Sleep disordered breathing and mandibular repositioning devices

There’s a growing body of clinical research that demonstrates the efficacy and compliance of mandibular repositioning devices (MRDs) in treating obstructive sleep apnoea and snoring.  MRDs generally improve patient compliance and quality of life, as well as reduce both snoring and the apnoea-hypopnoea index (AHI).

The following clinical research papers demonstrate results in particular for ResMed’s Narval CC™ MRD. 

A custom-made mandibular repositioning device for obstructive sleep apnoea-hypopnoea syndrome (OSASH): the ORCADES study

Published in Sleep Med. doi: 10.1016/j.sleep.2015.05.020

Vecchierini MF, Attali V, Collet JM, d’Ortho MP, El Chater P, Kerbrat JB, Leger D, Monaca C, Monteyrol PJ, Morin L, Mullens E, Pigearias B, Meurice JC for the ORCADES investigators

  • A five-year multicentre study covering 369 patients
  • Purpose is to prospectively determine the long-term efficacy and tolerability of 2 custom-made Narval CC MRDs for OSAHS patients
  • 3-to-6 month data is reported in the study

Key results:

  • 79% success rate in decreasing AHI by ≥50%
  • 66% achieved complete success (AHI < 10/h)
  • 89% stopped loud snoring
  • Patients used Narval CC on average 6.7 hours per night, and 6.7 nights per week

Get more detail about the ORCADES study


Efficacy and compliance of mandibular repositioning device in obstructive sleep apnea syndrome under a patient-driven protocol of care

Published in Sleep Med 2008;9(7):762-9

Vecchierini MF, Léger D, Laaban JP, Putterman G, Figueredo M, Levy J, Vacher C, Monteyrol PJ, Philip P.

  • 40 patients ­— 10 with severe OSA (AHI ≥ 30) and 30 with moderate (AHI 15 to 30) — enrolled by 4 sleep centres. 35 completed the study

Key results:

  • Overall AHI reduced by 51%
  • Narval CC demonstrated high level of compliance (86%)


Impact on temporomandibular joint (TMJ) of two mandibular advancement device designs

Published in ITBM-RBM 2006;27(5-6):223-237. DOI: 10.1016/j.rbmet.2007.01.004

Cheze L and Navailles B

  • Computer-simulated study
  • Designed to compare traction-based vs. compression-based devices, with mandible in a 10 mm protrusion position

Key results:

  • Findings may imply an improved side effect and compliance profile in clinical practice for traction-based over compression-based devices
  • The study resulted in  10% less stress on the temporomandibular joint


First-line treatment of obstructive sleep apnea syndrome (OSAS) by custom-made mandibular advancement appliance: medium-term results. Prospective study by the General Hospital Pneumologists College (CPHG)

Published in Rev Pneumol Clin 2010;66(5):284-92

Geraads A, d’Athis P, Lerousseau L, Larzul JJ, Bénichou M, Guyonnaud C, Figueredo M, Steinbauer J, Bedicam JM, Martin F, Just N, Gonzalez G, Devin E, Veyer AS

  • Prospective 1-year multicentre study (13 general hospitals) between June 2006 and December 2007, covering 129 patients
  • Purpose is to demonstrate efficacy and tolerance of present generation MRDs in first intention treatment, even in severe cases of OSA

Key results:

  • Overall AHI reduced by 56%
  • Epworth Sleepiness Scale decreased by 38%


18 month assessment of 54 patients referred for treatment of anti-social snoring (AHI ≤ 30/hr) with a custom mandibular repositioning device

Published in Sleep Med 2011;12 (Suppl 1):S103

Dr. Roy Dookun, Private Dental Practice, United Kingdom

  • Purpose is to evaluate snoring reduction, as well as effect on OSA-related symptoms, treatment compliance and side effects
  • 39 patients completed whole protocol; data reported covers 18 months

Key results

  • Narval CC demonstrated high level of compliance at 82%
  • Narval CC significantly reduced overall TSS*-measured snoring by 84%

Download brochure for more details about this clinical research.

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