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Which is the best oral appliance for treating snoring and obstructive sleep apnoea (OSA)?

7 Feb 2016

With over 80 mandibular advancement splints (MAS) available, this is a common question asked by dentists. In our clinic we only use appliances that have associated research studies that demonstrate effectiveness.

The two broad categories of custom made titratable (adjustable) MAS are firstly ones with an anterior mechanism that connects the upper and lower such as the MDSA, TAP and Orthoapnea.

The other category is MAS that have a posterior based, lateral mechanism such as the Dorsal, Somnodent, Silensor and Narval.

Back to back studies comparing MAS have not demonstrated a significant difference between appliances with regard to effectiveness, and at this point we can’t say that there is a superior MAS.

It would seem that the key to effectiveness in treating snoring and OSA is to hold the jaw forward- which is something they all do.  It is important to work with a lab that manufactures a range of appliances for dentists practicing in the field, and clearly success can be achieved with many of the different designs.

In my experience, having fitted over 6000 appliances, and used many of the MAS designs, a key difference I have found is in the potential for associated side effects.

 

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