ORAL APPLIANCES
 Oral appliance therapy was endorsed as effective management of obstructive sleep apnea by the American Academy of Sleep Medicine in the September, 1995 issue of their journal, SLEEP. Reduced Posterior Airway Space, increased ANB angle and increased Hyoid / Mandibular Plane distance have been shown to be the significant cephalometric predictors for sleep disordered breathing.
Most patients with narrowed airways will have increases in the volume of the airway and decreased resistance to airflow when the mandible is advanced. This is the fundamental principle of airway management, utilized in cardio-pulmonary resuscitation (CPR), where the tongue is moved from the airway by head and mandibular posture.
The base of the tongue is moved farther from the airway tissues to a position where contact and obstructions are less likely or unable to occur. Increased airway volume causes a slower rate of flow, which increases air pressure (Bernoulli's Principle), and increased tone is imparted to the tongue by the stretching of the masseter muscles.
Finally, as the hyoid bone is raised and advanced by the action of the digastric muscles, greater stability of the airway musculature is achieved and resistance to airflow is further decreased.
 TAP® & TAP TL®
The Thornton Adjustable Positioner (TAP) alleviates snoring and sleep apnea by holding the mandible forward during sleep to prevent the tongue and soft tissue of the throat from collapsing into the airway. The TAP is based on the same principle as cardio-pulmonary resuscitation (CPR). The airway must be opened to allow air to pass through the throat.
The TAP has a unique design. It allows the patient to adjust the degree to which the mandible is held forward, simultaneously allowing maximum comfort and effectiveness. It is a custom-made two-piece appliance that snaps firmly over the upper and lower teeth. The hook on the upper tray and the bar on the lower tray of the appliance engage enabling the mandible to be pulled forward. The dial mechanism (Front Assembly), found on the front of the upper tray, controls the amount the mandible is advanced (titrated). When the patient finds a comfortable, effective position, the Front Assembly can be removed from the upper tray allowing the lips to close.
The TAP is available with two significantly different linings, the TAP Thermacryl and the TAP Triple Laminate (TAP TL). The outer shells of both appliances are a thermoplastic orthodontic polycarbonate hard material. The metal components found in both the TAP and TAP TL are composed of 316 surgical stainless steel.
TAP Thermacryl
The lining of the TAP Thermacryl is a unique polymer, Thermacryl™, that becomes soft when heated, and can be molded to the patient's dentition when seated in the mouth. Once the Thermacryl hardens, it has a 1% shrinkage so it snaps tightly over the patient's teeth. The TAP can be easily relined and is optimal for patients who will have periodic dental work.
TAP Triple Laminate (TAP TL)
The lining of the TAP TL offers a different comfort level and seating approach than that of the TAP. The TAP TL lining is a dual laminate thermoplastic orthodontic material which is soft and flexible, and suctions around the patient's teeth for a firm grip. The lining of the TAP TL is a much more comfortable option than the TAP Thermacryl.
- The TAP has alleviated snoring in more than 96%* of patients who wear the appliance, making it more successful than any other oral appliance currently available.
- The TAP is the only oral appliance proven effective for the treatment of severe obstructive sleep apnea.
 TAP II®
The Thornton Adjustable Positioner II (TAP II) alleviates snoring and sleep apnea by the same mechanical and physiological methods as the TAP. It allows the patient to adjust the degree to which the mandible is held forward, simultaneously allowing maximum comfort and effectiveness.
The TAP II is a custom-made two-piece appliance that snaps firmly over the upper and lower teeth. The design of the TAP II hardware differentiates it from the TAP appliance. The Front Assembly (adjustment mechanism) on the upper tray of the TAP is eliminated from the TAP II tray, as is the Lingual Bar on the lower tray. Instead, a Base and Hook assembly with an internal adjustment mechanism replaces the Front Assembly, and a Socket replaces the Lingual Bar. The Socket on the lower allows the patient more tongue space unlike the Lingual Bar, which limits the amount of space for the tongue. The tool used to adjust the Hook on the TAP II is an allen wrench "key" that is removable. The Hook Key is a simple tool designed to effortlessly fit into the adjustment screw of the Base and allow the patient to easily keep count of each adjustment turn.
The TAP II features include:
- no Front Assembly protruding from the mouth
- more tongue space
- less visible in the mouth
- a ball and socket design that allows for easier coupling in the mouth
- parts that are made from 316 surgical stainless steel
- an unbreakable hook
The TAP II is available with two significantly different linings, the TAP II ThermAcryl and the TAP II Triple Laminate (TAP II TL). The outer shells of both appliances are a thermoplastic orthodontic polycarbonate hard material.
rmoore@drmooresleep.com
7931 NE Halsey - Suite 305
Portland, OR 97213
503.255.1200
503.408.6856 fax
| 
