title: The effect of nocturnal wear of dentures on the sleep quality: a systematic review and meta-analysis.
abstract: OBJECTIVE
  The effect of nocturnal wear of denture on sleep quality and integrity is still not well understood. Therefore, this systematic review was conducted to provide evidence on this topic.
  
  
  METHODS
  Electronic searches were conducted from 1964 up to September 2015, using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. Only publications in English or French, in which sleep quality of edentate adult individuals wearing dentures at night was compared to those not wearing were included in the review. Random effects models were used to pool the effect sizes.
  
  
  RESULTS
  A total of 10 studies were included in the systematic review and 5 in the meta-analysis. No statistically significant difference between sleeping with denture and without denture was found for the Apnea-Hypopnea Index (AHI; Standard Mean Difference = -0.60, 95 % CI -1.67-0.47; Z = -1.10; p = 0.27). However, there was considerable heterogeneity in the studies included in the meta-analysis (Tau2= 1.34; Q-value = 59.32, df = 4 (P < 0.0001); I2= 93.3 %). When results from randomized controlled trials (RCTs) were pooled in subgroup analyses of AHI, there was a tendency towards favoring sleeping without dentures (P = 0.059) and no evidence of heterogeneity between studies (Tau2= 0.000; Q-value = 0.06, df = 1 (P = 0.80); I2= 0.000 %).
  
  
  CONCLUSIONS
  The current evidence suggests that there is no difference in the sleep quality and integrity of individuals wearing or not wearing their denture during sleep. However, the results of randomized controlled trials favoring sleeping without dentures and the likely presence of bias in the previous studies indicate the need for further randomized controlled trials for the development of clinical guideline.
authors.affiliation: Faculty of Dentistry, Pavillon Roger-Gaudry, Université de Montréal, C.P. 6128, succ. Centre-ville, Montreal, Quebec, H3C 3J7, Canada. elham.emami@umontreal.ca.|School of Public Health, Université de Montréal, 7101, avenue du Parc, 3e étage Montréal, Montreal, Québec, H3N 1X9, Canada. elham.emami@umontreal.ca.
authors.forename: Elham
authors.initials: E
authors.lastname: Emami
authors.affiliation: Faculty of Odonto-Stomatology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
authors.forename: Huy Phan The
authors.initials: HP
authors.lastname: Nguyen
authors.affiliation: Faculty of Dentistry, Pavillon Roger-Gaudry, Université de Montréal, C.P. 6128, succ. Centre-ville, Montreal, Quebec, H3C 3J7, Canada.
authors.forename: Pierre
authors.initials: P
authors.lastname: Rompré
authors.affiliation: Faculty of Dentistry, Pavillon Roger-Gaudry, Université de Montréal, C.P. 6128, succ. Centre-ville, Montreal, Quebec, H3C 3J7, Canada.|Hopital du Sacré-Coeur de Montréal, Montreal, QC, Canada.
authors.forename: Gilles J
authors.initials: GJ
authors.lastname: Lavigne
authors.affiliation: Faculty of Dentistry, Pavillon Roger-Gaudry, Université de Montréal, C.P. 6128, succ. Centre-ville, Montreal, Quebec, H3C 3J7, Canada.
authors.forename: Nelly T
authors.initials: NT
authors.lastname: Huynh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002940:Circadian Rhythm; D003778:Dentures; D006801:Humans; D008875:Middle Aged; D009066:Mouth, Edentulous / Q000534:rehabilitation*; D016032:Randomized Controlled Trials as Topic; D020181:Sleep Apnea, Obstructive / Q000209:etiology*
keywords: Denture; Obstructive sleep apnea; Sleep; Sleep disorders; Tooth loss