Research/Thoughts on 3d printing MAD device (mouth guard)

[luckydxx]

HI,

my mom has trouble to wear masks at night, plus she has to take sleep med to help sleep. I am researching alternative method, and found some newer technology regarding 3d printing MAD device (mouth guard). Would anyone has done any research or has any insight regarding this topic? I also got some info about this kind of procedures in Korea.

Thank you for your advice.

[ardenum]

HI,

my mom has trouble to wear masks at night, plus she has to take sleep med to help sleep. I am researching alternative method, and found some newer technology regarding 3d printing MAD device (mouth guard). Would anyone has done any research or has any insight regarding this topic? I also got some info about this kind of procedures in Korea.

Thank you for your advice.

Narval CC from resmed is 3d printed in polyamide 12, there are 2 other companies that also print it in the sam material but i can't remember their names.

All 3 are made by 3d scanning the teeth directly or the teeth impressions themselves. I used narval, but now I use a custom one which also is printed in polyamide 12.

[legrunt]

I used a boil n bite MAD for years. While it did help me sleep, I noticed that eventually it started messing with my bite pattern. More specifically, my upper and lower molars started contacting only at the edges, rather than the whole surface, as though they were bowing inward.

That's the main reason I started on CPAP.

Something to think about before going the MAD route...

[ardenum]

I used a boil n bite MAD for years.  While it did help me sleep, I noticed that eventually it started messing with my bite pattern.  More specifically, my upper and lower molars started contacting only at the edges, rather than the whole surface, as though they were bowing inward.  

That's the main reason I started on CPAP.

Something to think about before going the MAD route...

This only happens on a boil n bite devices though.

[legrunt]

I used a boil n bite MAD for years.  While it did help me sleep, I noticed that eventually it started messing with my bite pattern.  More specifically, my upper and lower molars started contacting only at the edges, rather than the whole surface, as though they were bowing inward.  

That's the main reason I started on CPAP.

Something to think about before going the MAD route...

This only happens on a boil n bite devices though.

Why do you say that?  I mean, as far as the teeth are concerned, whats the difference between 3d printed vs boil n bite?

[ardenum]

I used a boil n bite MAD for years.  While it did help me sleep, I noticed that eventually it started messing with my bite pattern.  More specifically, my upper and lower molars started contacting only at the edges, rather than the whole surface, as though they were bowing inward.  

That's the main reason I started on CPAP.

Something to think about before going the MAD route...

This only happens on a boil n bite devices though.

Why do you say that?  I mean, as far as the teeth are concerned, whats the difference between 3d printed vs boil n bite?

Boil n bite have a lower shore hardness, meaning they are soft and do not contain the teeth strongly enough for them not to move under the pressure, when you bite the mad during sleep. all 'professional' MAD's are extremely solid overall, or in case 3d printed devices, the teeth part doesn't bend but the whole piece is slightly elastic so it doesn't ruin your teeth alignment yet it protects you against TMJ pain. 

Boil n bite are very bad for your teeth from dentistry point of view.

The best case scenario is a solid MAD with some kind of elastic connection between the upper and lower teeth. It would provide support for the teeth while minimizing the strain on the joint. Alternatively you can have a 3D printed MAD but you tell the engineer to make the teeth part thicker.

[legrunt]

This only happens on a boil n bite devices though.

Why do you say that?  I mean, as far as the teeth are concerned, whats the difference between 3d printed vs boil n bite?

Boil n bite have a lower shore hardness, meaning they are soft and do not contain the teeth strongly enough for them not to move under the pressure, when you bite the mad during sleep. all 'professional' MAD's are extremely solid overall, or in case 3d printed devices, the teeth part doesn't bend but the whole piece is slightly elastic so it doesn't ruin your teeth alignment yet it protects you against TMJ pain. 

Boil n bite are very bad for your teeth from dentistry point of view.

