Nocturnal wearing of complete dentures and obstructive sleep apnea: A meta-analysis

Statement of Problem: Improvement in outcomes of obstructive sleep apnea (OSA) could answer the question of whether nocturnal wearing of removable complete dentures is beneficial. Purpose: 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. Methods: 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. Results: 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). Conclusion: 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.