Truline Dental is continuing its push to ensure users of intraoral scanning systems have a broad range of treatment options available, over and above crown and bridge. Truline has accepted intraoral scans (aka digital impressions) from any open STL format scanning system for its Truline invisible aligner system; Click retainers; Digisplint splints; Implaguide surgical guides; and i-expander arch expansion appliances for some time. Now, it's adding sleep appliances to the range.
"Intraoral scanning is becoming increasingly popular, however, to date, much of the focus has been on restorative dentistry," said Truline Dental's founder, Mr Terry Whitty. "At Truline, around 10% of our customers are now supplying us with intraoral scans for surgical guide, splint, aligner and retainer manufacture and it makes for a very smooth, efficient workflow.
"Now, we have launched a new system for manufacturing the Myerson Elastic Mandibular Advancement or EMA appliance from digital scans, as well as from traditional impressions.
"There are obviously a plethora of mandibular advancement devices (MAD) on the market and all spruik their superiority over others based on this feature or that. We have manufactured several different types of sleep appliances over the years, however, the EMA stands out because it allows both vertical and horizontal movement of the jaw whilst in situ.
"In a nutshell, the EMA appliance is a simple, patient-friendly oral appliance created for non-invasive treatment of snoring and OSA. The design is brilliantly simple, extremely stable and allows for adjustability [titration] through the interchangeable elastic straps."
Mr Whitty said there is a large amount of scientific literature available supporting the basic function of MADs, which is to move the mandible forward to a position that gives a volumetric increase in the patient's airway during sleep. There is also growing evidence for a horizontal opening that also enhances the affects of this forward positioning of the mandible.
Digital or traditional
"To create the custom made appliance, its essential to have accurate impressions that extend to cover all surfaces of all erupted teeth, the buccal and labial vestibules of both entire arches, at least two-thirds of the palate, and the lingual surfaces of the mandibular alveolar arch," Mr Whitty said. "Hence the EMA is ideally created from intraoral scans because of their superior accuracy."
The EMA appliance resembles and fits like an orthodontic retainer. The primary treatment mechanism of opening the bite and gently moving the mandible forward is achieved with the use of occlusal bite pads and the combination of positioned lugs and interchangeable elastic straps that offer varying degrees of mandibular advancement. This positioning of the mandible causes a forward movement of the tongue, re-opening the air flow through the oral pharynx. The flexibility of these elastic straps provides unsurpassed lateral movement and overall TMJ comfort.
Additionally, because the straps offer varying degrees of elasticity, they allow for the jaw to move in all directions while moving the jaw forward into the desired position. This freedom of movement of the mandible significantly reduces the occurrence of TMJ dysfunction and pain associated with similar appliances currently on the market.
The EMA can only be used over intact, non-mobile teeth without periodontal involvement. Dental restorations must be secure, as any removable oral appliance can displace loose crowns, inlays, onlays or veneers. Having adequate numbers of secure teeth for retention of the EMA is particularly important in the maxillary anterior and premolar region and in the mandibular premolar and molar areas.