3D Sleep specialises in premium sleep appliances as well as providing education and clinical support.
Index
About Us
3D Sleep was established in a partnership between some of Australia’s most experienced dental sleep practitioners and leading digital technicians.
Our mission is to produce the best quality sleep appliances available in the world and to support dentists in the field.
Mr Tom Friedman
Co-Director
Tom graduated as dux from RMIT in Victoria Australia and went on to receive the Overseas Foundation Award. Tom is a qualified prosthetist and studied at Otago University in NZ and then worked with leading dental ceramists in Europe and USA.
Tom was the first person to design and utilise computer management systems in dental laboratories. He is a co-founder of Omega Ceramics Dental Laboratory which leads the way in dental technology and education. Tom is also a co-founder of 3D Sleep, and played a key role in the development of state of the art systems in the manufacture of the highest quality 3D printed nylon mandibular advancement splints.
Mr Russell Young
Co-Director
Russell graduated from RMIT in Victoria Australia in 1973 as dux of Applied Science of Dental Technology. He then won the Victorian Chamber of Commerce Study Award as well as Apprentice of the Year in Dental Technology. In 1974 he was awarded the Overseas Foundation Scholarship by Rotary International to study dental ceramics in New York and Chicago. He returned to Australia in 1975 and together with Tom Friedman, founded Omega Ceramics Dental Laboratory, which is now considered one of the leading dental laboratories in the country. He is also a co-founder of the 3D Sleep lab.
Russell has lectured widely in Europe, Asia, Australia and the United States, and has published articles in dental journals worldwide. He is a qualified dental prosthetist and has combined his comprehensive clinical knowledge with his vast experience to develop some of the finest dental sleep appliances in the world.
Dr Sam Talpis
BOH.Dsc, G,Dip.Dent (QLD), PG,Dip. Dent Imp (CSU)
Co-Director
Sam completed his dental degree in Queensland graduating with a Bachelor of Oral Health and a Graduate Diploma of Dentistry. He has completed a Craniofacial pain clinical residency program at the American Academy of Craniofacial Pain in the USA, a Sleep Residency in San Diego and has been accepted into the Master’s degree program in Sleep Medicine at the University of Sydney.
Sam has expertise in dental sleep medicine and has lectured for the Australasian Sleep Association. He has vast experience in providing oral appliances for snoring, sleep apnoea and bruxism and is a co-director of SleepWise Clinic. Sam is involved with the designs and innovations of state of the art oral appliances and has several patents in his name.
Dr Ken Lee
BHSc(Dent), MDent
Co-Director
Ken is a co-director at SleepWise Clinic and since 2016 has restricted his practice to dental sleep medicine and orthodontics. In 2019, he also completed a Graduate Diploma of Orthodontics through James Cook University.
His key areas of interest include the clinical prevention and management of occlusal changes and the research and development of new oral appliances for snoring and sleep apnoea. Ken is involved in training and supporting dentists in the field of dental sleep medicine and was a main presenter at the last Australasian Sleep Association Conference.
Dr Harry Ball
Co-Director
A world’s leading practitioner in dental sleep medicine, prior to founding SleepWise Clinic he was a principal clinician at the Temporomandibular Disorders Pain Clinic at the Royal Melbourne Dental Hospital. Dr Ball has been involved in training programs in dental sleep medicine for sleep physicians and general medical practitioners. He has presented highly acclaimed educational programs for dentists throughout Australia, as well as in England, Holland, Belgium, Germany, Singapore and Malaysia. He has also presented for many organizations including the Australasian Sleep Association, Dental Health Services of Victoria, the Australian Dental Association and the Australian Association of Orthodontists. Dr Ball is the past co-chairperson of the dental sleep medicine division of the Australasian Sleep Association.Range of Mandibular Advancement Splints
3DS Advance
The 3DS Advance is a 3D printed nylon dorsal wing design appliance. The dorsal design is the most popular custom made appliance in use worldwide. It is the only appliance in which the upper and lower components are not connected together.
The lateral fin design maximises patient comfort and minimises side effects and allows the patient to open and close, talk easily, sip water etc.
As the upper and lower components can move independently of each other during mandibular movements there are less forces on teeth, thereby enhancing patient comfort. The lateral fins hold the mandible forward, even during mouth opening. As the upper and lower components are not connected there are little dislodging forces when in use and retention is rarely a problem.
