title: Anatomically Based Outcome Predictors of Treatment for Obstructive Sleep Apnea with Intraoral Splint Devices: A Systematic Review of Cephalometric Studies.
abstract: OBJECTIVE
  The aim of this review is to summarize data from the literature on the predictive value of anatomy-based parameters, as identified by cephalometry, for the efficacy of mandibular advancement devices (MAD) for the treatment of obstructive sleep apnea (OSA).
  
  
  METHODS
  Articles were initially selected based on their titles or abstracts. Full articles were then retrieved and further scrutinized according to predetermined criteria. Reference lists of selected articles were searched for any missed publications. The selected articles were methodologically evaluated.
  
  
  RESULTS
  Of an initial 311 references, 13 were selected that assessed correlations between polysomnographic and cephalometric variables. The majority of studies demonstrated a correlation between treatment effectiveness and features as determined by cephalometric analysis, such as the mandibular plane angle, hyoid bone distance to mandible, antero-posterior diameter of the maxilla, tongue area, cranial base, and soft palate.
  
  
  CONCLUSIONS
  The mandibular plane angle and the distance between hyoid bone and mandibular plane was found to have a predictive value for MAD effectiveness in OSA patients. However, the relative weak and somewhat inconsistent cephalometric data suggest that decisions based solely on these factors cannot be recommended, especially because an integrated analysis of other risk factors (e.g., age, sex, BMI) should also be taken into account.
authors.affiliation: Department of Maxillofacial Surgery, TMD Clinic, University of Padova, Padova, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Guarda-Nardini
authors.affiliation: Institute of Otolaryngology, Department of Neurosciences, Padova University, Padova, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Manfredini
authors.affiliation: Institute of Otolaryngology, Department of Neurosciences, Padova University, Padova, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Mion
authors.affiliation: Center for Temporomandibular Disorders and Orofacial Pain, Rutgers University School of Dental Medicine, Newark, NJ.
authors.forename: Gary
authors.initials: G
authors.lastname: Heir
authors.affiliation: Institute of Otolaryngology, Department of Neurosciences, Padova University, Padova, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Marchese-Ragona
mesh_terms: D002508:Cephalometry / Q000706:statistics & numerical data*; D006801:Humans; D007568:Jaw / Q000033:anatomy & histology*; D008334:Mandible / Q000033:anatomy & histology; D019186:Mandibular Advancement / Q000379:methods*; D017286:Polysomnography / Q000706:statistics & numerical data; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D016896:Treatment Outcome
keywords: OSA; cephalometry; mandibular advancement device; predictors; splint