instructions for fitting

The upper arch impressions require the impression material to extend up to the anterior vestibule. An easy method for capturing the upper vestibule is to use a Monoject 35 CC syringe with catheter tips (#888-1) as an alginate syringe to inject alginate into the anterior vestibule and then taking the alginate impression of the upper arch. This will easily capture the upper vestibule region for the construction of the upper flange.

Take a bite registration with the mandible advanced 70-80% maximal protrusion and 3 mm interincisal opening,

Step 1. . Upper Splint Fitting
	Remove the device from the container. There are two parts the device itself and the upper splint. Begin by fitting the upper splint over the upper dental arch as you would for a periodontal splint or an orthodontic retainer. If the splint is too tight use a crown cutting scissors and shorten the length of the material in the area that feel tight. The most common area is the area labial region in the canine and incisor teeth region.

Step 2. OASYS Oral/Nasal Airway System™ Fitting

Heat soften the OASYS Oral/Nasal/Airway System™ device in warm tap water to soften the heat sensitive base material (Variflex). The OASYS Oral/Nasal/Airway System™ device is oriented for insertion. Have the patient open their mouth and seat the lower segment over the lower arch. With your index fingers over the occlusal surface of the lower portion of the device seat the device onto the teeth as one would seat a lower splint. If there are undercuts preventing this seating one can try to heat the base material in warmer water to fruther soften the material or if necessary remove undercuts with an acrylic bur on a slow speed hand piece or a lab motor. Continue to adjust the fit until the device fits firmly in place. It should have secure fit without too much pressure on any individual area.

Trouble shooting.
Problem: Can’t position the device over the teeth without inserting the upper portion fully in place.
Answer: In this case it is necessary to guide the upper portion in front of the upper teeth and under the upper lip and then snapping instruct the patient to bring their mandible forward to align the teeth with the base of the lower section and bite into place over the lower dental arch.

Problem: The fit is too loose.

Answer: If theRemove the OASYS Oral/Nasal/Airway System™ device and move the locking colar forward to contact the holding tube and lock down the lock screw. Try theOASYS Oral/Nasal/Airway System™ device in again and fine tune the adjustment as needed. device fits over the teeth but is not secure on the teeth it may be necessary to add a layer of acrylic to the inner surface of the lower segment.

Mix clear orthodontic acrylic (we have found that Dentsply orthodontic acrylic works well for this function) to a loose creamy consistency and load the inside of the lower portion with just enough material to spread and provide a thin coat of acrylic (usually about 1/3 of the volume). Allow the vapors to dissipate for about 10 seconds. Place the device into the mouth and seat firmly onto the teeth. The doctor, assistant or have the patient hold it to steady it in place for one minute. It is very important not to leave it in too long and allow the acrylic to completely set up. Remove and check for proper impression of the teeth without any pull away of material or tearing from an undercut.

Place in warm water or preferred a pressurized pot for about 5 minutes.

Reduce any obvious undercuts and repeat fitting.

Step 3. Positioning the upper segment.

Give the patient a hand mirror to begin their training for the insertion of the device.
The upper segment should be introduced into the oral cavity by bringing the mandible into the forward position and closing down as best as one can. With the index finger into the corner of the lip bring the lip over the nasal labial button on one side and then repeat on the other side.

An alternative to this is to angle one nasal labial button into position and then rotate the device into position and snap into place over the lower teeth and then with the index finger bring the opposite side over the button.

With the locking screws loosened only enough to move on the wire (be careful not to over loosen the screw to avoid it coming off the ring) position the mandible forward to the desired position. Because of the natural give of the device the patient is usually instructed to move the mandible forward to the most forward position. Push the upper flange back firmly against the upper anterior teeth note the position of the front 90 degree bend in the body wire to the base and hold it at that position.

Remove the device by having the patient open with the mandible protruding and lifting the OASYS up at the lower front corners.

Step 4 Setting the repositioning and locking the setscrew.
	Position the OASYS Oral/Nasal/Airway System™ to the most forward position as indicated by the alignment of the 90 degree corner of the body wire. Bring the locking collar forward against the metal tube. .Using the micro-screwdriver lock down the locking collar. Then repeat for the other side.

Step 5. Try-in
	Try in the Remove the OASYS Oral/Nasal/Airway System™ device and move the locking colar forward to contact the holding tube and lock down the lock screw. Try theOASYS Oral/Nasal/Airway System™ device in again and fine tune the adjustment as needed. and have the patient repeat repositioning their mandible and see if you have achieved the desired positioning. If you need to further reposition the mandible you can repeat Step 4 or you can estimate the desired repositioning and make the changes by sliding the wire back through the metal tube the desired amount by using the millimeter scale on the posterior of the lower portion then losing the set-screw and sliding it into position and locking it again.

Step 6 Nasal dilator buttons

Now that you have the Remove the OASYS Oral/Nasal/Airway System™ device and move the locking colar forward to contact the holding tube and lock down the lock screw. Try theOASYS Oral/Nasal/Airway System™ device in again and fine tune the adjustment as needed. positioned with the mandible forward to the desired position look at the position of the Nasal dilator buttons. They should be about 1/3 down the nasiolabial fold from the nose to the lip and just lateral to the canine eminence.

To adjust the position the initial adjustment can be made with the Remove the OASYS Oral/Nasal/Airway System™ device and move the locking colar forward to contact the holding tube and lock down the lock screw. Try the OASYS Oral/Nasal/Airway System™ device in again and fine tune the adjustment as needed. before inserting it in the patient’s mouth. Further adjustments can be made by have the patient keep their mouth closed while opening their lips enough to introduce your index finger through the lips and bend the button in the desired direction. Next check the amount of stretch on the tissue and adjust to get a moderate stretch without discomfort.

Have the patient breath through the nose for a few minutes. This should become easier after a brief period of use.

If you have instrumentation to measure the nasal volume such as Acoustic Rhinometry the initial readings should be made prior to fitting with the after treatment readings made after a few minutes of usage to appreciate the effect.

Patient education is an important part of the treatment. All dental devices are foreign objects that the patient has to get used to. Ideally a person would breathe easily all night long without any type of aid. Dental devices are the gentlest and kindest treatment for this serious disorder that has great potential to lead to many life-threatening diseases. Patients will usually be very happy to use the Remove the OASYS Oral/Nasal/Airway System™ device and move the locking colar forward to contact the holding tube and lock down the lock screw. Try the OASYS Oral/Nasal/Airway System™ device in again and fine tune the adjustment as needed. and see its advantages when they appreciate that this device is opening the nose and throat at the same time. Showing them the effect though instrumentation or on the grafts provided are great educational tools for you to use.

A very few patients have trouble adapting to the nasal dilators and they may be removed and Remove the OASYS Oral/Nasal/Airway System™ device and move the locking colar forward to contact the holding tube and lock down the lock screw. Try theOASYS Oral/Nasal/Airway System™ device in again and fine tune the adjustment as needed. makes an excellent mandibular repositioner that maintains is advantages of full oral volume and gentleness on the teeth.

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INSTRUCTION FOR IMPRESSION AND BITE REGISTRATION