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Tag Archives: mandibular advancement devices
1. What is snoring?
Snoring is generally caused by a restriction of airflow most commonly at the rear of the mouth in the area above the voice box called the oropharynx. Because the airway is restricted and the lungs need the same amount of air, the air speed increases and the normally flaccid tissues inside the oropharynx vibrate, resulting in the snoring noise.
2. What is obstructive sleep apnoea?
This is a rather more serious condition regularly connected with snoring, where the airway is briefly and repeatedly fully constricted. Air cannot enter the lungs and beathing stops. The blood oxygen levels decrease and the brain sends out an emergency signal causing a deep gasping breath. These apnoeas can occur many times each hour.
Mandibular advancement appliances, also known as mandibular advancement devices, or mandibular advancement splints, are used to help patients stop snoring. Generally they are made of thermoplastic or heat cured acrylic plastic. These are comparatively lower cost materials that can be easily adjusted. Till recently they were the sole materials that mandibular advancement splints were made of.
A new material, cast chrome cobalt alloy, has recently begun to be utilised for mandibular advancement devices. Notably the Somnowell appliance. Historically chrome cobalt alloy has been the standard for partial dentures. Partial dentures are also made from acrylic, but the highest quality partial dentures will be made of chrome cobalt.
Let’s draw parallels with the common ring. The ring and device needs to be made of inert materials that don’t react with the skin nor mouth environment. A metal, if used, must be thin and very strong in cross section. It has got to be light. It should be changeable. You have to be able to keep it clean and it shouldn’t taint nor change its properties with age. It should not be penetrable and should not hold bacteria, fungi and other germs.
Plastic and acrylic though initially an interesting material for mandibular advancement devices for snoring and obstructive sleep apnoea, are quite weak in thin section, they have a tendency to be porous, and they distort quite easily especially if heated. In the mouth they pick up stains, hold plaque, bacteria, fungal infestation and are tough to clean. Many of those materials become fragile with time and the active linking hinges regularly break and don’t stand the test of time.