Mandibular Advancement Devices for Reflux in Obstructive Sleep Apnea

NCT ID: NCT07049315

Last Updated: 2025-07-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

PHASE3

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-08-01

Study Completion Date

2026-12-01

Brief Summary

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The purpose of this randomized clinical trial is to learn if a mandibular advancement device (a type of oral appliance) can help reduce nighttime acid reflux in adults with obstructive sleep apnea. The study also aims to understand whether this device can improve sleep quality and quality of life.

The main questions the study aims to answer are:

* Does using a mandibular advancement device reduce the number and intensity of nighttime reflux episodes?
* Does the device improve sleep and daily well-being in people with sleep apnea and reflux?

Researchers will compare two types of oral appliances:

* A mandibular advancement device, which moves the lower jaw forward during sleep
* A lower jaw oral device without advancement, which also aims to help people with sleep apnea but does not reposition the jaw

Participants will:

Wear the assigned oral device every night for 6 months Visit the clinic for check-ups and adjustments Complete short questionnaires about reflux symptoms, sleep quality, swallowing, diet, and quality of life Have saliva pH measured and X-rays taken before and after using the device This study hopes to find out whether oral devices can be a good option for people who do not tolerate CPAP therapy.

Detailed Description

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Conditions

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Gastroesophageal Reflux Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be randomly assigned to one of two parallel groups:

The experimental group will receive a mandibular advancement device (MAD) that repositions the lower jaw forward during sleep.

The comparator group will receive a lower jaw oral device without mandibular advancement.

Each participant will use the assigned device nightly for 6 months. There is no crossover between arms.
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors
The participant, the primary investigator, and the assessor of outcomes will not know which device the participant receives. Only the provider who delivers the oral appliance will know.

Study Groups

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Mandibular Advancement Device (MAD)

Participants in this group will receive a custom-made mandibular advancement device (MAD), designed to reposition the lower jaw forward during sleep. The appliance is used nightly for 180 days and aims to improve upper airway patency and reduce nighttime gastroesophageal reflux episodes. The device is made of heat-cured acrylic and adjusted based on individual mandibular protrusion measurements.

Group Type EXPERIMENTAL

Mandibular Advancement Device

Intervention Type DEVICE

A custom-made intraoral appliance designed to reposition the mandible forward during sleep. The device increases the upper airway space by maintaining the lower jaw in a protruded position, aiming to reduce airway collapse and decrease nocturnal gastroesophageal reflux. It is fabricated from heat-cured acrylic based on individual dental impressions and bite registrations taken in a protruded mandibular position.

Lower Oral Device Without Mandibular Advancement (DIO)

Participants in this group will receive a lower jaw oral device that does not advance the mandible. The appliance is also indicated for patients with obstructive sleep apnea and provides dental disocclusion without altering jaw position. It will be used nightly for 180 days, serving as the control intervention. The device is fabricated similarly to the MAD but without mandibular repositioning.

Group Type ACTIVE_COMPARATOR

Lower Oral Device Without Mandibular Advancement

Intervention Type DEVICE

A lower jaw oral appliance made of heat-cured acrylic, fabricated from standard dental impressions and bite registration in habitual occlusion. This device does not reposition the mandible but provides posterior dental disocclusion. It is also used in patients with obstructive sleep apnea and serves as an active comparator to evaluate the specific impact of mandibular advancement on nocturnal gastroesophageal reflux.

Interventions

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Mandibular Advancement Device

A custom-made intraoral appliance designed to reposition the mandible forward during sleep. The device increases the upper airway space by maintaining the lower jaw in a protruded position, aiming to reduce airway collapse and decrease nocturnal gastroesophageal reflux. It is fabricated from heat-cured acrylic based on individual dental impressions and bite registrations taken in a protruded mandibular position.

Intervention Type DEVICE

Lower Oral Device Without Mandibular Advancement

A lower jaw oral appliance made of heat-cured acrylic, fabricated from standard dental impressions and bite registration in habitual occlusion. This device does not reposition the mandible but provides posterior dental disocclusion. It is also used in patients with obstructive sleep apnea and serves as an active comparator to evaluate the specific impact of mandibular advancement on nocturnal gastroesophageal reflux.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Adults aged 18 to 65 years
* Clinical diagnosis of obstructive sleep apnea (OSA) confirmed by polysomnography type I
* Presence of nocturnal gastroesophageal reflux symptoms
* Not currently using CPAP therapy
* Dentate individuals able to wear oral devices
* Able and willing to comply with the study protocol
* Provided written informed consent

Exclusion Criteria

* Severe OSA (Apnea-Hypopnea Index \> 30)
* Current or recent use of proton pump inhibitors or other anti-reflux medications
* Neurological or neuromuscular disorders
* Use of removable dental prostheses (partial or total)
* Prior surgeries for apnea or reflux
* Known allergy or intolerance to dental acrylic materials
* Inability to attend follow-up visits or complete questionnaires
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tuiuti University of Paraná

OTHER

Sponsor Role lead

Responsible Party

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Flávio Magno Gonçalves

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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José Stechman-Neto, PhD, DDS

Role: STUDY_DIRECTOR

Universidade Tuiuti do Paraná

Locations

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Universidade Tuiuti do Paraná - Centro de Diagnóstico das Alterações Temporomandibulares (CDATM)

Curitiba, Paraná, Brazil

Site Status

Countries

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Brazil

Central Contacts

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Flávio M Gonçalves, PhD, DDS

Role: CONTACT

+55(42)988167711

Rodolfo Jorge F Kubiak, MSc, DDS

Role: CONTACT

+55(42)999385573

Facility Contacts

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Rodolfo Jorge F Kubiak, MSc

Role: primary

+55(42)999385573

Other Identifiers

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NEC01

Identifier Type: -

Identifier Source: org_study_id

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