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Bloch et al. (2000) compared the effectiveness and side-effects of a novel, single piece MAA device (OSA-Monobloc) with a two piece, lateral Herbst attatchments (OSA-Herbst) appliance and concluded that OSA-Monobloc relieved symptoms to a greater extent than OSA-Herbst.[43] Ferguson et al. (1997) conducted a prospective cross-over study to compare efficacy, side-effects, patient compliance and preference between MAA and N-CPAP in patients with symptomatic mild to moderate OSA and concluded that MAA is a VX-680 research buy better treatment option with greater patient satisfaction.[44] Gale et al. (2000) evaluated the effect of a MAA on minimum pharyngeal cross-sectional R406 area (MPCSA) in 32 conscious, supine subjects with OSA and concluded that the MAA significantly increased MPCSA.[45] Barthlen et al. (2000) compared three different OAs: A MAA (snoreguard), a TRD and a SPL appliance for the treatment of severe OSA syndrome and stated that MAA is an effective treatment alternative in some patients.[46] Kyung et al. (2005) studied the pharyngeal size and shape difference between pre- and post-trials of MAAs, using cine computerized tomography and revealed that the MAA appeared to enlarge the pharynx to a greater degree in the lateral than in the sagittal plane at the retropalatal and the retroglossal levels of the pharynx, suggesting a mechanism for the effectiveness of the OA.[47] Almeida et al. studied the long-term sequelae of OA therapy and found that after a mean of 7.4 years, OAs induce clinically relevant changes in the dental arch and the occlusion.[48] MAA devices may have Peptide bond no effect on obstruction associated with cranial base morphology, nasal obstruction or retropalatal obstruction. Furthermore, the application of MAAs may not be a good choice for subjects with Class III malocclusion where the jaw is already protruded. A possible alternative to MAAs might be the use of a maxillary OA. Maxillary OAs putatively induce renewed midfacial development and provide an alternative approach to managing OSA, by permitting non-surgical remodeling of the upper airway.[49,50] OAs vs Other Treatment Continuous positive airway pressure (CPAP) prevails as the ��gold standard�� of treatment for OSA. Hence, any other newer approach has to be compared against it. There are almost seven randomized controlled studies that compared OAs with CPAP. In all studies, CPAP showed better results than OAs in bringing the AHI