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mandibular inclined repositioning appliance (MIRS)

Find A Sleep Medicine Dentist Who Provides Oral Appliance Therapy in the United States, Canada and Other Countries

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MIRS

An open airway is maintained with this appliance by directly holding the mandible in a downward and toward position with an incline flange. This flange is made out of a thermoplastic material that softens at body temperature keeping it comfortable for the patient. The body of the appliance is made out of hard acrylic and snap fits to the upper arch. The lower dentition is deeply indexed into the occlusal surface of the appliance to hold the mandible in the forward position. A breathing hole is placed in the anterior portion of the appliance to allow for easy breathing throughout the night.

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In the Practice Parameters Report published in Sleep, Vol. 29, No. 2, 2006, the American Academy of Sleep Medicine makes the following recommendation: "Oral appliances (OAs) are indicated for use in patients with mild to moderate OSA who prefer them to continuous positive airway pressure (CPAP) therapy, or who do not respond to, are not appropriate candidates for, or who fail treatment attempts with CPAP. Until there is higher quality evidence to suggest efficacy, CPAP is indicated whenever possible for patients with severe OSA before considering OAs. Oral appliances should be fitted by qualified dental personnel who are trained and experienced in the over- all care of oral health, the temporomandibular joint, dental occlusion and associated oral structures."