The registration is an important clinical step in order to achieve optimal results with oral appliance therapy.
An inadequate registration at the record taking visit can result in the following problems for the patient:
Taking these factors into account during the registration procedure will go a long way in achieving optimal results and minimising side effects.
A specifically designed instrument is indispensable for taking an adequate registration. While there are many theories and instruments available, the one I use in my practice is the George Gauge. The registration using the George Gauge is simple, usually taking less than five minutes, and is used by the majority of leading clinicians and researchers in the field.
A question I’m often asked is what degree of protrusion should the mandible be set in the registration?
In my clinical practice, the degree of initial advancement is set somewhere between 50-75% of maximum mandibular protrusion.
It is closer to 50% if the patient is:
It is closer to 75% if the patient is:
The general principle is that if the patient is just a snorer, or has mild sleep apnea, the aim is to advance the mandible the minimal distance forward that gets rid of the problem. If the patient has severe sleep apnoea, and particularly with medical comorbidity, the aim is to advance the mandible as far as is tolerable.
There are a number of videos on You Tube demonstrating how to use a George Gauge.