ORAL APPLIANCE THERAPY FOR SNORING, SLEEP APNEA & CPAP PROBLEMS

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oral appliance therapy

Now there is an effective way to control snoring and obstructive sleep apnea without resorting to cumbersome CPAP devices. A small device, similar to an orthodontic appliance, can be an alternative to cumbersome CPAP machines and, in some cases, be the first choice for treatment of mild to moderate obstructive sleep apnea.

This is something a person who wants to know details should know

Pittsburgh Dental Sleep Medicine is the only dental practice in the tristate area that is devoted exclusively to solving the problems of those who suffer from sleep disordered breathing.If you or a loved one snores or has had difficulty wearing their medically prescribed CPAP

Dr. Robert Rogers of Pittsburgh Dental Sleep Medicine has had the years of experience necessary to offer a unique dental solution. Dr. Rogers is happy to consult with those who feel that they are having a problem with snoring or sleep apnea but have not been diagnosed and as well as those who are unable or unwilling to wear a CPAP unit. Dr. Rogers also works closely with other dentists in the tri-state area and with family physicians and sleep specialists. Hide it

Appliances used in our office

• TAP -Thornton Adjustable Positioner



The Thornton Adjustable Positioner (TAP®) oral appliance is a mandibular advancement device composed of two separate arches (maxillary and mandibular) containing an advancing mechanism which permits unlimited advancement of the lower jaw. The arches are custom fit to a patient's models. The advancing mechanism is engaged and the screw mechanism in the upper tray is then turned to advance the mandible until the patient begins to feel any discomfort in the temporomandibular joint or in the facial muscles (maximum mechanical protrusion which is an average of 2.5mm beyond maximum protrusion). The advancing screw is then turned back until patient is comfortable. Hide It

• PM Positioner



The Adjustable PM Positioner™ utilizes materials and a design that minimize office chair-time and provide the patient control of adjusting the jaw position under the dentist’s supervision. Research studies have shown that this appliance is successful in treating 77% of patients with moderate obstructive sleep apnea. The appliance fits over all maxillary and mandibular teeth and is made of a special acrylic material (Bruxeze™) that softens in hot water to provide a combination of comfort, strength, and retention. This material has proven to be very durable. Expansion screws are located on the right and left buccal areas to allow maximum space for the tongue and easy anterior-posterior positioning of the mandible to achieve optimal effectiveness. This design permits ample lateral and protrusive movement to maintain jaw comfort.

The device uses a unique method of retention consisting of small projections of acrylic within the device that comfortably grip the undercut areas of two posterior teeth in each quadrant. Therefore, no metal clasps are necessary. Hide It

• Elastomeric



Constructed in a dental laboratory, it is made of a very pliable soft, custom-injected silicone and is tooth retained. There are no clasps or wires to adjust. The flexibility of the material lends itself to a high degree of patient comfort. The Elastomeric appliance is not protrusively adjustable. The vertical opening is 5 mm and the mandible is afforded some limited movement due to the high flexibility of the material.

Proven effective by the University of Kentucky Medical Center Sleep Apnea Laboratory. Recommended for partially edentulous patients and non-bruxers. Hide It

• TRD - Tongue Retaining Device

  
  
  The TRD is lab constructed of a flexible polyvinyl material adapted to the general contours of the teeth and dental arches. It does not depend on teeth for retention. Rather, the tongue is held forward by the negative pressure created in the vacuum bulb on the front of the appliance.
  
  The appliance is available in four tongue extensions and with or without air way tubes for patients with compromised airway patency. It is constructed in conjunction with the Kel Gauge (described in another section of this program.)
  
  Since the mandible is not rigidly or firmly held by the appliance, freedom of movement is possible during use. This would seem to make the TRD a good choice for the edentulous patient, the patient with periodontal disease and the patient with temporomandibular joint dysfunction.
  
  There is ample research available documenting the effectiveness for treatment of snoring and OSA in certain patients.
    Hide TRD - Tongue Retaining Device

• Somnomed

  
  
  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. If required, a part can be added to make the device adjustable. This feature provides incremental and adjustable levels of lower jaw advancement, which improves the effectiveness and comfort-level of treatment as the jaw is moved only as far as is required to alleviate snoring and reduce OSA. Key features and benefits of the device include: Permits normal mouth opening Allows speech and drinking Provides full lip-seal Easily adjustable Safe and effective Clinically proven Custom-fitted Additionally, the SomnoMed MAS is made from durable fade-proof acrylic that retains its shape and color for at least four-five years and is covered by a two year manufacturer's warranty.
  
  FDA Approval received July 2005
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• EMA

   

  
  
  The EMA® - Custom appliance is a simple, patient-friendly oral appliance created for noninvasive treatment of snoring and OSA. The primary treatment mechanism of opening the bite and gently moving the mandible forward is achieved with the use of interchangeable elastic straps that offer varying degrees of mandibular advancement. The flexibility of these elastic straps provides unsurpassed lateral movement and overall TMJ comfort. The 2 mm thick pressure formed bases offer orthodontic retention (resulting in no tooth movement) and maximum anterior tongue space because there are no projections in the palate.
  
  The Elastic Mandibular Advancement (EMA®) appliance uses elastic force to advance the mandible. Hand plastic trays are pressure formed to the patient's models and utilize the undercut areas of the teeth for retention. This insures that there will be no movement of the patient's teeth. Bite planes are used to open the bite. Mandibular advancement is achieved with different length straps. The elastic pull can also be adjusted to suit the patient's musculature. The straps provide complete lateral movement.
  
  The EMA® - Custom is available only to dental professionals
  
  FDA Approval: Approved for both Snoring and OSA
  Date of FDA Approval: Sept. 29, 1997
  FDA Registration Number: K971794
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