Emerging monitoring techniques in oral appliance therapy for sleep apnea: a narrative review with a focus on mandibular jaw movement analysis.

INTRODUCTION

Oral appliance therapy (OAT) for obstructive sleep apnea (OSA) is a complex and dynamic intervention that requires efficient tools to evaluate treatment response and monitor therapeutic outcomes.

AREA COVERED: This review aims to provide a structured overview of current techniques for OAT monitoring, with a particular focus on mandibular jaw movement (MJM) analysis - a promising yet underutilized approach. Literature searches were conducted in PubMed, Scopus, and the Cochrane Library databases up to February 2025. Fifty-six studies were examined, encompassing morphometric and physiological measurements applied at different stages of OAT management in OSA patients. A wide range of measurement techniques were identified and categorized into three groups based on clinical utility.

EXPERT OPINION: The clinical relevance of any monitoring technique depends on its dynamic or static properties, the clinical setting (in sleep or wakefulness) and alignment with the specific clinical objectives within the OAT workflow. While static imaging and endoscopic-based methods offer anatomical and functional insights, only sleep-based assessments can capture treatment efficacy in clinically meaningful terms. Among alternative technologies for sleep testing, MJM analysis stands out as a promising approach for continuous and reliable monitoring, with ability to evaluate the dynamic, synchronized mechanisms underlying OAT efficacy.