Intraoral Snoring Therapy - Diagnostics - Indications - IST Appliances

Transcription

1 Intraoral Snoring Therapy - Diagnostics - Indications - IST Appliances 2010,

2 Snoring does not only disturb the partner but also the snorer s health Intraoral appliances are used to avoid snoring and to treat moderate sleep apnoea. They are scientifically recognized by the new S3 guideline of the German Society for Sleep Research and Sleep Medicine, provided they are individually manufactured two-splint systems to be inserted by a dentist only. For more than 15 years, Prof. Hinz together with the sleep medical-technical special department of Dr. Hinz laboratories has been developing Intraoral Snoring Therapy (IST ) appliances, testing them in the sleep laboratory and permanently improving them further. These experiences and skills are no secrets. All necessary materials are also available to other practice or commercial dental laboratories for their own processing. Moreover hands-on courses are offered for making the different appliances. We are pleased about your interest in dental sleep medicine. To allow an easy access to this difficult issue, we would like to give you an overview of our products for anamnesis, diagnostics and our IST appliances on the following pages. Besides information on making and use of intraoral appliances the dentist needs a basic knowledge of sleep medicine, above all. Dr. Hinz Dental Corp. and Haranni Academy in Herne therefore support further training of dentists and dental technicians on the topic of dental sleep medicine.

3 Information material Brochures Information for treating dentists, dental technicians and patients can be gathered from the following brochures/products: Best.-Nr Patient Brochure " Snoring not only disrupts sleep" (incl. anamnesis questionnaire) Doctor s/dental Technicians Brochure " ISTplus Appliance" (Language: German) Book " Sleep Medicine" (Compendium for Dentists, Language: German) Patient Information System Sleep Medicine" " (Language: German) Order-No Book " Sleep Medicine" Patient Information System " Sleep Medicine"

4 First diagnostic steps For patients with sleep related breathing disorder (SRBD) the anamnesis is different from our usual questions in regular dental therapy. Therefore we recommend using a special anamnesis form which will give you an initial clue on either harmless" snoring or suspicion of a serious disease like sleep " apnoea. The severity and treatment of a sleep related breathing disorder can only be assessed by a sleep doctor. For severe sleep apnoea a mechanical therapy with a positive pressure breathing appliance (NCPAP) will be necessary. Harmless Snoring" and mild or moderate obstructive sleep " apnoea (AHI up to 25/hour) can be treated with an Intraoral Snoring Therapy (IST ) appliance. Besides, IST appliances are recommended regardless of the severity, in case NCPAP therapy fails or is not accepted. Before continuous use of intraoral protrusion splints you have to check the dental premises. These include a dental screening as well as functional diagnostics, an inspection of the jaw joints and a panoramic X-ray. Occlusion of airway through flagged musculature of tongue and soft palate during sleep. An Intraoral Snoring Therapy appliance relocates the lower jaw and tongue forward and thereby opens up the airway.

5 SleepStrip Sleep apnoea sensor SleepStrip is a cost-saving single-use appliance for measuring apnoea and hypnoea. It consists of signal measuring, recording, analysis and display. The patient s airflow is monitored by three mini sensors throughout the night. The breathing pattern is analyzed by the CPU integrated. In the following morning the total value based on the patient s AHI will be calculated and shown on the permanent display. Order No SleepStrip, single IST Testing Appliance by Prof. Hinz The IST testing appliance can give the indication for an individually manufactured IST appliance, because not all patients will react with a therapeutic effect when protruding the mandible. The testing appliance is a prefabricated standard appliance made of thermoplastic resin that will adjust to the upper/lower dentition. It opens the bite and protrudes the lower jaw approximately 6 mm. The testing appliance will be gradually adjusted after heating it in boiling water. Available for Cl. I (clear) and Cl. II (blue) patients. The set can be equipped at customer s option. Order-No IST Testing Appliance-Set by Prof. Hinz, 4 pieces IST Testing Appliance by Prof. Hinz, Cl. I (clear), single-use IST Testing Appliance by Prof. Hinz, Cl. II (blue), single-use

