ArrowPath Sleep Airway Bite — Instructions for Use

Clinical instructions for recording a protrusive bite registration with the ArrowPath Sleep Airway Bite. To make an airway device you need to record the best jaw position for the airway and relate that position to the lab.

Before you begin — take a digital scan of the upper and lower jaws without a bite.

Class II

Device shifted back so it sits flush with the buccal surface of the front teeth.

Class III

Device shifted forward so the lingual surface of the front teeth touches the device.

Phase one

Fit the device

ArrowPath Sleep Airway Bite positioned for Class II and Class III occlusions, alongside the 4 mm anterior stop seated on the upper front teeth.Enlarge
APS Airway Bite with 4 mm anterior stop. Reline with Parkell Blu-Mousse Super Fast; a second reline can be done over the first if needed.

  1. Trial and positioning

    Try the device in the mouth. Adjust forward for a Class III bite or backward for a Class II bite. Once positioned, note the orientation.

  2. Silicone application

    Fill the device with Parkell Blu-Mousse Super Fast silicone. A second reline can be performed over the first if needed.

Phase two

Map the range of movement

Marking the furthest forward and back jaw positions and the midline with a disposable pencil, measuring protrusive movement on an OraStretch MIO scale, and placing bonding agent on the device.Enlarge
Mark the furthest forward and back jaw positions and the midline with a disposable pencil, then measure the protrusive amount to build into the mandibular advancement device.

  1. Jaw movement assessment

    With the device affixed to the upper teeth, have the patient move their jaw as far back as possible. Mark the position of the lower incisor and the midline with a disposable pencil. Repeat with the jaw moved as far forward as possible.

  2. Measurement

    Remove the device from the mouth and measure the total anterior–posterior movement. Typically this is around 10–12 mm.

  3. Target position marking

    Mark a point halfway between the most retruded and most protruded positions. This is the target position for jaw posture — roughly 50% of total movement is typically a good place to start.

Phase three

Lock in the position

Flowing composite in front of and behind the lower incisors with the jaw tapped into the forward position, then curing to hold the jaw stable.Enlarge
Move the jaw into position, verify with tap-tap, then flow composite in front of the lower incisors and at the edge of the anterior stop, and cure. The jaw is now held stable in the forward position.

  1. Patient tapping

    Instruct the patient to repeatedly tap their teeth on the airway bite, guiding them to tap at the midway forward mark.

  2. Flowable composite application

    Once you are satisfied with the forward arcing position of the lower jaw, have the patient rest and hold there. Verify it is in the area you marked with the pencil. Apply flowable composite to the airway bite in front of and behind the lower incisors, then cure. This holds the jaw in the desired forward position.

Phase four

Capture and send to the lab

Jaw held stable in the forward position, digital scan of the bite sent to the lab, and the resulting final mandibular advancement device.Enlarge
Take the digital scan bite with the anterior stop in place and the jaw positioned forward, then send to the lab digitally. The device can also be used to take a silicone bite registration.

  1. Digital scan

    With the jaw held in the forward position, perform a digital scan of the bite. This aligns the upper and lower arch models so the dental lab can fabricate the sleep device.

  2. Alternative: silicone bite

    If not using a digital scanner, a silicone bite can be created by squirting silicone into the back of the device.

Printable instructions

A one-page version for chairside use.

Download PDF

Ordering

The ArrowPath Sleep Airway Bite is available from Great Lakes Dental.

greatlakesdentaltech.com