Evaluation of Oral Appliance Therapy Using a Novel Titration Method for Obstructive Sleep Apnea

The purpose of an oral appliance (OA) is to relieve upper airway obstructions by advancing the mandible. This study evaluated the effectiveness of a new OA fabrication method in which the mandibular position was determined through MRI-based soft tissue assessment. An OA was fabricated using SomGauge (SomnoMed, Inc), and patients who underwent polysomnography at diagnosis (T0) and follow-up (T1) were included. OA response rates were compared between the following 2 groups: the S group, in which the OA was fabricated using the standard method, and the S-MRI (SomGauge-MRI) group, in which fabrication was guided by MRI soft tissue evaluation. Twenty-five patients were enrolled in the S group and 19 in the S-MRI group. No significant differences in age, body mass index (BMI), apnea-hypopnea index (AHI), or mandibular advancement were noted between groups. AHI reduction rates were 44.29%±6.37% in the S group and 65.09%±5.04% in the S-MRI group; hypopnea index reduction rates were 39.10%±7.15% and 62.97%±5.22%, respectively, with both showing significant improvement. No significant difference was found in apnea index reduction rates between the S (58.57%±13.61%) and S-MRI (61.60%±10.33%) groups. The MRI-based mandibular positioning method improved the success rate of OA therapy compared with the conventional approach, supporting its clinical utility in enhancing airway patency in sleep-disordered breathing.