A Eficácia de Cirurgias Orais no Tratamento da Apneia Obstrutiva do Sono: Revisão Sistemática sobre Dispositivos de Avanço Mandibular e Avanço Maxilomandibular

Abstract

Introduction: Obstructive sleep apnea (OSA) is a prevalent respiratory disorder
associated with multiple comorbidities. Despite the efficacy of continuous positive
airway pressure (CPAP), its low clinical adherence motivates the search for therapeutic
alternatives, including mandibular advancement devices (MAD) and maxillomandibular
advancement (MMA).
Objective: To systematically evaluate the clinical effectiveness of oral surgical
interventions—specifically MADs and MMA—in the treatment of OSA.
Methods: A comprehensive search was conducted in PubMed, Scopus, Web of
Science, EMBASE, and BVS databases for studies published between 2000 and 2024.
Eligible studies included clinical trials, systematic reviews, and meta-analyses involving
adult patients diagnosed with OSA and reporting outcomes such as the
apnea-hypopnea index (AHI), oxygen saturation, and quality of life.
Results: Twenty studies were included. MADs demonstrated significant improvements
in AHI and adherence among patients with mild to moderate OSA. MMA was highly
effective in patients with severe OSA, showing success rates above 80% and sustained
long-term results. Comparative studies indicated that both MADs and MMA can serve
as viable and safe alternatives to CPAP, with lower impact on structures like the
temporomandibular joint.
Conclusion: MADs and MMA are effective interventions for OSA and represent valuable
alternatives to conventional therapy. Further high-quality clinical trials are recommended
to standardize indications and support broader interdisciplinary use.