The new generation dorsal appliance has been successfully used in tens of thousands of patients throughout the USA, Europe and Australia. There have been many studies of the dorsal fin designed appliances demonstrating effectiveness and comfort.
The 3DS Advance is made from 3D printed nylon and is unbreakable in the mouth. This is in stark contrast to dorsal designed appliances made from acrylic resin which are prone to fracture – a very undesirable problem with potentially serious consequences.
3DS Eclipse
The 3DS Eclipse is made from medical grade nylon with the side connectors designed in Germany.
The design makes for an extremely unobtrusive appliance and is in widespread use throughout the USA and Europe. It comes with an array of different length side connectors, which allows for optimal mandibular positioning.
It is simple for the patient to be able to change the connectors in achieving control of snoring and sleep apnoea.
The 3DS Eclipse can be indicated when the patient has narrow arches, minimal intra oral space or is a gagger.
3DS Connect
The 3DS Connect is an Australian designed appliance that has excellent scientific studies demonstrating effectiveness and comfort.
The 3DS Connect is indicated for those patients who sleep with their mouths open as it prevents jaw-dropping. Mouth opening is undesirable for a small percentage of people during sleep and tends to reduce the effectiveness of an appliance.
It is easy for the patient to make adjustments for mandibular advancement thereby achieving optimal control of the symptoms of sleep apnoea and snoring.
The 3DS Connect allows for an excellent range of lateral mandibular movements when in use thereby enhancing comfort and minimising the potential for side effects.
Which is the best oral appliance for snoring and sleep apnoea?
Despite the claims made by manufacturers, multiple studies demonstrate that the various designs of custom made MAS are similar in terms of efficacy. There have been 10 studies since 2005 all demonstrating no significant differences in the efficacy between the appliances. There are however differences in the side effect profiles between the various appliances. The following are regarded as the two key factors for achieving successful outcomes.
Comfort and Compliance
Experts in dental sleep medicine are in agreement that a key factor for achieving successful outcomes lies in the comfort of the appliance. This is related primarily to the type of material which is used and the resultant thinness, volume and mass. This is particularly important for patients new to using an appliance, as well as for patients with small mouths and/or a strong gag reflex.
Strength and Durability
The second factor of importance is strength and durability. The 3D printing technology has revolutionised the field allowing appliances to be extremely thin, down to 0.5mm yet unbreakable in the mouth. As a result, 3D printed nylon appliances are extremely comfortable to use, in stark contrast to the CPAP machine in which studies show most patients can’t use, and those that do can only do so for an average of 3 hours per night.
Any acrylic oral appliance, even when milled, and no matter how well made, can fracture in the mouth resulting in potentially very serious consequences. Acrylic resin is fast becoming an obsolete material for use in oral appliances as a result of its brittleness and the thickness required.
Occlusal Splints for Bruxism
3DS Protect
A mini full mouth occlusal splint designed by dentists to fulfil the criteria for an optimal splint.
Fulfilling the Criteria for an Optimal Splint
- Absolutely minimal dimensions making it extremely comfortable and easy for patients to wear long term
- Minimal chair side time for the dentist. No adjustment is required to the fit or the occlusion through the digital design and thermoplastic property
- Maintains long term occlusal stability
- High strength with virtually no chance of fracture.
Thermoplastic Property
A very useful property of an appliance material is the ability to soften in boiling water. This is particularly important as the appliance can be easily loosened or tightened. This is also very useful if there have been changes to the dentition as the thermoplastic property allows for easy re-adaptation. Any such adaptation is maintained without the need to use hot water again.
A valuable service and mandatory part of the treatment plan
Many dentists are making the provision of the 3DS Protect splint a mandatory part of the treatment plan when there is any evidence of bruxism. This is a very valuable service for your patients and a significant source of revenue for your practice. The 3DS Protect can be made in the “Michigan” style with anterior and cuspid guidance or with a fully flat occlusal plane.
Occlusal splints of other designs, such as the Gelb or Tanner can be made on request.
The 3DS Protect is widely regarded as the most comfortable, unobtrusive, full mouth splint available.
Hard or Soft Splints?
It has been established that the occlusal surface of the splint should be made of a hard material. Professor Jeffrey Okeson published an article* demonstrating that a hard occlusal splint significantly reduced muscle activity in eighty per cent of participants. A soft occlusal splint significantly reduced muscle activity in only 10 per cent of subjects while causing a statistically significant increase in muscle activity in 50 per cent of the participants.
*“the effects of hard and soft occlusal splints on nocturnal bruxism.”
Okeson JP.J Am Dent Assoc. 1987 Jun;114(6):788-91
Which type of splint is best – flat plane or cuspid and anterior guidance?
A published scientific study** demonstrated that both these occlusal schemes are equally effective when used for patients with TMD or for the medium to long term protection of teeth. It can be left to the personal choice of the dentist.
**“effects of canine versus molar occlusal splint guidance on
nocturnal bruxism and craniomandibular symptomatology.”
J D Rugh; G S Graham; J C Smith; R K Ohrbach
Journal of craniomandibular disorders : facial & oral pain 1989;3(4):203-10.
Professor Robert Cronin on Bruxism
“The best thing that dentists can do for patients with bruxism”
– an interview with Professor Robert Cronin.
Professor Robert Cronin, from the University of Texas Health Science Centre, is the director of the postdoctoral prosthodontics program and a Professor at the San Antonia dental school.
Prof. Robert Cronin:
If you have a patient in your practice over a long period of time who is bruxing and severely wearing his teeth, causing deficiency aesthetically in the vertical dimension of occlusion, and as far as the maintainability of his teeth, it’s a pretty easy lawsuit for a lawyer.
Dr Patrick Meaney:
And what sort of therapy would you offer them in the first instance?
Prof. Robert Cronin:
Well, the first therapy is patient education. It’s surprising how many patients can grind their teeth but not really be totally aware of the tremendous aggressive loss of tooth structure that is secondary to this bruxing event.
So the first thing that we have to do, and it is our professional responsibility to do so, is to inform the patient of the severity of this habit and its effect on the entire oral mechanism. Because it can affect not just the teeth but obviously it can affect the temporomandibular joints, it can create muscular problems, headaches and all kinds of symptoms that we are aware of.
Secondarily, once the patient is informed, various treatment alternatives should be presented to the patient. The least of those is a protective nocturnal device because the placement of a nocturnal device can certainly stop 80-85% of the damage.
Dr Patrick Meaney:
So you’re saying maybe the first resort wouldn’t be a full mouth reconstruction?
Prof. Robert Cronin:
The best thing we can do for our patients is to be proactive in early diagnosis so we can prevent the need for this patient to spend ten’s of thousands of dollars and have a lifetime of prosthodontic maintenance secondary to full mouth reconstruction, but if we can get the practitioner involved in recognising the ideologies of wear early on, before the damage results in teeth that must be restored, we have done a far greater service for our patients than restoring those patients following severe wear.
Dr Patrick Meaney:
Any thoughts on splint design for that sort of patient? Are they complicated or simple?
Prof. Robert Cronin:
They can be complicated and they can be simple…. There is a myriad of different designs. The classic splint is a full maxillary splint that creates a harmonious contact on the posterior teeth in centric relation and creates anterior guidance, that’s the classic splint.
Dr Patrick Meaney:
Two quick points: My big problem is the lack of compliance and denial in these patients, any quick solutions?
Prof. Robert Cronin:
There are no quick solutions if you are a good communicator with your patients. I don’t think anybody wants to accept the potential disease state that bruxism is going to inevitably result in, and they also are not too thrilled about accepting the financial problems that they are going to have with the full mouth reconstruction.
So we use those two facts to our advantage and when we discuss this with the patient, the patient is made aware of the fact that they are not at a point where they absolutely have to be restored yet. We can buy them for several years, sometimes 20 years, by absolute avoidance of the habit. So it’s that ‘c’mon’ that gets the patients involved in their care.
This is a transcript from the ADA Clinical & Business Updates for dentists – Audio Program Three – 2007 Track One: Bruxism
Taking a registration for an occlusal splint
Which is the best oral appliance for snoring and sleep apnoea?
A valuable service and mandatory part of the treatment plan.
The degree of the vertical opening should be similar to the thickness of the occlusal splint. This ensures that the occlusion of the casts on the articulator will replicate the occlusion in the mouth. This is not the case if you take the registration at a closed vertical and the articulator needs to be opened. There is an inherent error built-in when this is done. Now when you receive the splint from the lab very little adjustment will be required.
The 30-second bite registration – at the correct vertical opening.
