Herbst appliance improves sleep quality in patients with mandibular retrognathia and obstructive sleep apnea
In a randomized clinical trial of 46 patients with mandibular retrognathia and OSA, the Herbst appliance significantly reduced AHI (mean change 1.08, p=0.031), supine AHI (mean change 3.29, p=0.001), and ODI (mean change 2.09, p=0.013) after an average 8-month follow-up. Twin Block appliance showed no significant changes in these sleep parameters. Both groups showed significant improvements in PSQI scores and skeletal sagittal measurements.
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Herbst appliance improves sleep quality in patients with mandibular retrognathia and obstructive sleep apnea The current body of evidence comprises 1 study, including 1 randomized controlled trial. EvidenceHub rates the overall confidence at 44/100 (low).
The Claim
Herbst appliance improves sleep quality in patients with mandibular retrognathia and obstructive sleep apnea
This conclusion is most relevant to: 46 patients with mandibular retrognathia and obstructive sleep apnea (OSA).
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Polygraphic evaluation of the effects of functional orthodontic treatment with twin block and herbst appliances on sleep quality: a randomized clinical trial. (Sleep & breathing = Schlaf & Atmung, 2026) — In a randomized clinical trial of 46 patients with mandibular retrognathia and OSA, the Herbst appliance significantly reduced AHI (mean change 1.08, p=0.031), supine AHI (mean change 3.29, p=0.001), and ODI (mean change 2.09, p=0.013) after an average 8-month follow-up. Twin Block appliance showed no significant changes in these sleep parameters. Both groups showed significant improvements in PSQI scores and skeletal sagittal measurements.
How It Works
The proposed biological pathway:
- ▸Functional appliance advances the mandible
- ▸Mandibular advancement enlarges the upper airway
- ▸Reduced airway collapsibility during sleep
- ▸Improved sleep parameters (AHI, ODI) and subjective sleep quality
Who Might Benefit
Evidence fit by population:
- ▸46 patients with mandibular retrognathia and obstructive sleep apnea (OSA)
Recommended Dose
N/A
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Small sample size (46 patients)
- ▸Short follow-up (average 8 months)
- ▸No placebo or control group without treatment
- ▸Only patients with mandibular retrognathia, limiting generalizability
Frequently Asked Questions
What is the effect of Herbst appliance on AHI in OSA patients?▼
The Herbst appliance significantly reduced AHI by a mean of 1.08 events per hour (p=0.031) after 8 months of treatment.
Does Twin Block appliance improve sleep quality in OSA patients?▼
Twin Block appliance did not show statistically significant changes in AHI, supine AHI, or ODI, but PSQI scores improved significantly.
What sleep parameters were measured in this study?▼
The study measured AHI, supine AHI, oxygen desaturation index (ODI), minimum oxygen saturation, and PSQI score.
How long was the follow-up period?▼
The follow-up was an average of 8 months after baseline.
References
- 1.Gokce G, Akan B, Basoglu OK, Tasbakan MS, Emir B. “Polygraphic evaluation of the effects of functional orthodontic treatment with twin block and herbst appliances on sleep quality: a randomized clinical trial..” Sleep & breathing = Schlaf & Atmung, 2026. PMID: 42560468 DOI: 10.1007/s11325-026-03778-w