The Update Protocol
Demonstrate your clinical skills
The real clinical work for treating OSA with OAT is in the bite - where to position the mandible in relation to the maxilla. Everything else is just taking impressions.
Based on the predominant finding of intercondylar asymmetry,
simply advancing the appliance along a pre-determined plane seems inadequate.
Many tools and techniques are available for DSM clinician.
Moses Bite Shims with Manual muscle testing
Testing with Moses Express temp device and a recording oximeter or mini HST.
Register new bite
Analog or Digital Bite registration
Once you believe you have the new position identified, then quickly record the bite.
We recommend Moses bite shims, to insure that lip seal is attained. Remember that mid line will probably shift when protruded. Accept the natural midline for best results.
Analog bite registration is great, but you can also scan and produce a digital bite.
Order new Alpha Update
Keep the original for back-up
Make sure you provide new upper impression and new bite with the retainer in place. Include with the lower arch impression.
Modern Dental will hand build a new custom lower component, which we call the Alpha Update.
The patient gets to keep the original as a back-up and gets a new fresh appliance. Nice touch Doc.
Indications: Alpha Update is designed to treat adults over age 18 with sleep disordered breathing, from snoring to moderate OSA.
FDA: Alpha Update has been cleared to treat Snoring and Sleep Apnea.
Materials: The Alpha Update is 100% dental acrylic (PMMA - Poly Methyl Methacrylate) No metal hardware.
Ordering: The Alpha Update is a custom dental appliance built by our manufacturing partner. Contact Modern Dental Laboratory for your starter kit to begin.
Impressions and Bite: This is the key to a successful treatment. You can submit either digital or analog. The impressions are full arch. Capturing the distal surface of the most posterior molar on the lower arch is important. The bite defines where you want to place the mandible. For Update cases, Upper arch impressions and the bite for the Alpha Update is taken with the Essix tray in place. This may be done on the model, for a quicker patient appointment.
Delivery: First insert the upper tray. Then insert the lower device. Have the patient bite down to engage the appliance. It should "snap" together with slight force. If needed you can adjust the lower with an acrylic bur on a slow speed handpiece. You can even add acrylic as needed.
Adjustment: Simply take an impression of the upper arch with retainer in place. Record the new maxillo-mandibular relationship and send both to the lab.
You are not limited by one dimensional adjustments. You are able to increase/decrease the vertical, protrusion or alter the lateral position too. No limits to your treatment. Best of all, the patient keeps the original lower for back-up.
Inserting: Proper dental hygiene is important when using a sleep appliance. It is essential to brush, floss and rinse prior to inserting the appliance for the night. Insert the upper tray, then insert the lower component. Slide the jaw slightly forward and bite down. It should "snap" together.
Removing: Disengage the upper from the lower by opening the jaw. Remove the lower first, then the upper tray. If it is difficult to get the back teeth to touch, chew a piece of sugarless gum until the back teeth touch again. This should only take a few minutes.
Cleaning: After removing, soak the appliance in a denture cleaner (follow package directions), rinse it, pat it dry, and store it away from children and animals. Animals love to chew dental appliances. We recommend Kleenite from Regent labs.