Treatment of OSA has gone through many changes in appliances over the last 25 years. And we have been there with all of them. It was through this experience treating thousands of patients with a variety of appliances that the Luco Hybrid OSA Appliance was born.
The design is one of the “new generation of appliances” that treats by stimulation of pharyngeal reflexes that act to advance the mandible and tongue and keep it forward with minimum pressure on the appliance. The design provides the patient with a very comfortable appliance they do not mind wearing.
The patented cast framework reduces the bulk of the appliance significantly while providing considerable strength. The appliance is very resistant to breakage and very durable.
This appliance is FDA market cleared as a class II medical device for the treatment of mild to moderate obstructive sleep apnea and primary snoring in adults.
What is Needed to Order a Luco Hybrid OSA Appliance?
There is no change to your current methods of impressions or bite registrations. We require upper and lower high quality casts or digital scans and a protrusive bite registration. A George or Andra gauge are ideal for this (click here for instructions on the use of a George Gauge). Please note that you can use any protrusive bite registration technique with this appliance and start at any position. The appliance is adjustable up to 6 mm.
Inserting the appliance is very straight forward:
- There is usually no acrylic to adjust
- All that is needed is to tighten the ball clasps until the appliance is secure. Bird beak pliers or hand instruments may be used.
- Once the appliances are fitting well, place both in and verify the wings contact evenly when protruding and retraction the jaw slowly. If not adjust forward the side that does not contact. This adjustment is very important to prevent jaw strain.
- Then check the occlusion. Remember there are only two points of contact on this appliance. Adjust the pads on the lower appliance until the contact is equal.
- Have your staff go over the manual and training the patient for proper insertion and removal of the device. Once proficient, schedule them in 7-10 days to resasses their progress.
Adjusting the appliance:
- When the patient returns, if they are symptomatic, advance the side screws 0.5 (2 turns) to 1.0 mm (4 turns) per side.
- Palpate the patient’s lateral pterygoid muscles.
- If one side is sore, the wings are not balanced. Advance the side with the sore lateral pterygoid 1-2 turns and try in again. The patient should report an improvement in comfort immediately.
- Recheck the wing contact and the bite and you are done
Tips:
- With UARS patients, when advancing, do so in small increments as even small amounts (0.25mm) have large results (1 to 2 turns)
- Remember that if the snoring isn’t gone, neither is the apnea!
We are confident that you will find this appliance effective and you and your patients will be impressed with the results.
