EFFECTIVENESS OF FUNCTIONAL ORTHOPEDIC APPLIANCES IN THE MANAGEMENT OF OBSTRUCTIVE SLEEP APNEA IN CHILDREN: EVIDENCE, INDICATIONS AND LIMITATIONS

Abstract

Pediatric obstructive sleep apnea (OSA) is a sleep-related breathing disorder associated with behavioral impairment, altered growth and reduced quality of life, and maxillomandibular developmental deficiencies may contribute to a narrowed airway. This study aimed to analyze the effectiveness of functional orthopedic appliances in children with OSA associated with maxillomandibular developmental alterations, discussing the evidence, indications and limitations. This is an integrative literature review conducted in October 2026 in PubMed/MEDLINE and PubMed Central, emphasizing systematic reviews, meta-analyses and clinical trials. The analyzed studies indicate improvement in the apnea-hypopnea index, oxygen saturation, symptoms and airway dimensions with mandibular advancement appliances and with maxillary expansion combined with other therapies. However, most primary studies are uncontrolled case series, isolated rapid maxillary expansion did not show superiority over watchful waiting in controlled evidence, and spontaneous resolution of OSA in childhood is common. It is concluded that functional jaw orthopedics is a promising option and should be indicated selectively, together with Pediatrics and Otorhinolaryngology, without replacing established treatments, and that improvement in clinical parameters does not equal proof of apnea resolution.