Clasp Retained Mandibular Positioner (CRMP)

This is a dental laboratory manufactured appliance, and as such requires two visits to your doctor to use it. This appliance uses a combination of a hard plastic shell and multiple clasps to lock the mandible into the appliance and prevent it from moving backward in the patients mouth (thereby decreasing airway volume). Because it is a one-piece appliance the dentist can control the vertical dimension by changing the height of the appliance. This newer, improved design provides for a larger airway cut into the acrylic.

Current FDA approval status is unclear.



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Clasp Retained Mandibular Positioner (CRMP)

Elastomeric Sleep Appliance

The Elastomeric sleep appliance is made of medical grade silicone and is custom adjusted to fit each patient and is extremely comfortable. They are individually made in the dental laboratory from impressions your dentist takes of your mouth. It is “tooth retained” and has no clasps or wires, so is compatible with those who have allergies to some metals. This appliance does not have the ability to adjust the lower jaw either forward or backward of the position determined by your dentist and dental lab… though the jaw is afforded some movement because the material is so flexible. Proven effective by the University of Kentucky Medical Center Sleep Apnea Laboratory. Recommended for partial edentulous patients and non-bruxers.

FDA approved for treatment of snoring and mild to moderate OSA.



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Elastomeric Sleep Appliance

Myerson EMA (Elastic Mandibular Advancement)

The E.M.A. is thinner and less bulky then most snoring/OSA appliances. It is similar to clear acrylic orthodontic retainers, and the 'hardware' (located to the cheek side of the molar teeth) consists of specially designed, patented elastic bands. The appliance is designed to both advance the lower jaw (mandible) and open the bite to allow for less restricted airflow during sleep.
EMA appliances help promote a deeper, more restful sleep by preventing snoring and relieving the symptoms of obstructive sleep apnea (OSA). The EMA does not interfere with breathing through the mouth, even in cases of congested nasal passages. The EMA has many options for patient advancement with 5 strap lengths and 4 different elastic tension options. Non-restricted side-to-side (lateral) or front-to-back (protrusive) movements of the jaw are possible while wearing the appliance due to varying elastic bands.
Some care must be taken to avoid breaking the lower portion when replacing the custom elastics. The EMA is well tolerated by patients who grind their teeth. It has no metal and can be used by patients with a nickel metal allergy.

FDA approved for treatment of snoring and mild to moderate OSA.



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Myerson EMA (Elastic Mandibular Advancement)

Full Breath Solution

While other oral sleep appliances advance the mandible to open the airway, the Full Breath Solution directly treats most sleep disorders at the tongue. The design of the Full Breath Solution focuses on inhibition of tongue movement; inhibiting the rise and backward movement of the tongue so that it does not block the airway during sleep. As a single arch appliance designed to provide subtle yet effective adjustments, the Full Breath Solution improves airflow 100% of the time and stops snoring with a high percentage of patients. The appliance's design makes it comfortable for the patient to wear while advancing the mandible to an end-to-end position. The FBS causes no permanent occlusal changes or TMJ problems; however, it is not ideal for those who have strong gag-reflexes.

FDA approved for treatment of snoring and mild to moderate OSA.



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Full Breath Solution

Herbst

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.
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 further forward by two options of adjustability.
The advantage of the Herbst appliance is that it allows for quick, easy and accurate adjustment by the dentist.

FDA approved for treatment of snoring and mild to moderate OSA.



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Herbst

Hilsen Adjustable Positioner

The Hilsen sleep appliance has custom-made, separate upper and lower arch shells. These appliances each have velcro-like material on them that adhere to each other and provide an ideal jaw-to-jaw relationship throughout the night, thus enhancing the body’s ability to breathe during sleep. Adjustments to the position of the lower Hilsen appliance is easily accomplished by both the patient and the doctor. Vertical dimension is customizable and is mostly dependent on the lab fabrication process.

FDA approved for treatment of snoring and mild to moderate OSA.



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Hilsen Adjustable Positioner

Klearway

Fabricated of comfortable, thermo-active acrylic, the Klearway is easy to insert, conforms securely to teeth, and permits lateral movement. The Klearway provides full occlusal coverage of both arches, and does not encroach on tongue space. This appliance is suitable for most patients including those who brux (clench/grind), have missing or complicated dentitions, some upper edentulous cases, extensive bridgework and/or short clinical crowns.

