Left-to-Right Mobility Bands of varying elasticity move the lower mandible forward into the desired position while continuing to allow the jaw to move in all directions.

TMJ Friendly The freedom of movement of the mandible significantly reduces the occurrence of temporomandibular joint dysfunction and pain.

Approved The EMA sleep apnea and snoring appliance is FDA and ADA approved and has been in use since 1995.

Bite Technique Bite open 8 mm incisally, with hinge open from centric. The lab will need upper and lower models poured in die stone with pencil marks on crowns, implants and sensitive teeth.

Obstructive sleep apnea (OSA) is a respiratory disorder characterized by repetitive closure of the pharyngeal airway during sleep. The high prevalence of OSA, its associated morbidity and mortality, and its economic impact on society underscore the importance of developing effective treatments. Nasal continuous positive airway pressure and uvulopalatopharyngoplasty are the most widely used treatments but have significant drawbacks.

Currently available oral devices are regarded as second line treatments and have failed to gain widespread application. We have developed a novel elastic mandibular advancement appliance (EMA) which overcomes the limitations associated with other devices. The major design innovations include the precise regulation of the amount of advancement and freedom of mandibular motion.

Overnight sleep studies were performed with and without our current EMA prototype in 13 OSA patients: mean age 50 +/- 9 (SD) yr, mean height 174 +/- 9 cm, mean weight 101 +/- 13 kg. EMA advanced the mandible in these OSA subjects by 9 +/- 4 mm (range 3 - 19 mm). There were no differences on the sleep studies with and without EMA in the amount of time spent in a particular sleep state or a particular body position.

On the sleep studies without EMA, the mean number of abnormal respiratory events per hour of sleep (apnea-hypopnea index) was 60 +/- 20 events/hr, range 24 - 101. EMA reduced the apnea-hypopnea index to 21 +/- 15 events/hr (p < .001 on paired t-test). Five (39%) subjects had an apnea-hypopnea index < 15 with EMA. There was a 64 +/- 23 (SD)% improvement in apnea-hypopnea index with EMA for the group as a whole with a range of 12 to 93%. Pearson product moment correlation indicated that the degree of improvement in apnea-hypopnea index with EMA was not related to the severity of OSA, body mass index (kg/m), neck circumference (cm), or age (yr).

These preliminary results compare favorably with results reported in the literature for other mandibular advancement devices and uvulopalatopharyngoplasty. Our preliminary results disagree with the current recommendation that a trial of an oral appliance should be reserved for patients with mild OSA as some of the greatest responders in our group were individuals with moderate to severe OSA--i.e. apnea-hypopnea index > 40 events/hr. With further development, the innovative design of our appliance gives it the potential of becoming a cost effective, primary medical treatment alternative for OSA. Supported by a grant from the Moody Foundation.

              Request a copy of this document.

Return To Top