THANK YOU - Great Lakes Dental Tech
T H A N K YO U for choosing the Medley Sleep Appliance for your Patient Introduction - by Dr. Robert Rogers The new Medley Appliance represents personalized, state-of-the-art technology in appliance therapy for the treatment of sleep disordered breathing. I have been using it in my office almost exclusively for the last five years. It has served me and my patients very well. The Medley features a platform with dual configuration options that will accept different design applications: rigid nylon links, elastomeric straps, and Herbst * arms. Each of the applications can be placed or removed from the platform in about 60 seconds chairside by an assistant. The Medley gives us the ability to address specific patient needs and circumstances without delay or multiple appliances. I hope you and your patients find it as effective and successful as my patients and I have. Three Different Design Applications 1 2 MEDLEY ROD SLEEVE This design employs a “pushing” force. Extra strength and a firmer jaw positioning are available with this approach. Initial delivery should employ UP2, LA1 (Upper Posterior 2, Lower Anterior 1) support positions. It should be noted that these support positions are not the same screw supports that the elastomeric and link applications utilize. The Medley Rod Sleeve is PDAC approved. MEDLEY LINKS This design employs a mandibular “pulling” force and is very similar in concept to the Medley Elastomeric. However, the nylon link material provides a rigid, firmer advancement feel, will not deform in a significant way, and will last at least 1-2 years. Initial delivery should employ UA2, LP2 (Upper Anterior 2, Lower Posterior 2) support positions. G RE AT P EO P L E . G R EAT P R O D U CTS . G R E AT L A K E S . greatlakesdentaltech.com 800.828.7626 1
T H A N K YO U for choosing the Medley Sleep Appliance for your Patient Three Different Design Applications (continued) 3 MEDLEY ELASTOMERIC This design employs a mandibular “pulling” force. The elastomeric (EMA) straps allow maximum comfort during advancement due to the slight stretching capability and may be helpful for patients who have tender temporomandibular joints, slightly mobile teeth, or simply prefer a “softer feel”. It may also serve as a transition appliance prior to introducing a more rigid approach to jaw positioning. This design is a vast improvement over other traditional elastomeric appliances because the attachment buttons (screws) are stronger and the straps are much easier to place and remove. Initial delivery should employ UA2, LP2 (Upper Anterior 2, Lower Posterior 2) support positions. Support Design The supports embedded into the base appliance frame allow the different design applications to be placed and removed easily, in-office, in a matter of minutes. Different screw holes are available to accept the different design applications and to allow for stepped up advancement capability when the initial advancement potential is exceeded. All the design applications are fixed to the support via screws which must be tightened securely (to between 3.0 and 3.5 inch-pounds) prior to delivery of the appliance to the patient. The patient should be instructed to check the tightness of the screws on a regular basis and the provider should check the tightness of the screws at each periodic evaluation. Care must be taken to avoid over-tightening the screws to avoid stripping the threads. G RE AT P EO P L E . G R EAT P R O D U CTS . G R E AT L A K E S . greatlakesdentaltech.com 800.828.7626 2
T H A N K YO U for choosing the Medley Sleep Appliance for your Patient Design Application and Use ELASTOMERIC AND LINK APPLICATION Both of these design applications should be initially attached to the supports at the UA2, LP2 (Upper Anterior 2, Lower Posterior 2) positions. Begin therapy utilizing the longest strap or link. After an initial adjustment period of several days, the patient can proceed through the strap or link series utilizing successively shorter straps or links to advance the mandible slowly and comfortably during a timeframe determined by the provider. Each successive strap or link will move the jaw 1mm. If more advancement is needed after the shortest strap or link is used, simply move the upper screw anteriorly into the UA1 position and transition through the straps or links again. If the initial therapeutic jaw position is too far forward for patient comfort at the delivery visit, simply move the lower screw anteriorly into the LP1 position to allow the mandible to retrude into a more comfortable position. ROD SLEEVE APPLICATION This design application should be attached to the supports at the UP2, LA1 (Upper Posterior 2, Lower Anterior 1) positions. (It should be noted that these attachment locations are different than the elastomeric/link attachment locations.) Begin therapy with the rod at a slightly advanced position. (Leave room to retrude 2mm if necessary for patient comfort.) After an initial adjustment period of several days, the patient can proceed through the length of the rod adjustment by advancing the telescopic ring in the appropriate manner to bring the mandible forward slowly and comfortably during a timeframe determined by the provider. Note: Patient instructions are available on the Great Lakes website (greatlakesdentaltech.com). It is recommended that the provider be familiar with the patient instructions regarding advancement, use of the AM Aligner, and appliance care. G RE AT P EO P L E . G R EAT P R O D U CTS . G R E AT L A K E S . greatlakesdentaltech.com 800.828.7626 3