Once warmed under hot water for easy insertion, the Klearway's thermoactive acrylic resin contracts as it cools, providing superior retention and fit. This significantly decreases soft tissue and tooth discomfort. Lateral and vertical jaw movements are permitted, allowing patients to yawn, swallow and drink water without dislodging the appliance.

FDA approved for treatment of snoring and mild to moderate OSA.



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Klearway

Medical Dental Sleep Appliance (MDSA)

The Medical Dental Sleep Appliance (MDSA) was developed in conjunction with Australian dentists, sleep physicians, and dental technicians. It is a titratable mandibular advancement appliance with these special added features:

  • Ability to adjust the advancement when the appliance is in place using a key
  • Lateral movement of the mandible with the appliance in place reduces TMJ problems and improves comfort
  • Low profile of the appliance allows minimum opening of the bite

The MDSA is scientifically proven as an effective method for treating snoring and mild to moderate sleep apnea.



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Medical Dental Sleep Appliance (MDSA)

Mandibular Inclined Repositioning Appliance (MIRS)

The MIRS is a custom-made, one-piece splint and snaps onto the upper teeth (making it easily removeable). The majority of the appliance/splint is made of a hard acrylic material, though some parts of the appliance are constructed from a thermoplastic material that softens at body temperature, keeping it comfortable for the patient. The lower aspect of the MIRS appliance (which contacts with the teeth in the lower jaw) is contoured to match the lower teeth. This ensures that the lower jaw positions itself downward and forward to allow for improved airway function while sleeping. There is also a breathing hole in the front of the appliance for easy breathing throughout the night.

FDA approval is unclear.



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Mandibular Inclined Repositioning Appliance (MIRS)

The Moses™

The Moses appliance is a two-piece device that allows patients to talk, drink, open wide and close their lips, making this one of the most comfortable appliances available. It stimulates protrusive tongue reflexes while an open anterior design advances the tongue and enlarges the cross-sectional area of the airway. The flexible upper retainer (in green) helps prevent tooth movement and acts as an anchor for the entire maxillary arch. Attached to the base, the blue section determines how far the mandible is pushed forward.

Additional benefits of the Moses include:

  • Elevates tongue to the hard palate and increases nasal air flow
  • Allows lip seal
  • Corrects dysphagia (difficulty swallowing)
  • Comfortable and adjustable

  • FDA approved for treatment of snoring and mild to moderate OSA.



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The Moses™

Nocturnal ORal Airway Dilator (NORAD)

The Nocturnal ORal Airway Dilator (NORAD) is a non-custom approved oral appliance for the treatment of snoring and sleep apnea. It is a “boil & bite” appliance, which means it can be fit and delivered to a patient immediately without waiting for lab fabrication. This makes it an ideal temporary appliance to use when patients need to undergo dental work or if they’ve lost or damaged their existing appliance. The strong construction of the NORAD can hold up for several weeks or even months. Some additional features and benefits include:

  • Unlimited lateral mobility
  • Adjustable vertical and protrusive positions
  • Ability to open the mouth with appliance in place
  • Very good retention
  • Low profile (minimum vertical is just 5mm), making it less bulky than other appliances

FDA approved for treatment of snoring and mild to moderate OSA.



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Nocturnal ORal Airway Dilator (NORAD)

OASYS Oral/Nasal Airway System™

The OASYS Oral/Nasal Airway System™ is the first dental device for snoring and sleep apnea that treats the two major causes of sleep disordered breathing by addressing both upper airway resistance in the nasal region and blockage in the throat region. The OASYS not only repositions the lower jaw forward and opens the nasal passages for better breathing, but also helps to guide the tongue forward to further enlarge the breathing opening.
The OASYS treats both vulnerable areas of the upper airway with one patented system while strengthening the throat area by pulling the lower jaw and tongue forward to prevent the tongue from blocking the airflow and strengthening the throat against collapse. This appliance is approved not only for the treatment of snoring and sleep apnea, but also as a nasal dialator for improved ease of breathing.

FDA approved for treatment of snoring and mild to moderate OSA.