The best case scenario is a solid MAD with some kind of elastic connection between the upper and lower teeth. It would provide support for the teeth while minimizing the strain on the joint. Alternatively you can have a 3D printed MAD but you tell the engineer to make the teeth part thicker.

I see... ok, glad I'm off MADs anyway.

[luckydxx]

HI,

my mom has trouble to wear masks at night, plus she has to take sleep med to help sleep. I am researching alternative method, and found some newer technology regarding 3d printing MAD device (mouth guard). Would anyone has done any research or has any insight regarding this topic? I also got some info about this kind of procedures in Korea.

Thank you for your advice.

Narval CC from resmed is 3d printed in polyamide 12, there are 2 other companies that also print it in the sam material but i can't remember their names.

All 3 are made by 3d scanning the teeth directly or the teeth impressions themselves. I used narval, but now I use a custom one which also is printed in polyamide 12.

Hi Crowtor,

thank you for your reply. Are you mild/moderate apnea?

how do you get the custom one made and how do you feel about the usage, can it replace cpap? Also how much the cost estimate is?

thanks again.

[Gideon]

thank you for your reply. Are you mild/moderate apnea?

how do you get the custom one made and how do you feel about the usage, can it replace cpap? Also how much the cost estimate is?

thanks again.

Can it Replace CPAP?  Only for some.    CPAP (IMHO in all its forms) is considered the gold standard for sleep apnea treatment.

Here is an abstract from a medical journal in 2018.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5803051/
The Boil & Bite and other MAD devices are discussed

Continuous positive airway pressure (CPAP) remains the gold standard treatment for obstructive sleep apnoea hypopnoea syndrome (OSAHS). However, the high efficacy of CPAP is offset by intolerance and poor compliance, which can undermine effectiveness. This means that alternatives to CPAP are also necessary. In recent years, oral appliances have emerged as the leading alternative to CPAP. There is now a strong body of evidence supporting their use in OSAHS and clinical guidelines now recommend their use in mild OSAHS and in more severe cases when CPAP fails. These devices are by no means a homogenous group as they differ greatly in both design and action. The most commonly used appliances are mandibular advancement devices (MAD) that increase airway diameter with soft tissue displacement achieved by mandibular protrusion. Despite the growing evidence, there are still barriers to MAD provision. Their effectiveness can be difficult to predict and there is debate about the required level of design sophistication. These uncertainties prevent more widespread inclusion of MAD within clinical sleep services. This review will focus on the efficacy, effectiveness, design features, side-effects of and patient selection for MAD therapy. Comparison will also be made between MAD and CPAP therapy.

[ardenum]

HI,

my mom has trouble to wear masks at night, plus she has to take sleep med to help sleep. I am researching alternative method, and found some newer technology regarding 3d printing MAD device (mouth guard). Would anyone has done any research or has any insight regarding this topic? I also got some info about this kind of procedures in Korea.

Thank you for your advice.

Narval CC from resmed is 3d printed in polyamide 12, there are 2 other companies that also print it in the sam material but i can't remember their names.

All 3 are made by 3d scanning the teeth directly or the teeth impressions themselves. I used narval, but now I use a custom one which also is printed in polyamide 12.

Hi Crowtor,

thank you for your reply. Are you mild/moderate apnea?

how do you get the custom one made and how do you feel about the usage, can it replace cpap? Also how much the cost estimate is?

thanks again.

Sometimes I'm AHI 9, sometimes AHI 100+. My current one is made like narval cc, same process and it's based on my narval, with some tweaks. I had my teeth scanned and then I modeled it in CAD, adding a few things like a removable tongue retaining bubble, mouth breathing canals combined with a tongue strap at the back.

I wear it with my full face mask though.

If you want to get rid of your cpap, the only thing that's cpable of that is an Inspire2 implant, that is if your apnea is the type of apnea it is intended for and you have no other mechanical issues in your breathing. If you're fully CA, then a diaphragm pacemaker could be an option. Otherwise sit tight and do your vows, cpap is staying.