440 A Multi-Center Preference study of a Novel Oral Appliance Design and Material

Introduction AASM guidelines for OAT advise sleep medicine physicians to consider patient preference when determining the treatment modality for mild and moderate OSA. This investigation evaluates patient preference for a novel OAT device in comparison with CPAP and other legacy OAT devices. Methods A novel OA (ProSomnus EVOTM, Pleasanton, CA) was manufactured from digital records of U/L impressions and bite registrations. 31 Patients (all with one or more legacy OAs and 20 previous CPAP users) across 7 dentists were surveyed regarding preferences of this novel OA using a 0–10 scale. Samples were analyzed for stainability by mustard at 37C for 10 days against representative predicates using colorimetry. Results Patient Survey 100% Preferred the novel OA over CPAP, would wear it and easier to clean and preferred over their previous appliance This novel OA was comfortable and smaller 9.3 Easier to close my lips together 8.8 Confident in device durability/will not break 9.1 No crowns were removed/damaged Dentists Survey 81% no adjustment interventions for fit at delivery, average adjustment time was 3.1 min. 100% Would prescribe this novel OA again and recommend to colleagues This novel OA was easier to deliver than other devices 9.1 Retention was just right at delivery 8.9 Would use this novel OA on wider range of patients 9.8 This monolithic novel OA would be easy to keep clean 9.8 Stain Testing in □E from Colorimetry Milled PMMA 3.06 Milled novel OA 3.20 CPAP Mask plastic 7.54 Milled PMMA w/soft Liner/Fulcrum Strap 8.27 CPAP Mask silicone 11.60 PMMA +Liner Anterior Hook 19.05 PMMA with Liner Herbst 32.05 Nylon/Airway 90.70 Nylon/Strap 96.99 Conclusion Patients preferred this novel OA over CPAP and all other devices similarly designed for comfortable easy fit and delivery (soft liners and printed nylon) without compromising the comfort, cleanability or strength. Liner-less milled devices outperform all other devices with less staining. Color stability from mustard was significantly better for the milled PMMA and this Novel OA materials than all other combinations Support (if any) None

Maxillary protraction in adult cleft lip and palate by a rigid external distraction device with dentoskeletal anchorage

ABSTRACTObjective: The objective is to evaluate the effects of maxillary distraction osteogenesis (DO) in an adult patient with unilateral cleft lip and palate (UCLP) by using a rigid external distraction (RED) device with dentoskeletal anchorage.Method: 31-year-old male patient with UCLP with severe maxillary hypoplasia, dolichofacial growth pattern, negative overjet and 1.5 mm openbite. After pre-surgical orthodontic treatment, an intra-oral appliance was modified to prevent extrusion of the molars and clockwise rotation of the mandible. Stainless steel plates were soldered bilaterally to the intra oral appliance at the level of canines. During surgery, miniplates were inserted in the maxillary segment and fixed to the plates of the intra oral appliance with screws.Results: The mean distraction length was 12 mm immediately after DO. SNA increased from 73o to 82o after distraction. A significant advancement of the maxilla and correction of the sagittal Class III skeletal relationship was achieved. The vertical position of the mandible and the face was kept stable, and the soft tissue profile became more balanced.Conclusion: This intra oral appliance design achieved desired skeletal changes during maxillary protraction with RED device in dolichofacial CLP patient. Occlusion and facial profile changes was found to be stable in 1-year follow-up. (Eur J Dent 2012;6:206-211)