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A. The initial bite position is the greatest vertical height at which the patient can comfortable keep their lips closed and the maximum comfortable protrusive mandibular position. The bite registration must be taken with bite shims inside the mouth so the lips can be comfortably closed. Nothing can stick out of the lips. Dr. Moses suggests that you follow this protocol exactly in order for us to fabricate an appliance that will work best for your patient. For complete instructions, please click here.
A. Yes, the patient must wear the flexible maxillary guard in order to prevent movement, increase stability and help with alignment. The mandible is being anteriorly held in a protrusive position and exerts pressure to retrude. If the upper component is not worn teeth may move from both tongue and mandibular pressure. The upper retainer splints all maxillary teeth to the task of holding the mandible forward.
A. The jaw relationship established by your bite registration will be the exact jaw position that your Moses™ appliance will be fabricated. You will be able to titrate the device by activating the screw mechanism with the key provided (1 turn = 1/8 of a mm). The screw has a 6mm thread. You cannot wind the screw back from the starting position, so be conservative when taking your protrusive measurement.
A. The side screws are to be used by the doctor to accomplish the mandible advancement. A conservative starting point is an advantage. Also, occasionally, the midline needs adjustment. A tiny “key” is sent to you with your Moses™ appliance.
A. The Moses™ is not indicated for children because they grow too quickly. The Moses™ can be made to fit over full dentures.
A. Studies have been presented to the FDA to substantiate efficacy of The Moses™. In addition we have feedback and clinical evaluations from doctors who have used this appliance in the past. The Moses™ device is commercially still new, we will be pro-actively collecting clinical documentation on an ongoing basis and will be engaging in clinical research studies in the near future.
A. The Moses™ is still new, so there are no results for long-term TMJ issues. So far, we haven’t had any problems or concerns from any doctors and patients who have ordered The Moses™. In fact, most sleep patients who also experience symptoms of temporomandibular disorder have found that their symptoms have improved by wearing The Moses™ appliance.
A. Yes The Moses is FDA cleared for the treatment of Snoring and Obstructive Sleep Apnea.
A. The maxillary labial flanges hold the mandible in place. The maxillary retainer splints the maxillary teeth so no movement can occur.
A. For accuracy and stability we always prefer a Polyvinyl Siloxane impression material (not alginate). We get consistent results with a Polyvinyl impression material (it doesn’t dry and distort).
A. The bite requires the doctor to get a comfortable vertical opening with the patient still able to close their lips. In addition, the bite measures the horizontal mandible advancement that is also comfortable with the patient. This is normally a little past edge to edge incisally (excepting class II cases) with the skeletal midlines aligned. So, this is much more than a regular habitual bite registration; however, it is essential to achieving the positive results and efficacy.
A. The laboratory will manufacture the appliance to the thicknesses of the bite registration you provide, while creating maximum opening and space for the tongue. It is important that you follow the Bite Registration protocol.
A. Our stringent quality systems ensure that the Moses device returned to you is manufactured to very high standards. It would be rare for any adjustments to be needed. The device has been specifically designed for patient comfort and efficacy; any changes may alter the overall function.
A. No they will not, this is due to the design of the appliance and the bite registration protocol. It encourages good lip seal which will in turn prevent the lower anteriors from flaring forward, in addition to providing room for the tongue to sit in an anterior position and out of the airway.
A. Recommend that they chew gum in the shower, eat an apple or just have some breakfast. In some patients, more so in some than others feel this occur. It is primarily due to the facial muscles adjusting to the vertical dimension and also the anterior posterior relationship, should restore function within an hour after taking the appliance out.
A. SCDL offers a 2 year warranty on all Removable products. This includes Moses™