Appliances Used in Our Office

We use several oral appliances in our office depending on the size and shape of your mouth and tongue. Dr. Lowitz will discuss the advantages and disadvantages of each with you before making a final choice.

• Adjustable PM Positioner
  

  The Adjustable PM Positioner(tm) 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(tm)) 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.

  Clinical Research Associates gave the Adjustable PM Positioner(tm) its highest rating for appliances tested.

  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)
  • Excellent freedom of 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

  FDA Approval: Approved for both snoring and OSA
  Date of FDA Approval: Feb. 8, 1996
  FDA Registration Number: K955503

• Elastic Mandibular Advancement Appliance (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

• SomnoDent(r) MAS
  

  The SomnoDent(r) 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 SomnoDent(r) 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

• SUAD
  

  The SUAD is also a custom-made appliance that is made of a heat-sensitive acrylic and is reinforced by a metal framework. The SUADadjustment mechanism (Herbst) is positioned on the sides of the device and consists of a piston that slides within a tube. The appliance is comfortable on the teeth and the mechanism allows good freedom of movement of the jaw. Therefore it is used frequently in patients who tend to grind their teeth heavily. The position of the jaw can be adjusted by using small rings that slide over the piston and when the tube is positioned over the piston it will advance the jaw the width of the ring. Small elastics (rubber bands) are used to keep the jaw from falling open during the night although the patient is able to partially open the mouth, which can improve comfort when using the appliance.
• TAP
  

  The Thornton Adjustable Positioner (TAP(r)) is a custom-made two piece adjustable appliance that is worn while sleeping. The trays of the appliance snap over the upper and lower teeth and hook together. The design is based on the same principle as cardiopulmonary resuscitation, CPR. The airway must be opened to allow air to pass through the throat. The TAP(r) holds the lower jaw in a forward position so that it does not shift nor fall open during the night. This prevents the airway from collapsing. The more you pull your jaw forward, the more your airway will open.

  The TAP(r) is the only mandibular advancement device that can be adjusted easily by the patient or practitioner while in the mouth. This feature allows the patient to always be in control of their treatment. The unique design also allows the patient to fine-tune their treatment position at home to achieve maximum results.

  Most patients experience relief the very first night they wear their TAP(r). Although it may take up to a week to get used to wearing a TAP(r) appliance, this is a small hurdle for patients. Nine in ten patients wear the device all night, every night  making the TAP(r) a highly effective solution for both snoring and sleep apnea.

  Features

  • Patient-friendly
  • Superior results
  • Easy to fit
  • Infinitely adjustable
  • Precise control of advancement
  • Interchangeable hooks
  • Freedom for lateral movement
  • More room for tongue
  • Allows lips to close

  The TAP® can help prevent conditions linked to sleep apnea:

  • Chronic daytime sleepiness
  • High blood pressure
  • Heart attack
  • Stroke
  • Heartburn, reflux
  • Morning headaches
  • Depression

  FDA Approval: Approved for both snoring and OSA
  Date of FDA Approval: August 21, 1997
  FDA Registration Number: K972061

• Tongue Retaining Device (TRD)
  

  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.

  NOTE: Mandibular repositioners have been successfully used in edentulous patients over dentures in certain cases where the dentures have had adequate retention. Mandibular repositioners have also been successfully used in patients with compromised periodontal status or TMJ function. In these cases, however, the clinician needs to be especially careful in design and follow up.

  FDA Approval: Approved for both snoring and OSA
  Date of FDA Approval:
  FDA Registration Number: