“Snoring and Sleep Apnoea: The Critical Factor in Choosing an Oral Appliance for Success “

Dr Harry Ball

Effective treatment with oral appliances can have a profound impact on the quality of life for patients suffering from snoring and sleep apnoea. As awareness of sleep-related disorders continues to grow, oral appliances are becoming an essential frontline treatment. Despite various claims by some manufacturers, research shows that the efficacy of different oral appliance designs is quite similar¹. However, one critical factor significantly influences the success of these treatments: the material from which the appliance is made.

The Evolution of Oral Appliances

Historically, the success of an oral appliance largely depended on the skill of the technician to ensure it wasn’t overextended, too thick, or poorly designed. With advancements in digital technology, optimal dimensions and a precise fit have now become standardised, ensuring consistent, high-quality results.

The Critical Choice: Nylon vs Acrylic

Acrylic Appliances

Acrylic has been a trusted material in dentistry for many years, but it has several drawbacks when used for mandibular advancement splints. Its brittleness requires thicker, more obtrusive designs to prevent fractures, which are common among patients with bruxism. These fractures compromise the effectiveness of the appliance and can also pose serious risks, such as the potential for choking or inhaling fragments.

Nylon Appliances

In contrast, 3D printed nylon represents a significant leap forward. Nylon appliances can be fabricated to a thickness of just 0.5 mm or less while remaining unbreakable. This results in smaller, more comfortable, and highly compliant appliances.

Nylon appliances used to have a tendency to stain, but this issue has been completely resolved through Vapour Polishing technology. This process polishes and seals all surfaces, making the nylon impermeable to bacteria and fluids, while also being inert against intraoral tissues.

Why Size Matters

The footprint of the material significantly impacts the appliance’s comfort and effectiveness.

Among all tested designs, nylon appliances have the smallest dimensions by far, which is vital for patient comfort and long-term compliance. The reduced size, combined with the durability of nylon, results in significantly better outcomes for patients.

Shift in the Industry

Many of the leading oral appliance manufacturers have moved away from acrylic in favour of 3D printed nylon. When paired with a digital workflow and AI-assisted design, nylon materials produce consistently high-quality, well-fitting appliances.

At our clinic, SleepWise, we have exclusively used 3D printed nylon appliances for over five years. Thousands of patients have transitioned from acrylic to nylon, and the feedback has been overwhelmingly positive. Nylon appliances offer greater comfort, durability, and ease of use, making them the superior choice for both patients and practitioners.

Choosing an Appliance

Although all appliances may have similar efficacy, the dorsal-style appliance has emerged as the preferred design among many leading experts. Its main advantage is that the upper and lower components are not connected, which reduces side effects and improves patient compliance. When made from nylon, dorsal appliances offer even greater patient satisfaction compared to their acrylic counterparts.

Embrace the Future of Dental Sleep Medicine

Oral appliances are now considered a frontline treatment, supported by high-level studies and the latest guidelines from the American Academy of Sleep Medicine (AASM) and the American Academy of Dental Sleep Medicine (AADSM). With the integration of new technologies like 3D-printed nylon and AI-assisted design, there has never been a better time to bring these valuable services into your practice and significantly improve your patient’s quality of life.

If you have any questions or would like further assistance, please don’t hesitate to contact us at info@3dsleep.com.au.

Regards,

Dr Harry Ball
BDSc LDS (Melb)) M Counsell (Latrobe), Grad Dip Counsell & HS (Latrobe)
Fellow of Dental Sleep Medicine (ASA)
Past Co-Chair Dental Sleep Council, Australasian Sleep Association

Reference:

Lo Giudice, A., La Rosa, S. Diagnostic and Therapeutic Indications of Different Types of Mandibular Advancement Design for Patients with Obstructive Sleep Apnea Syndrome: Indications from Literature Review and Case Description. Diagnostics 2024, 14(17). Available at: https://www.mdpi.com/2075-4418/14/17/1915