The Herbst Appliance has been proven to be effective on chronic snoring and mild to moderate obstructive sleep apnea sufferers. This appliance allows patients to move laterally and vertically without disengaging the appliance. Also, if it is determined that the initial position does not provide the anticipated relief of the condition, the mandible can easily be moved forward by two options of adjustability. The first option is traditional hardware with sets of 1,2 and 3 mm shims for advancing those increments only. The second being the Telescopic version allowing the clinician to advance in ¼ mm increments by making one full turn of the protrusion collar up to 6-8mm from the start position. The appliance can be fabricated from hard acrylic, thermoactive and soft materials and is tooth retained via friction grip or clasps.The Herbst Appliance is a mandibular repositioner that has been in use many years for orthodontic and TMJ therapy prior to its modification for treatment of sleep disordered breathing.The greatest advantage of the Herbst appliance is that it allows for very quick, easy and accurate mandibular protrusive adjustability. This is accomplished through simple manipulation of the rod/sleeve plunger mechanism. Vertical opening varies is 5 mm and there is limited freedom of movement for the mandible in a lateral direction. Bilateral interarch elastics are recommended to keep the jaw closed during sleep.NOTE: Some clinicians feel that limited lateral movement of the lower jaw during appliance use is beneficial for TMJ comfort while others believe it is of no benefit. Also, some clinicians find compromised effectiveness if the mandible is allowed to drop down even as much as a millimeter during appliance use while others find no difference. These are both areas that require more scientific study. We are presently unaware of the precise effect of these parameters on appliance effectiveness.FDA Approval: Approved for treatment of snoring
Date of FDA Approval: March 1996
FDA Registration Number: K955822
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