{"title":"下颌骨再定位器(MRA)相关不良事件分析——FDA制造商和用户设施设备体验(MAUDE)数据库的研究","authors":"Tala Al Khouri , Issam Halasa , Boris I. Medarov","doi":"10.1016/j.rmed.2025.108342","DOIUrl":null,"url":null,"abstract":"<div><h3>Study objectives</h3><div>Mandibular repositioning appliances (MRAs) are widely used for obstructive sleep apnea (OSA) and snoring, but their safety profile remains underexplored. This study analyzes adverse events associated with MRAs using the FDA Manufacturer and User Facility Device Experience (MAUDE) database.</div></div><div><h3>Methods</h3><div>A retrospective review of the MAUDE database identified adverse events related to MRAs under the product code “LRK” from January 1, 2015, to February 8, 2025. Reports were categorized into seven groups: allergic reactions, broken parts, loose screws, dental issues, ill-fitted appliances, temporomandibular joint (TMJ) problems, and miscellaneous issues. Duplicate reports and unrelated cases were excluded.</div></div><div><h3>Results</h3><div>A total of 517 reports were analyzed, with allergic reactions (40.3 %) and device breakage (39.4 %) being the most frequently reported issues. Other events included loose screws (6.3 %), dental issues (3.5 %), ill-fitting appliances (3.3 %), TMJ problems (2.9 %), and miscellaneous complaints (3.3 %). Custom-made MRAs were involved in 85 % of cases, while boil-and-bite devices accounted for 15 %.</div></div><div><h3>Conclusion</h3><div>Our analysis of the MAUDE database reveals an increasing number of adverse event reports related to MRAs, reflecting their growing use in treating OSA and snoring. Outcomes and success depend on factors like device type, patient selection, and adherence. Adverse events such as allergic reactions and device breakage highlight the need for proper material selection and maintenance, favoring MRAs made from biocompatible materials over polymethyl methacrylate or metal.</div><div>MRAs also present limitations such as dental contraindications and occlusal changes, stressing the importance of patient monitoring. Future research should focus on prospective studies to better assess outcomes.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"248 ","pages":"Article 108342"},"PeriodicalIF":3.1000,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"An analysis of adverse events associated with Mandibular Repositioning Appliances (MRA)- study of the FDA Manufacturer and User Facility Device Experience (MAUDE) database\",\"authors\":\"Tala Al Khouri , Issam Halasa , Boris I. Medarov\",\"doi\":\"10.1016/j.rmed.2025.108342\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Study objectives</h3><div>Mandibular repositioning appliances (MRAs) are widely used for obstructive sleep apnea (OSA) and snoring, but their safety profile remains underexplored. This study analyzes adverse events associated with MRAs using the FDA Manufacturer and User Facility Device Experience (MAUDE) database.</div></div><div><h3>Methods</h3><div>A retrospective review of the MAUDE database identified adverse events related to MRAs under the product code “LRK” from January 1, 2015, to February 8, 2025. Reports were categorized into seven groups: allergic reactions, broken parts, loose screws, dental issues, ill-fitted appliances, temporomandibular joint (TMJ) problems, and miscellaneous issues. Duplicate reports and unrelated cases were excluded.</div></div><div><h3>Results</h3><div>A total of 517 reports were analyzed, with allergic reactions (40.3 %) and device breakage (39.4 %) being the most frequently reported issues. Other events included loose screws (6.3 %), dental issues (3.5 %), ill-fitting appliances (3.3 %), TMJ problems (2.9 %), and miscellaneous complaints (3.3 %). Custom-made MRAs were involved in 85 % of cases, while boil-and-bite devices accounted for 15 %.</div></div><div><h3>Conclusion</h3><div>Our analysis of the MAUDE database reveals an increasing number of adverse event reports related to MRAs, reflecting their growing use in treating OSA and snoring. Outcomes and success depend on factors like device type, patient selection, and adherence. Adverse events such as allergic reactions and device breakage highlight the need for proper material selection and maintenance, favoring MRAs made from biocompatible materials over polymethyl methacrylate or metal.</div><div>MRAs also present limitations such as dental contraindications and occlusal changes, stressing the importance of patient monitoring. Future research should focus on prospective studies to better assess outcomes.</div></div>\",\"PeriodicalId\":21057,\"journal\":{\"name\":\"Respiratory medicine\",\"volume\":\"248 \",\"pages\":\"Article 108342\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-09-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Respiratory medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0954611125004056\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respiratory medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0954611125004056","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
An analysis of adverse events associated with Mandibular Repositioning Appliances (MRA)- study of the FDA Manufacturer and User Facility Device Experience (MAUDE) database
Study objectives
Mandibular repositioning appliances (MRAs) are widely used for obstructive sleep apnea (OSA) and snoring, but their safety profile remains underexplored. This study analyzes adverse events associated with MRAs using the FDA Manufacturer and User Facility Device Experience (MAUDE) database.
Methods
A retrospective review of the MAUDE database identified adverse events related to MRAs under the product code “LRK” from January 1, 2015, to February 8, 2025. Reports were categorized into seven groups: allergic reactions, broken parts, loose screws, dental issues, ill-fitted appliances, temporomandibular joint (TMJ) problems, and miscellaneous issues. Duplicate reports and unrelated cases were excluded.
Results
A total of 517 reports were analyzed, with allergic reactions (40.3 %) and device breakage (39.4 %) being the most frequently reported issues. Other events included loose screws (6.3 %), dental issues (3.5 %), ill-fitting appliances (3.3 %), TMJ problems (2.9 %), and miscellaneous complaints (3.3 %). Custom-made MRAs were involved in 85 % of cases, while boil-and-bite devices accounted for 15 %.
Conclusion
Our analysis of the MAUDE database reveals an increasing number of adverse event reports related to MRAs, reflecting their growing use in treating OSA and snoring. Outcomes and success depend on factors like device type, patient selection, and adherence. Adverse events such as allergic reactions and device breakage highlight the need for proper material selection and maintenance, favoring MRAs made from biocompatible materials over polymethyl methacrylate or metal.
MRAs also present limitations such as dental contraindications and occlusal changes, stressing the importance of patient monitoring. Future research should focus on prospective studies to better assess outcomes.
期刊介绍:
Respiratory Medicine is an internationally-renowned journal devoted to the rapid publication of clinically-relevant respiratory medicine research. It combines cutting-edge original research with state-of-the-art reviews dealing with all aspects of respiratory diseases and therapeutic interventions. Topics include adult and paediatric medicine, epidemiology, immunology and cell biology, physiology, occupational disorders, and the role of allergens and pollutants.
Respiratory Medicine is increasingly the journal of choice for publication of phased trial work, commenting on effectiveness, dosage and methods of action.