Why is Home Sleep Testing Essential for Dental Treatment of OSA?

The subject of the Home Sleep Test (HST) seems to always invite much debate regarding accuracy of “HST compared to in-lab polysomnography” and of “auto-scoring outcomes vs. technician scored outcomes”...

John VivianoMay 6, 2015Comment

Titration End Point; What Standard of Care are You Striving For?

When I first became involved with Sleep Disorders Dentistry circa 1995, I remember feelings of frustration regarding the lack of an objective way to establish the titration endpoint of an oral appliance...

John VivianoApril 29, 2015 Comments

Narval CC & D-SAD Strap Failures: Where would you place the Fuse?

Although 3D printed nylon appliances such as the Narval CC by ResMed and D-Sad by Panthera have demonstrated themselves to be extremely robust, it turns out that they do have an “Achilles Heel”; the advancement strap...

John VivianoApril 21, 2015 Comment

Tooth Movement: The Third Rail of Sleep Apnea Appliances

CAD-CAM Sleep Apnea appliances such as the Narval CC by ResMed and D-SAD by Panthera incorporate a unique band of nylon that attaches the right and left side without contacting the anterior teeth. The design of this band is in our control when prescribing these devices and selecting the wrong design can result in unfavorable outcomes, potentially impacting on ”Tooth Movement” and ”Retention”...

John VivianoJanuary 15, 2015 Comment

ResMed Webinar: Enhancing Retention of a Narval CC Sleep Apnea Appliance and much more...

Webinar on enhancing retention of a nylon 3D CAD CAM Sleep Apnea appliance and much more...

John VivianoDecember 16, 2014Comment

Panthera D-SAD Seminar at Rotsaert Dental Laboratory

My recent presentation on the treatment of Snoring and Sleep Apnea to the folks at Rotsaert Dental Laboratory in Hamilton, Ontario was an absolute pleasure...

John VivianoDecember 9, 2014Comment

Polishing 3-D Printer Fabricated Sleep Apnea Appliances

Recently, an article on increasing retention of a 3-D printer fabricated appliance (Narval CC by RESMED and D-SAD by Panthera) resulted in many requests for information on how to polish these appliances after adjusting them with an acrylic bur...

John VivianoNovember 30, 2014 Comment

Increasing Retention of a 3-D Printed Sleep Apnea Appliance

By now most everyone practicing Sleep Dentistry has seen or handled a CAD-CAM sleep apnea appliance; Narval by RESMED and D-SAD by Panthera are common examples. Fabricated by a 3-D printer using a laser sintering process, these appliances are made of type 12 organic polyamide, better known as nylon; a material we simply don’t have much experience with in Dentistry...

John VivianoNovember 26, 2014 Comment

Size Doesn't Matter, Unless...

Kelly was first diagnosed with mild OSA, oxygen desaturations and a high arousal index in early 2006. After 4 years of struggling with CPAP she presented at my clinic to inquire about oral appliances...

John VivianoNovember 20, 2014 Comment