Creating custom fitted mandibular advancement devices, or MAD, is what we at Premier Sleep do best. The FDA has cleared more than 130 such appliances; we have extensive experience with enough of them to find the best match for each of our patients. What’s most important is that we know ‘one size does not fit all!’ There are many factors we take into account. One benefit of working with Premier Sleep is our experience in matching thousands of patients with just the right MAD.
MAD typically vary on the mechanism that is used to hold the jaw forward. Most MAD are made from acrylic, a common dental material; some are laser-printed from medical-grade nylon. The advancement mechanisms are usually surgical stainless steel, but nylon, acrylic, and nickel-free metals are used as well. No matter the material, every component has been approved for use by the FDA.
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One of the most common MAD, acrylic shells are created to fit the teeth and the jaw is advanced by adjustable bars on either side of the jaw between the teeth and the cheek. This mechanism is the same as orthodontist’s use in correcting bites in children.
3D printed from nylon, this one is the toughest device we have and is excellent for patients who have a history of tooth grinding. Adjustments are made by varying the length of nylon bands on either side.
This one comes in several varieties, but in common they have a hook on one arch that wraps over a metal bar on the other, keeping both the jaw forward and the mouth closed. Excellent for people who want some help breathing through their nose, not their mouth. This design has been proven in dozens of scientific studies.
There are several laboratories that make a MAD that uses a plastic, triangular wing on the lower arch to hold the jaw forward against an adjustable block on the upper arch. One common manufacturer is SomnoDent, who pioneered this design. Known as one of the most comfortable and easy to get used to, it is a very popular design.
This one is computer-milled from a solid block of acrylic, so it fits the best of all of our choices. Adjustability comes in the selection of four positions of a wing on each arch, holding the jaw forward by using different combinations of upper and lower devices.
With more than a hundred other designs, Premier Sleep doctors constantly evaluate features, choices, and other details to have more ‘arrows in the quiver’ when it comes to choosing the perfect match for the individual patient we treat.