Klearway™ is a fully-adjustable or titratable oral appliance used for the treatment of snoring and mild to moderate Obstructive Sleep Apnea. Fabricated of thermoactive acrylic resin, Klearway becomes pliable with hot water for easy insertion and conforms securely to the dentition for an excellent fit, while significantly decreasing soft tissue and tooth discomfort. Small increments (0.25mm) of forward lower jaw advancement are initiated by the patient under the direction of a dentist and this helps avoid rapid jaw movements that can cause significant patient discomfort.
Once warmed under hot water and inserted, the acrylic resin hardens as it cools to body temperature and firmly affixes itself to both arches. Lateral and vertical jaw movement is permitted which enables the patient to yawn, swallow, and drink water naturally without dislodging the appliance. Klearway is easy to insert or remove and is quite comfortable once in place. This is a well researched and widely used appliance.
The Thornton Adjustable Positioner (TAP®) oral appliance is a very popular mandibular advancement device composed of two separate arches (maxillary and mandibular) containing an advancing mechanism which permits advancement of the lower jaw. The arches are custom fit to a patient's models and fit very snug.
The advancing mechanism is engaged and the screw mechanism in the upper tray is then adjusted or titrated to the most beneficial protrusive setting. TAP appliances have a very small profile; yet a proven success in some of the more severe cases.
SomnoMed MAS ™
The Somnomed MAS™ is a Mandibular Advancement Splint (MAS) that treats snoring and mild to moderate OSA by moving the lower jaw forward slightly. This forward movement tightens the soft tissues and muscles of the upper airway, which prevents them obstructing the airway while you sleep. The tightening created by the device also prevents the tissues of the upper airway vibrating as air passes over them- the most common cause of loud snoring.
The SomnoMed MAS is a custom-made device, consisting of upper and lower dental plates with a unique patented fin-coupling component, which allows normal mouth opening and closing. The device is adjustable, which provides adjustable levels of lower jaw advancement. This improves the effectiveness and comfort level of treatment, as the jaw is moved only as far as it requires to alleviate the condition. The SomnoMed MAS design has a number of key features that are significant improvements on existing MAS oral appliances. These improvements make the device both more comfortable and provide more effective treatment.
Permits normal mouth opening and closing
No feeling of claustrophobia; allows speech and drinking during night.
Fits comfortable in mouth
Provides normal tongue space; permits full lip seal; discreet when worn.
Can find optimum position; provides more comfort and improves patient tolerance.
Stable, flat occlusion
Better protection for teeth because forces are evenly distributed over the two plates.
Demonstrated to work in most cases of snoring and mild to moderate OSA.
Superior comfort; longer life provides value for money compared with lower cost products.
Warranty against breakage
Will be repaired or replaced if broken through normal wear within warranty period.
Customizable to suite patients' needs
Devices are available with additional features which may suit bruxers and mouth breathers.
Herbst Telescopic Appliance
The Herbst Appliance has been proven to be effective on chronic snoring and mild to moderate obstructive sleep apnea sufferers. This appliance allows patients to move laterally and vertically without disengaging the appliance. Also, if it is determined that the initial position does not provide the anticipated relief of the condition, the mandible can easily be moved forward by a Telescopic Advancing Mechanism in 1/4 mm increments by making one turn of the protrusion collar. The appliance can be fabricated from hard acrylic, thermoactive and soft materials and is tooth retained via friction grip or clasps.
The Herbst Appliance is a mandibular repositioner that has been in use many years for orthodontic and TMJ therapy prior to its modification for treatment of sleep disordered breathing.
The advantage of the Herbst appliance is that it does not encroached on tongue space and allows for quick and easy mandibular protrusive adjustability. This is accomplished through simple manipulation of the rod/sleeve plunger mechanism. Vertical opening is up to 5 mm and there is limited freedom of movement for the mandible in a lateral direction. Bilateral interarch elastics are recommended to keep the jaw closed during sleep.
The APM Ultra is the next generation Adjustable PM Positioner. The APM Ultra has incorporated many design features that will increase patient comfort and acceptance in addition to effectiveness.
The design features include:
Made of a comfortable heat-sensitive acrylic
Retention by projections of acrylic (no clasps)
Open in the anterior for easy breathing through the mouth (or nose)
Allows limited jaw movement (6 mm in lateral excursion)
Smaller expansion screws on R and L buccal segments
Smaller overall size with shorter periphery and increased tongue space
The Silencer Professional is a laboratory fabricated fully adjustable oral appliance for the treatment of sleep apnea and snoring. The appliance features a titanium precision attachment, which controls the anatomical settings of the appliance. It is capable of anteroposterior adjustment as well as vertical adjustment through a range of 10mm, in both dimensions. The design of the precision attachment also allows lateral movement of the mandible which respects and protects the TMJ. The titanium Halstrom Hinge is made of implant grade titanium and carries a five-year warranty.
There are three component materials in the Silencer. The body of the appliance is constructed of elastomer,a pliable material which offers the patient a much greater degree of comfort than harder acrylic materials. For additional support, to the dentition as well as the temporomandibular joint, hard acrylic "bite pads" are placed in the molar regions. A commercially pure titanium articulating component gives the appliance the many adjustment characteristics that make the Silencer unique - kind to the tissues, the teeth, and the temporomandibular joint.
Snore Guard®, an oral appliance easily assembled at chair side, comprises a structure shaped to conform to the upper dental arch of the user and to create a ramp behind the lower anteriors. This ramp prevents the user's jaw from receding; in addition, the tongue seeks an opening between the upper and lower portion of the Snore Guard, thus keeping the air passage of the throat open.
It is made of two polycarbonate thermoplastics fused together under high pressure. This unique combination of materials allows stability of the unit while providing ease of wear and insertion.
Snore Guard has been marketed since 1989 with a 95% reported success rate for reducing snoring. Snore Guard's design allows the user to breathe orally while promoting nasal breathing. It also permits lateral movement of the mandible.
The Silent Nite® appliance is prescribed by many dentists for the initial treatment of snoring. It is a laboratory made appliance that can be adjusted by changing the white side straps. Persons with mild sleep apnea also may be treated when surgical and other medical treatments are ineffective or not desired. A soft/hard frame material is available for increased patient comfort.
Additional Appliances Carried in our Office
Adjustable Therasnore- Similar to Snoreguard
Rest Assured- Similar to Snoreguard
EMA- Similar to Herbst or Silent Nite
NORAD (Nocturnal Oral Airway Dilation)- Similar to Therasnore but with vertical adjustment as well
Snore-Aid- for patients with no upper teeth
TONGUE RETAINING & STABILIZING DEVICES
SNOREX & TRD - These appliances hold the tongue forward by suction and do not rely on teeth for retention. They are useful for compromised dentitions.