T H A N K YO U for choosing the Medley Sleep Appliance for your Patient The Medley Configuration Kit Features all the necessary components to easily change the advancement mechanisms or as a convenient inventory of replacement parts for patient requests. The kit includes: 1 Set of Rigid Nylon Links (sizes 17-22mm) 4 Link Screws 1 Set of Blue & Yellow Elastomeric Straps (sizes 16-21mm) 4 Elastomeric Screws 4 Screw Wrenches AM Aligner The AM Aligner exercises the patient’s mandible comfortably back into normal occlusion. Heat-softening material easily conforms to dentition and conveniently softens in a therm bath at 160 . Note: It is recommended that the AM Aligner be adapted at the same time the initial records are being captured to help the patient find their normal bite position after wearing a sleep appliance. The AM Aligner is included on the Medley prescription or can be purchased on the Great Lakes website. Contraindications This device is contraindicated for patients under 18 years of age and/or with: Central Sleep Apnea Severe respiratory disorders Loose teeth or advanced periodontal disease Loose dental work, dentures, or other oral conditons which would be adversely affected by utilizing dental appliances G RE AT P EO P L E . G R EAT P R O D U CTS . G R E AT L A K E S . greatlakesdentaltech.com 800.828.7626 4
T H A N K YO U for choosing the Medley Sleep Appliance for your Patient Warnings Use of this device may cause the following: Tooth movement or changes in dental occlusion Gingival or dental soreness Muscle pain or soreness Obstruction of oral breathing Excessive salivation Excessive dry mouth Loosening of teeth or dental restorations Considerations Dentists should consider the medical history of patients, including history of asthma, breathing, or inspiratory disorders, or other relevant health problems and refer the patient to the appropriate healthcare provider as needed before prescribing the device. The patient should understand that any future dental work that changes the shape of the teeth or arch may require significant adjustments to the appliance or an entirely new appliance. SMLI150Rev012820 *Herbst is a registered trademark of Dentaurum, Inc. G RE AT P EO P L E . G R EAT P R O D U CTS . G R E AT L A K E S . greatlakesdentaltech.com 800.828.7626 5
for choosing the Medley Sleep Appliance for your Patient Introduction - by Dr. Robert Rogers The new Medley Appliance represents personalized, state-of-the-art technology in appliance therapy for the treatment of sleep disordered breathing. I have been using it in my office almost exclusively for the last five years.
DENTAL SCIENCES 1 Chapter 1 I Dental Assisting— The Profession 3 The Career of Dental Assisting 4 Employment for the Dental Assistant 4 The Dental Team 6 Dental Jurisprudence and Ethics 12 Dental Practice Act 12 State Board of Dentistry 12 The Dentist, the Dental Assistant, and the Law 13 Standard of Care 13 Dental Records 14 Ethics 14
Cigna Dental Care DMO Patient Charge Schedules 887394 09/15 CDT 2016 Covered under Procedure Code1 Dental Description and Nomenclature Cigna Dental 01 and 02 PCS Cigna Dental 03 PCS Cigna Dental 04 PCS Cigna Dental 05 PCS Cigna Dental 06 PCS Cigna Dental 07 PCS Cigna Dental 08 PCS Chair Time Per Y/N Minutes Code # (if different) Y/N Code # (if .
coasts of the Great Lakes, with many more living within the watershed. All First Nations occupying the Great Lakes region are engaged in fishing activities to varying degrees. This paper considers potential issues arising from First Nations fishing, aboriginal and human rights vis-à-vis Great Lakes pollution. Aspects of the Great Lakes hydrology,
2016 - Rev A ARRL November Sweepstakes - PHONE Page 6. Callsign Score Category Section Year Division K8DX 298,778 SOHP OH 1997 Great Lakes AA4RX 235,448 SOLP KY 1994 Great Lakes K9TM 133,120 SOQRP OH 2002 Great Lakes KW8N 267,520 SOUHP OH 2010 Great Lakes KW8N 200,030 SOULP OH 2012 Great Lakes
SHAPING GREAT LAKES ECOSYSTEMS 60th Annual CONFERENCE ON GREAT LAKES RESEARCH MAY 15 - 19, 2017 COBO CENTER . 9 indicators that were prepared for the 2016 State of the Great Lakes Technical Report as well as the presentation that was given at the 2016 Great Lakes Public Forum. . land use change since European settlement has generally .
is a detailed list of dental services provided by a dental office and given to Delta Dental for payment. Delta Dental means Delta Dental Plan of Michigan, Inc., a service provider for dental benefits under the Michigan Dental Program. Delta Dental ID Card is a permanent (not monthly) card. We send
Mid-level dental providers, variously referred to as dental therapists, dental health aide therapists and registered or licensed dental practitioners, work as part of the dental team to provide preventive and routine dental services, such as cleanings and fillings. Similar to how nurse practitioners work alongside physicians, mid-level dental .
consumption of Great Lakes fish. (7) The lower Great Lakes are uniquely different from the upper Great Lakes biologically, physically, and in the degree of human use and shoreline development, and special fishery re source assessments and management activities are necessary to respond effectively to these special circumstances. SEC. 1003.