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OASYS Oral/Nasal Airway System™

OSAP

The OSAP is a custom-made oral appliance that can be manufactured with or without an oral air passage. The appliance covers all teeth in both the upper and lower arches, and is made of a soft, flexible material that enhances patient comfort. The OSAP appliance can work well with upper edentulous (no upper teeth) and some full edentulous patients. As an added bonus, it can be used for home bleaching techniques. A ready-made, semi-universal trial version can be obtained for sleep apnea patients that do not want to have their impressions taken. When tolerance of dental devices is in question, this is one of the best and most inexpensive ways to test a particular patients' tolerance to oral therapy.

FDA approved for treatment of snoring and mild to moderate OSA.



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OSAP

OSB Balance

The OSB Balance appliance has some similarities with the dental orthotics that have been used in the treatment of snoring and OSA, however OSB therapy is quite different in that the appliances do not solely rely on alteration of jaw position to keep the tongue from falling back into the throat. Developed by Dr. Farrand Robson DDS, Oral Systemic Balance therapy applies new knowledge of the effect that the shapes and contours of the teeth and other oral structures have on the tongue and airway. In this way, snoring and OSA are better managed as breathing, swallowing, and speaking are made easier. The OSB Balance appliance is a customized pair of acrylic shells joined by elegantly designed titanium hinges. It has a wide variety of adjustable features, though one of the core elements is adjusting the inside acrylic contours to better enable the tongue to posture upward and forward.


OSB Introduces Daytime Therapy

OSB Day-time appliances are also part of OSB Orthotic Therapies. Maintenance of an open throat is not only a night issue, even though treatment of OSA and related symptoms has up until now been focused on nighttime concerns. There are many serious day symptoms associated with snoring and OSA, as the dysfunction of the throat and oral structures are often present 24 hours a day. Specially designed unobtrusive day-time orthotics have had marked benefit for many OSA and other sleep disordered breathing patients. These OSB Day-time appliances are similar to the Balance appliance, with the exception of the hinges, giving the appliance a lower profile that doesn’t interfere with daily activities.

OSB appliances can only be administered by dentists who have been trained in these therapies. To get a listing of dentists who have completed the training, visit: www.OralSystemBiology.com

OSB appliances have not yet been reviewed by the FDA.



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OSB Balance

Adjustable PM Positioner

The Adjustable PM Positioner is a custom-made appliance constructed of a heat-sensitive acrylic that fits over the upper and lower teeth. The appliance is comfortable on the teeth and leaves added space for the tongue compared to other devices. It allows a small amount of jaw movement (4mm) so that the patient does not feel "locked into position". The adjustment mechanisms are on the cheek side of the appliance near the molars and allow for easy advancement of the jaw position to improve effectiveness of the appliance.

The upper and lower portions of the Adjustable PM Positioner are thermal-plastic and must be heated prior to seating.

FDA approved for treatment of snoring and mild to moderate OSA.



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Adjustable PM Positioner

The Silencer

The Silencer is a laboratory fabricated fully adjustable oral appliance for the treatment of sleep apnea and snoring. There are three component materials in the Silencer appliance: 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. Lastly, a commercially-made pure titanium articulating component allows lateral movement of the mandible, which also protects the TMJ. This titanium precision attachment, which controls the anatomical settings of the appliance, is capable of anterior-posterior adjustments as well as vertical adjustments through a range of 10mm in both dimensions.

FDA approved for treatment of snoring and mild to moderate OSA.



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The Silencer

Silent Nite®

Silent Nite is an affordable, custom-made snore prevention device, which is flexible, thin, and comfortable for the patient. This appliance positions the lower jaw into a forward position by means of special connectors that are attached to transparent flexible upper & lower trays. Silent Nite devices do not interfere with breathing through the mouth, and even in cases of congested nasal passages the device prevents snoring and allows uninhibited oral breathing. Small forward movements of the lower jaw are possible with this appliance, which helps minimize stiffness in the joints of the jaw in the morning.

FDA approved for treatment of snoring and mild to moderate OSA.



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Silent Nite®

SNOAR

The SNOAR Open Airway Appliance can be prescribed for patients with mild to moderate sleep apnea and snoring problems. It is a one-piece appliance that moves the lower jaw forward while holding the mouth open at night to increase the ease of breathing. Patients and their bed partners that had previously been exposed to nasal CPAP unanimously preferred the SNOAR Open Airway Appliance.
Johns Dental Laboratories is the sole and exclusive laboratory in the United States licensed to fabricate this appliance.

