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+<br>Obstructive sleep apnea is characterized by recurrent obstruction of the upper airway during sleep, leading to episodic reductions in blood oxygen saturation and arousals from sleep. Mandibular repositioning appliances (MRAs) that are worn intra-orally at evening, mechanically advance the mandible to assist maintain a patent oropharygeal airway and have been confirmed to be an efficient alternative for steady positive airway strain within the therapy of obstructive sleep apnea. Titratable MRAs are designed to regularly protrude the mandible applying an easy-to-use mechanical advancing mechanism, until a protrusive position with optimistic impact on sleep apnea is reached. Considering the comparatively low-tech strategy of the essential advancement mechanism, the interest in the mechanistic ingredient of the dental treatment of obstructive sleep apnea has elevated. The present paper gives an outline of the different titration protocols described within the recent literature together with a dialogue of both the clinical and mechanical aspects of treatment. At present, a consensus exists that an optimal titration protocol is of primary significance to attain a profitable therapy consequence with an MRA. Thus far nonetheless, there isn't a consensus on the way to define the optimum titration protocol.<br>
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