Abstract: Introduction: In obstructive sleep apnoea (OSA), treatment with mandibular advancement devices (MADs) reduces patients' Apnoea-Hypopnoea index (AHI) scores and improves their sleepiness and quality of life. The variability of responses to these devices makes it necessary to search for predictors of success. The aim of our study was to evaluate the presence of structural variables as a predictor of MAD efficacy in OSA. Material and methods: Retrospective cohort study. Clinical and structural variables (cephalometric and the presence or absence of mandibular torus) were collected. Statistical analysis was performed to evaluate the existence of predictive factors for the efficacy of MADs Results: 103 patients were consecutively referred for treatment with MAD were included (89.3% men); the mean age of the participants was 46.3 years, and the mean AHI before MAD was 31.4 (SD 16.2) and post- MAD 11.3 (SD 9.2). Thirty-three percent of patients had mandibular torus. Torus was associated with a better response (odds ratio (OR) = 2.854 (p = 0.035)) after adjustment for sex, age, body mass index (BMI; kg/m2), the angle formed by the occlusal plane to the sella?nasion plane (OCC plane to SN), overinjection, and smoking. No cephalometric predictors of efficacy were found. Conclusions: The presence of a mandibular torus practically triples the probability of MAD success. This is the simplest examination with the greatest benefits in terms of the efficacy of MAD treatment for OSA. We did not identify any cephalometric predictor variable.

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