FDA approved for treatment of snoring and mild to moderate OSA.



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SNOAR

SomnoDent MAS

The SomnoDent 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 improves the efficacy and comfort level of treatment, as the jaw is moved only as far as is required to alleviate the condition. The SomnoDent 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 tissue and muscles of the upper airway, which prevents obstruction of the airway during sleep. Made from a softer inner lining for comfort, SomnoDent MAS is a good appliance for those who need freedom of movement. Its upper and lower parts are held together by elastics (rubber bands) or alternatively they can be completely separate.

FDA approved for treatment of snoring and mild to moderate OSA.



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SomnoDent MAS

SomnoGuard (Original, AP, and AP Pro)

The original SomnoGuard is a one-piece (upper and lower) thermoplastic body that will customize itself to each patient during the insert process (which is overseen by the dentist). The AP model was developed to provide additional customization by the dentist, for each patient. This model consists of two pieces of self-customizing thermo-plastic. Once the “fit” has been customized the hardware (an adjustment screw) is used and ideal lower to upper jaw relationship is established. The AP Pro model is a further advancement whereby a dental lab produces the upper and lower shell from impressions taken of the patient’s teeth.

FDA approved for treatment of snoring and mild to moderate OSA.



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SomnoGuard (Original, AP, and AP Pro)

SUAD

The SUAD snoring and sleep apnea appliance is a custom-made appliance. The metal hinge holding the upper and lower arches together function to hold the lower jaw forward and thus improve the overall structure and function of the airway while sleeping. Small rings that can be added to the hinge allow for virtually unlimited protrusive (forward) advancement of the lower jaw. Rubber bands attached to both upper and lower portions help keep the mouth closed while sleeping, yet also allow for the patient to open their mouth (yawn, talk, drink, etc…). The freedom of movement of the SUAD makes it quite appropriate for TMJ/TMD patients as well as heavy bruxers (teeth grinders).

FDA approved for treatment of snoring and mild to moderate OSA.



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SUAD

Thornton Adjustable Positioner - TAP®

The Thornton Adjustable Positioner (TAP) is a custom-made adjustable appliance that is worn while that snaps over the upper and lower teeth and hook together. The TAP holds the mandible in a forward position so that it does not shift or fall open during the night. The further protrusive the mandible, the more the airway will open.
The TAP is the only mandibular advancement device that can be adjusted easily while in the mouth. This feature allows patients to be in control of their treatment by fine-tuning their treatment position at home to achieve maximum results. The TAP appliance utilizes a simple hook mechanism attached to the upper tray, which slides under a bar attached to the lower tray and positions the lower jaw forward. Three hook sizes offer increased range of adjustment. An adjustment key enables the patient to adjust the protrusion of the lower jaw while wearing the device until a comfortable and effective position is achieved. The TAP also allows for lateral movement as well as lip closure.

FDA approved for the treatment of both snoring and obstructive sleep apnea



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Thornton Adjustable Positioner - TAP®

Tongue Retaining Devices (TRD)

Tongue Retaining Devices (TRD) are custom-made appliances with an anterior bulb that holds the tongue in a forward position during sleep by means of negative pressure (or suction). Since the mandible is not rigidly or firmly held by the appliance, freedom of movement is possible during use. Currently, the TRD appears to be the appliance of choice for patients who have few or no teeth and for patients who have large tongues. In addition, the TRD is a good appliance for patients who cannot adequately advance their mandible because of restrictions in the TMJ or other reasons. This appliance may be difficult to tolerate if the patient has trouble breathing through their nose.

FDA approved for the treatment of both snoring and obstructive sleep apnea



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Tongue Retaining Devices (TRD)

VIAdmd™

The VIAdmd appliance is a single piece appliance that fits over the upper teeth. By urging the tongue into a forward and upward posture, the appliance opens up your airway to increase the oxygen intake into the body. Each VIAdmd oral device is custom-fitted to ensure comfort during sleep. The device allows patients close and seal their mouths, allowing for comfortable and natural sleep.

FDA approval is pending.



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VIAdmd™