by Dr Darryl Moses, Align Dental, Pennant Hills, NSW
These splints are used for treating snoring and obstructive sleep apnoea. The dentist takes an impression, bite registration and other required, relevant records. This information is sent to SomnoMed which custom fabricates the appliance for each patient and then sends it back to the dentist to be fitted.
What’s good about it
The main advantage of the SomnoMed MAS is that it’s titratable. There are adjustable screws or attachments on either side of the appliance that allow the jaw to be continually advanced. As tissue tends to get flaccid with increasing age, the ability to adjust the appliance over time is a major advantage. If a patient has a dental procedure after being fitted with a MAS, there’s no need to make a whole new appliance. The SomnoMed can be easily adjusted for most restorative dental procedures. It’s important when treating patients with sleep-disordered breathing that continual re-evaluation is undertaken, including follow-up sleep studies. I’ve placed many of these appliances and the majority of patients are very happy with the clinical results that have been achieved. There’s certainly an adjustment period, but once patients experience the benefits, the consensus is that they can’t live without it. Often the happiest person is the partner of the sufferer who’s no longer kept awake.
What’s not so good
The biggest problem—and this is true of all mandibular advancement splints—is the bulkiness of the device. Ideally, any MAS should have minimal lingual coverage so as not to encroach on the tongue space. But at present, the design is limited by the strength of materials available.