This can be best achieved with the Leaf Gauge (see Fig. 1) – the ideal device for taking a registration at an open vertical. The leaves of the Leaf Gauge make it easy to select a vertical opening. The material used for recording the registration should be stable and able to maintain its shape.
Place the Leaf Gauge between the anterior teeth. Select an appropriate number of leaves from the Leaf Gauge to open the vertical to approximately the same degree as the thickness of the splint (Fig. 2 ). Inject a mousse-like, polyvinylsiloxane registration material into both posterior spaces on either side of the Leaf Gauge (Fig. 3) and send it to the lab with impressions.
Patient Educational Material & Resources
You will have many patients in your practice who have been diagnosed with sleep apnoea or don’t know they have it. The dentists at 3D Sleep can help you with a variety of effective materials and templates for identifying these patients and motivating them toward treatment.
Click here to access these valuable resources that will help you manage and treat these patients effectively.
Oral Appliance Brochure
This excellent brochure, using photos and diagrams, helps patients to identify the presence and the consequences of bruxism. It also helps patients to understand the importance of treatment, particularly with a bruxism splint.
Demonstration Oral Appliance
Occlusal Splint Brochure
This brochure educates your patients and explains what bruxism is, the effects clenching and grinding can have over time and the importance of getting treated.
Demonstration Occlusal Splint
Patient Education Diagrams
ADA Newsletter
This ADA newsletter on oral appliances is very informative and will be of great interest to many of your patients. It will let them know why dentists have one of the best available evidence-based treatments for snoring and sleep apnoea.
The George Gauge
Bur Kit
Four specially selected burs including three zirconia burs, for adjusting nylon occlusal splints and sleep appliances. These are the only burs you will need to make any required adjustments and to achieve a lab quality finish.
The Leaf Gauge
Registering as a client and working with 3D Sleep
To become a client and book your cases please go to laboratory.3dsleep.com.au and register as a new client.
The online portal allows you to track the progress of your cases in real-time and the delivery details. Another benefit of the portal is immediate and streamlined communication with the lab. Register or book new cases at laboratory.3dsleep.com.au.
Impressions and Scans
We accept all types of intraoral scans, PVS impressions, and poured models.
For Trios please search for bookings@omegaceramics.com.au as your lab partner.
For Carestream, Medit, Primescan, Cerec please search techs@omegaceramics.com.au as your lab partner. When you are asked to request a connection please enter “Omega Ceramics” in the search facility.
If you are using ITERO you need to contact your rep to request a connection with us. If you have any other scanners please call the lab for more information.
The following information will help facilitate a successful relationship with your practice and will help you achieve optimal results for your patients.
Sending Cases
Please log the cases in at laboratory.3dsleep.com.au. If physical impressions are used, please tick that on the form.
Pick Up
Production Time
Choosing an Appliance
3D Sleep can assist with appliance selection and design. If you have any clinical or technical questions please call Dr Sam Talpis, senior clinician and co-director at 3D Sleep.
Impressions/Scans
3D Sleep can assist with appliance selection and design. If you have any clinical or technical questions please call Dr Sam Talpis, senior clinician and co-director at 3D Sleep.
Bite Registration
For optimal results please provide a bite registration for every case to ensure minimal adjustments at the insertion visit.
Mandibular Advancement Splints:
A bite registration of a selected mandibular protrusion is necessary and is best achieved with the use of the George Gauge*.
Occlusal Splints:
In addition to a scan/silicon registration, a Leaf Gauge* can be used to provide a registration at an open vertical.
Lab Sheets
We have gone digital and all cases need to be booked in our portal at laboratory.3dsleep.com.au
Terms of Payment
Accounts are due and payable within 30 days from the date of invoice. Payments can be made by Visa, MasterCard, American Express EFT or cheque. Please contact us if you have any queries about your account.
Warranty
- 3D Sleep warrants all new oral appliances to be free from defects in materials and workmanship for a period of three years from the date of invoice.
- 3D Sleep cannot guarantee that the given oral appliance will be efficacious in the treatment of snoring, obstructive sleep apnoea or bruxism.
- Appliances are covered only for in-mouth breakages.
- Repairs not covered under warranty include, but are not limited to: reset bites, subsequent restorative work, device modifications made by non-3D Sleep technicians and other damage not caused by manufacturing defects.
- Warranty work may only be carried out by 3D Sleep.