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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.

Last updated: Aug 11, 2026•1 RCTs•📖 Read as article →

Evidence Score

Evidence Score44/100
Human RCT★★☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Polygraphic evaluation of the effects of functional orthodontic treatment with twin block and herbst appliances on sleep quality: a randomized clinical trial.

rct

Gokce G, Akan B, Basoglu OK, Tasbakan MS, Emir B · Sleep & breathing = Schlaf & Atmung (2026)

Participants: 46
Duration: 8 months
Intervention: Functional orthodontic treatment with Herbst appliance or Twin Block appliance
Outcome: Sleep parameters (AHI, supine AHI, ODI, minimum oxygen saturation), PSQI score, skeletal sagittal measurements (SNB, ANB, Wits)
Effect Size: N/A (mean differences reported: AHI change 1.08, supine AHI change 3.29, ODI change 2.09)
Population: 46 patients with mandibular retrognathia and obstructive sleep apnea (OSA)

Result: 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.

PubMed: 42560468DOI: 10.1007/s11325-026-03778-w

Mechanism Graph

Functional appliance advances the mandible
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Mandibular advancement enlarges the upper airway
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Reduced airway collapsibility during sleep
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Improved sleep parameters (AHI, ODI) and subjective sleep quality

Limitations

  • ⚠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.

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References

  1. 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
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.