Elastomeric Mandibular Advancement Device (Myerson Ema)

The EMA Devices fabricated by Dream Systems use the Myerson Hooks and Straps. The standard appliance design has been modified, incorportating a flat plane design of the splints for added strength and function, The ThermoFlex Hard Material is used upon request and in circumstances where there are impres-sion flaws, edentulous areas and where clasping can be of benefit.

An Into Strap Pack is included with each case, which will provide 5mm of additional advancement from the Protrusive Bite provided (+ 4mm Inicisal opening). The Strap Sequence and Color Flexibility of the Straps will vary by individual case. Straps may be included to decrease the protrusion or strain of a more rigid strap. Additional Straps can be ordered as determined by effectiveness.

E.M.A. First Step 90 Day Trial

The E.M.A. 90 Day Trial Device is inexpensive to produce and is an effective way of testing if oral appliance therapy is beneficial to the patient.

An inexpensive, custom, trial E.M.A. device is available so that a patient may try an adjustable sleep device for 90 days before committing to oral appliance therapy with a standard E.M.A. appliance. Three adjustment elastic straps in 2mm increments are included.

E.M.A. Straps

The E.M.A.’s unique adjustment straps train the lower jaw to adjust itself; by periodically changing out the current strap for a less elastic counterpart, the pressure on the lower jaw is slowly increased over time. This trains the mandible to adjust its positioning and opens the airway, effectively treating sleep apnea and allowing more airflow.

If blue 20mm straps have been placed on the E.M.A. as a starting position, and the 20mm puts strain on the joint, switch the strap to a yellow 20mm or blue 21mm. When changing the straps, place them under hot water for easier placement onto the buttons on each side, with the number facing out, the E.M.A. logo facing the tooth side.

Doctor Instructions

Insert the E.M.A. device in as one piece, placing the upper splint on first and guiding the lower jaw up into the lower splint. Use finger pressure to securely seat both of them. If the E.M.A. device is made of a thermoplastic material, it should be placed under warm-hot tap water for 5-10 seconds before seating. Check the posterior pads for even occlusion. If either side is high, conservatively grind the high side until both sides occlude evenly. If more adjustment is needed the splints can be tried in separately, first by carefully removing the straps under warm to hot water for a few seconds, and then spotting in the posterior blocks to achieve even occlusion in the protrusive position.

Side Effects

Common side effects of initial wear are clenching, sore teeth, TMJ sensitivity and increased salivation, but usually resolve in ten days. If more severe pain occurs, the patient should contact his or her doctor immediately. The patient should be advised to chew sugar free gum every morning after wearing the appliance to help return the condyles to normal position.