Strengths
The standardized titration protocol used for both types of MAD is one of the major strengths of the present study. To the best of our knowledge, when comparing different MADs, few previous studies have reported a standardized titration protocol. In the present study, a detailed standardized titration protocol was applied, and no significant difference was found in finial protrusion position of both MAD groups, which enables an unbiased comparison. The standardized stepwise titration protocol for MAD, developed by one of the co-authors of this paper (GA), has been proved to have good efficacy, good tolerance, and good adherence [Inserting an MAD intra-orally induces a certain amount of mandibular vertical opening. A study of Mayoral et al. [