Obstructivesleep apnea (OSA), characterized by periodic and repetitive collapse of the upper airway during sleep, is a common disease with an estimated prevalence of 3% to 7% worldwide. 1 Patients with OSA undergo apnea and/or hypopnea, resulting in hypoxia, hypercapnia, sleep fragmentation, increased sympathetic activity, and altered immunity. 2,3 According to the American Academy of Sleep Medicine's (AASM) clinical practice guidelines, the management of patients by dentists through oral prosthesis therapy is accepted as an appropriate treatment. 4 An oral appliance has also been an effective treatment for OSA, improving not only OSA symptoms but also a variety of physiologic and behavioral outcomes. 5 Periodontitis is a disease with high prevalence, which affects 10.8% of the adult population worldwide. 6 The fourth National Oral Health Survey in China identified a periodontitis frequency of 52.8% in the 35-to 44-year age group. 7 Periodontitis is a chronic infectious and inflammatory disease caused by bacterial pathogens that initiate an inflammatory response from the host. 8 The synergetic effect of bacterial toxins and host immune response results in the destruction of periodontal tissues, manifested clinically as loss of alveolar bone, progressive loss of periodontal attachment, pocket formation, and, ultimately, tooth loss. 9

Background: To determine whether utilizing high-resolution pulse oximetry is a viable method for evaluating the successful titration of oral appliances for the treatment of obstructive sleep apnea (OSA) patients. Methods: Of 136 consecutive potentially eligible OSA patients, 133 were fitted with mandibular advancement devices (MADs), and 101 completed all phases of treatment. The vertical and horizontal dimensions of the appliances were adjusted based on three-nights with a high-resolution pulse oximeter during sleep and associated software after each adjustment. Results: Significant improvements in OSA severity were apparent in patients at all disease severity levels. High-resolution pulse oximetry provided reliable guidance in the titration process of mandibular advancement therapy. In 67 subjects (66.3%), a respiratory event index of <5 events/hour was achieved. Conclusions: OSA can be effectively treated with a MAD at any severity level, and high-resolution pulse oximetry provides critical information to guide oral appliance titration.

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