title: Quality Assessment of Systematic Reviews on the Efficacy of Oral Appliance Therapy for Adult and Pediatric Sleep-Disordered Breathing.
abstract: To assess the methodological quality of published systematic reviews (SRs) and meta-analyses (MAs) about the efficacy of oral appliances (OA) in the management of adult and pediatric sleep-disordered breathing (SDB).
  
  
  
  SRs/MAs that evaluated the efficacy of OA therapy on the treatment of SDB in human subjects of all age groups were sought. Multiple electronic databases were searched for articles published in any language from the database's inception until January 2016. Two reviewers independently selected and then assessed the methodological quality of the studies using the Assessment of Multiple Systematic Reviews (AMSTAR) measurement tool.
  
  
  
  Thirteen reviews on adult SDB were included (2 SRs and 11 SRs with MAs). Of those, seven were medium quality and six were high quality. Only four reviews were included on pediatric SDB (3 SRs and 1 SR with MA). Three of these were of high quality and one was medium quality. The identified limitations in the included reviews were failing to reference the excluded studies or describe reasons for exclusion, lack of applying valid criteria to assess the quality of included studies, lack of publication bias assessment, and absence of conflicts of interest reporting.
  
  
  
  Overall, SRs/MAs on OA therapy for adult and pediatric SDB were conducted with acceptable methodological quality. High AMSTAR scores should not be extrapolated as a proxy of the methodological quality of the included evidence. There is a need for more primary studies and then that information can be used to be synthesized through SRs on pediatric SDB.
authors.affiliation: Clinical Assistant Professor and Program Director, Department of Orthodontics, State University of New York at Buffalo, Buffalo, NY.
authors.forename: Thikriat S
authors.initials: TS
authors.lastname: Al-Jewair
authors.affiliation: Lecturer, Department of Preventive Dental Sciences, College of Dentistry, University of Dammam, Saudi Arabia.
authors.forename: Balgis O
authors.initials: BO
authors.lastname: Gaffar
authors.affiliation: Professor, Orthodontic Graduate Program Director, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alberta Canada.
authors.forename: Carlos
authors.initials: C
authors.lastname: Flores-Mir
mesh_terms: D000328:Adult; D002648:Child; D006801:Humans; D019186:Mandibular Advancement / Q000379:methods*; D011785:Quality Assurance, Health Care / Q000379:methods*; D012196:Review Literature as Topic; D012891:Sleep Apnea Syndromes / Q000628:therapy*; D016896:Treatment Outcome
keywords: mandibular advancement device; sleep apnea syndrome; systematic review; treatment efficacy