.
- 分析牙骨变化,关节问题,肌问题和牙周健康状况.
主要方法:
- 进行了对26项相关研究的系统审查,并在2024年5月之前进行了文献搜索.
- 审查的重点是副作用,包括牙骨变化,关节疾病,肌疼痛和牙周疾病.
- 统计分析包括对特定结果指标的元分析,如过度喷射和过度咬伤变化.
主要成果:
- 与可调节的MAD相比,非可调节的MAD导致过喷和过咬的变化略大.
- 可调节的MAD对关节和肌的影响低于非可调节的MAD.
- 两种MAD类型之间没有观察到 sella-nasion-A, sella-nasion-B或 A-nasion-B点的显著差异;在可调节的MAD中没有注意到牙周炎或骨再吸收.
结论:
- 这些发现为选择MADs用于OSA治疗的临床医生提供了宝贵的见解,突出了设计特定的副作用概况.
- 目前,根据现有证据,没有一个单独的定制MAD设计在减轻所有潜在副作用方面绝对优越.
- 需要进一步的研究,以充分阐明不同MAD设计的长期副作用概况.
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