Mandibular Advancement Devices With Remote Monitoring Technologies: Expanding the Dentist's Role in the Management of Obstructive Sleep Apnea.

Obstructive sleep apnea (OSA) is a prevalent disorder with significant systemic and quality-of-life consequences. Mandibular advancement devices (MADs) are an established treatment option, but conventional follow-up often relies on intermittent visits and self-reported adherence. Sensor-integrated MADs and remote monitoring may enable objective adherence assessment and personalized longitudinal care, although their additional clinical value remains uncertain. This narrative review critically appraises current evidence on sensor-integrated MADs with remote monitoring for OSA, focusing on treatment adherence, objective monitoring, personalized therapy, and dentists' evolving role in longitudinal multidisciplinary care. We searched PubMed/MEDLINE, Embase, Scopus, and the Cochrane Library through 2025 for English-language studies on MADs, sensor-integrated oral appliances, and remote monitoring in OSA. We synthesized evidence across six domains spanning pathophysiology, clinical practice, and digital innovation. The evidence indicates that MADs improve respiratory and patient-reported outcomes, while integrating sensor-based and remote monitoring technologies offers additional opportunities for objective assessment of adherence and nightly appliance use. Remote monitoring and feedback may improve the consistency of MAD use, although increases in total nightly wearing time have not been consistently demonstrated. Emerging smart MADs can also monitor parameters such as sleep duration, sleep position, and respiratory events, while adaptive systems may enable individualized adjustment of mandibular advancement. However, current evidence does not yet establish that smart MADs provide superior long-term physiological, cardiovascular, or patient-reported outcomes compared with conventional MAD therapy. Smart MADs may nonetheless strengthen adherence assessment, expand the dentist's role in longitudinal care, and support personalized, multidisciplinary OSA management; further clinical validation and standardized long-term studies are needed to determine their incremental therapeutic value.