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Mandibular advancement appliance? OSA treatment?  

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darkindigo
Reputable Member

Now let me put it out there right now. Dr. Mike Mew does not like mad appliances.  He thinks that it’s not a good idea to pull the maxilla back. I just agree if the maxilla is fairly stable and most maxillas are.  With recent mewing or braces or other disarticulation of the maxilla it may not be the best.  However when he created his video on Matt appliances, he was talking about it more for long-term use. That was my take away. I would be shocked and awed if he thought that the Herbst appliance was not beneficial to a growing person. That would be kind of ridiculous because it may be an option that’s non-surgical.

From yours truly, braces shop here’s something interesting:

https://www.bracesshop.net/en/clear-retainers-and-fake-braces/

It is listed under fake braces and retainers, so it’s hard to tell if this is actually a toy or real.  There are some real things under the heading and so that is why it’s confusing. It looks like it might actually be a legitimate appliance?

 

 

 

 

 

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Posted : 21/06/2019 11:36 am
darkindigo
Reputable Member

I know sometimes these devices can actually pull condyles out of sockets if you’re not growing.  However this article talk about using Herbst post puberty and even into early adulthood.

https://pdfs.semanticscholar.org/e563/016c28322ca02d28dfc630c20437d1aecae4.pdf

I know aligners can trap growth.

Anyway, wearing something like this at night looks to be similar to OSA devices.  Ex. https://www.westcoastsleepsolutions.com/oat.php

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Posted : 21/06/2019 11:46 am
Apollo
Reputable Member

I tried a MAD and found that it drastically reduced my snoring and improved sleep quality. It's not a sustainable solution, but I'm tempted to keep using it until I can get a more permanent treatment. However, I am concerned by the reciprocal force on the maxilla. I've been considering the idea of an external fixation point to hold the mandible in its advanced position rather than relying on the maxilla to hold it forward. I would attach something like the Chimpancerda BOW or the Crane neck brace, to the mandibular tray. I think I would still use the maxillary support as a backup. So the external anchorage would hold the mandible at a certain position but if it slipped out of place because of body movement during sleep, the maxillary tray would still prevent the mandible from sliding back. I suppose the external framework would be more uncomfortable and might disrupt my sleep quality. What do you think of this idea? Is it worth trying?

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Posted : 21/06/2019 7:41 pm