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1.4

Minor Versionm

by Patrick Tessier

Introduction

The purpose of the AM Aligner is to counteract the forces that represent the most significant side effect of a mandibular advancement device used for the treatment of obstructive sleep apnea and other sleep disordered breathing.

Repositioning the mandible forward at night creates a transient malocclusion in the morning with anterior tooth contact and posterior open bite. The AM Aligner is designed to reestablish the proper intercuspation of the teeth.

The forces that are inherent in repositioning the mandible forward can also incline the maxillary anterior teeth lingually and the mandibular anterior teeth facially. The AM Aligner counteracts this movement by creating a centric occlusion splint that is fabricated before the MAD is delivered.

The AM Aligner is constructed of a unique thermoplastic material that can be made in the office. It is used every day by the patient to return the mandible the original relationship to the maxilla.

Contraindications:

Allergic response may occur to the thermoplastic material.

Severe Class 2 or severe Class 3 malocclusion may require a custom splint.

Do not store or soak at high temperatures (such as hot car or hot water). This would cause distortion of the appliance.

Tools

Parts

  1. Remove the AM Aligner from the package.  Place in boiling water for about 1 min. The ThermAcryl Plus material becomes soft and pliable in water heated about 160 degrees F.
    • Remove the AM Aligner from the package. Place in boiling water for about 1 min.

    • The ThermAcryl Plus material becomes soft and pliable in water heated about 160 degrees F.

    • While the Aligner is in the water, have the patient practice closing in their usual bite position. Every morning it is important that the patient return to this position so that their occlusion doesn’t change.

  2. Place the softened aligner over the upper teeth.  The wafer should be centered on the incisor edge. Have the patient bite hard into their usual bite position. The patient should try to bite all the way through the Aligner. (When held to the light, the plastic should be very thin and almost translucent where the tooth indentations are).
    • Place the softened aligner over the upper teeth. The wafer should be centered on the incisor edge.

    • Have the patient bite hard into their usual bite position.

    • The patient should try to bite all the way through the Aligner. (When held to the light, the plastic should be very thin and almost translucent where the tooth indentations are).

    • Mold the excess plastic over the upper teeth beginning in the middle and working your way backwards.

    • Using your thumb, create a slight dip in the middle so that the aligner dips down over the bottom front teeth.

    • Continue molding to the sides

    • Have the patient mold the lingual plastic with tongue against palate. Have the patient closed their lips and suck on the material to create a good fit around the teeth.

  3. Once the AM Aligner is properly fit, let it set-up in the mouth for 2-5  minutes. Carefully loosen the plastic from the back teeth first, then remove the Aligner from the mouth.
    • Once the AM Aligner is properly fit, let it set-up in the mouth for 2-5 minutes.

    • Carefully loosen the plastic from the back teeth first, then remove the Aligner from the mouth.

    • Place the wafer under cool water for about 1 minute to fully set the material.

    • The Aligner should have a good shape of the upper arch with deep indentations of the lower arch on the bottom of the tray.

    • Hold the AM Aligner to the light. You should be able to see light through the bite impressions in the tray. If not, follow instructions to re-fit and bite harder into the wafer.

    • Put the AM Aligner back into the mouth and check for fit. Repeat as needed.

  4. After removing the treatment appliance in the morning, wait 30 minutes before using the AM Aligner. When you are ready to use the AM Aligner, insert the Aligner over your upper teeth.  Pull your lower jaw back   to engage your lower teeth into the indentations on the bottom of the tray. Once your lower jaw is in the correct position, squeeze or bite on the tray as if to put your back teeth together
    • After removing the treatment appliance in the morning, wait 30 minutes before using the AM Aligner.

    • When you are ready to use the AM Aligner, insert the Aligner over your upper teeth. Pull your lower jaw back to engage your lower teeth into the indentations on the bottom of the tray.

    • Once your lower jaw is in the correct position, squeeze or bite on the tray as if to put your back teeth together

    • Repeat the process of squeezing the jaw together into the AM Aligner until usual bite position is achieved. This may take anywhere from 5 to 10 minutes.

    • If it takes longer than 10 minutes, take a hot shower or place a warm pack on the joints to warm up the jaw joints and accomplish this process faster.

    • Instruct the patient to contact you if these methods are not successful.

    • To remove the AM Aligner, take the tray off your back teeth first and then remove it from your mouth.

Finish Line

One other person completed this guide.

Patrick Tessier

Member since: 08/09/2017

56 Guides authored

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