Mandibular repositioning devices

Thanks to a wealth of clinical research, mandibular repositioning devices (MRDs), also known as oral appliances, have gained recognition over the last decade as an effective solution to snoring, as well as an alternative to continuous positive airway pressure (CPAP) treatment in cases of mild to moderate obstructive sleep apnoea (OSA).

In these latter cases, the Mean Disease Alleviation of MRD treatment, which factors in both AHI reduction and compliance, is 51.1%, which is similar to what is generally reported for CPAP (50%).These results fit the hypothesis that MRD treatment, despite being inferior to CPAP in terms of AHI reduction, might translate into a similar adjusted AHI and effectiveness because of a higher compliance.1


Narval CC* MRD has high compliance rates

At ResMed, we are conducting a five-year study ­— the largest of its kind — among 369 users, and found the regular use of ResMed’s Narval CC™ MRD led to a full disappearance of loud snoring in almost 9 of 10 users.2 It also reduced OSA levels by 50% in almost 8 of 10 users.2  


Two types of MRDs: custom and off-the-shelf

There are two types of MRDs on the market: custom-made ones like Narval CC, and thermoplastic ones that patients need to fit themselves. A recent comparative study demonstrated that a custom-made oral appliance is twice as effective in reducing snoring than non-custom, thermo-plastic MRDs.3 It has a higher compliance rate – 94% over 69%– and patients are more likely to prefer it (82%)1.

Thanks to MRDs, dentists who specialise in dental sleep therapy have a vital role to play in helping patients who snore as well as those with OSA, reclaim their sleep.



  • 01

    Vandervecken et al. Objective measurement of compliance during oral appliance therapy for SDB. Thorax 2012;0:1–6, Non comparative prospective study

  • 02

    Vecchierini MF & al. A custom-made mandibular repositioning device for obstructive sleep apnoea-hypopnoea syndrome: the ORCADES study. Sleep Med. 2016 Mar;19:131-40. doi: 10.1016. Two-year follow-up results.

  • 03

    Vanderveken OM. Comparison of a custom-made and a thermoplastic oral appliance for the treatment of mild sleep apnea, Am J Respir Crit Care Med. 2008 Jul 15;178(2):197-202.

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