Critical appraisal of the systematic review on mandibular advancement using clear aligners in obstructive sleep apnea management

Dear Editor,

I would like to extend my sincere congratulations to Samater et al. on the publication of their valuable systematic review of mandibular advancement using clear aligners in patients with sleep apnea.^[1] The paper presents an important and timely contribution to the field, offering undoubtedly benefits to both clinicians and researchers.

I found the article to be comprehensive and well-organized while reading it with great interest. Nevertheless, I would like to humbly suggest a few additional aspects that may further enrich the discussion and practical relevance of the work, if the authors consider a future update or follow-up publication.

Sokolina reported the use of clear aligner therapy to ameliorate symptoms of moderate sleep apnea and Continuous Positive Airway Pressure (CPAP) intolerance.^[2] This study was published in 2024 and, given the inclusion criteria for studies in this review, may have provided valuable data, but it was not included in the final studies.

In this systematic review, it may be necessary to include the study by Cretella Lombardo et al.,^[3] which addressed a similar issue. Both aligner-treated and twin-block-treated groups were analyzed in this study. The systematic review may have missed valuable information by not including this study.

In addition to the previous information, it may be necessary to review and add other studies to the systematic review, such as studies by Atali,^[4] Al-Jewair et al.,^[5] Horani et al.,^[6] Fountoulaki and Thurzo,^[7] and Dianiskova et al.^[8]

Thank you for your time and consideration.