6 Intraoral Snoring Therapy: Selection of Appliances For making an IST appliance you need a model of the upper and lower jaw, a recording of the protruded position and the occlusal opening. As the appliances have to be worn continuously during nighttime, acceptance is very important for successful therapy. The delicately designed ISTclassic and ISTplus appliances meet all requirements of protrusion splints for treatment of SRBD, (coverage of all teeth, adjustable guiding rods, free movement of the lower jaw, enlargement of internal mouth space by lateral bite planes). IST Bite fork IST bite fork is used for controlled protrusive positioning of the lower jaw for manufacturing intraoral snoring therapy appliances. By means of the IST bite fork the maximum protrusion of the mandible is determined exactly and the therapeutic protrusion is fixed. The inhibition of the dentition by the bite fork determines the height of the lateral bite planes of the IST appliance. Order No IST Bite fork Set by Prof. Hinz, 3 pieces IST Bite fork by Prof. Hinz, single

7 The fixed nighttime protrusion of the mandible should reach about 50 % of maximum protrusion capacity. Initially, the maximum protrusion of the mandible is measured by means of the IST bite fork. After this the reduced therapeutic protruded position for making the appliance is fixed. Mounting Aid Normally, for mounting jaw models in an articulator a face bow and a bite record is needed. In a lot of cases the dental technician lacks them so the models will be mounted according to table level. Our mounting Aid has an average cranium related inclination of the lower jaw which was gained by instrumental functional analysis of hundred patients. It serves for mounting jaw models into an average articulator (SAM, SAM-P and ARTEX). Order No Mounting Aid

8 ISTclassic NEW The improved ISTclassic NEW appliance by Prof. Hinz is made in deep-drawn forming. Connection between upper and lower jaw is achieved by two parallel adjustable guiding rods so that the lower jaw is protruding. By changing the anchorage elements of the molar area of the lower jaw and the canine area of the upper jaw, the protrusion is secured permanently even in an open mouth position. The appliance is especially suitable, if only little bite opening is possible (elongated teeth or pronounced curve of Spee). ISTclassic NEW Set Order No ISTclassic NEW Set, combination foil Ø 120 ISTclassic NEW Set, deep-drawing foil and separating foil Ø 120 ISTclassic NEW Set, deep-drawing foil and separating foil Ø 125

9 Accessories for Making IST Appliances Order No Guiding rods ISTclassic NEW Telescopes ISTclassic, HF 9 Telescopes ISTclassic, HF 15 Anchorage elements for ISTclassic and ISTclassic NEW Screw-locking Adhesive, components A + B Positioning aid Safety key Storage box, blue Separating foil, Ø 120 (no fig.) Separating foil, Ø 125 (no fig.) Deep-drawing foil, Ø 120 (no fig.) Deep-drawing foil, Ø 125 (no fig.)

10 ISTplus ISTplus appliance by Prof. Hinz is a further development of the conventional IST appliance. This appliance offers maximum comfort with optimal space for ventral positioning of the tongue by its interocclusal guiding rods, connecting from the lower distal to the upper mesial. For making this appliance a larger bite opening is necessary, so it cannot be used in case of a pronounced curve of spee or elongated teeth, because there is not enough space for the plastic anchorage elements. ISTplus Kit Order No ISTplus Kit by Prof. Hinz, consisting of: two adjustable connecting rods, one safety and allen key.

11 ISTplus Set ISTplus Set contains, additionally to the kit, two deep-drawing and separating foils, resin, a storage box and a bite fork. Order No ISTplus Set by Prof. Hinz Deep-drawing foil Ø 120 and separating foil Ø 120 ISTplus Set by Prof. Hinz Deep-drawing foil Ø 125 and separating foil Ø 125 ISTplus Set with Laminating foil by Prof. Hinz Finishing Set for Laminating Foils Order No Finishing Set Refill Pack Prepolisher Caps, 10 pieces (no fig.)

12 Mont-Cenis-Str Herne, Germany +49 (0) 23 23/ (0) 23 23/ Mont-Cenis-Str Herne, Germany +49 (0) 23 23/ (0) 23 23/