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Now Madrid, Expodental stand 9A08


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See you in our next

days where we will present the intraoral Scanner

3Shape Trios Pod Color, ships stl files

3D printer in action.

Expodental Madrid 13/15 March

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Madrid Expodental 13/15 Marzo



Send the first case

EMA Treatment Protocol

Step 1


1. ¿Snore heavily?.
2. Do you often feel tired or asleep?.
3. Has anyone noticed that you stopped breathing in your sleep?.
4. Do you have high blood pressure?.

If the patient answers "yes" to two or more questions. you may be suffering from "OSA".

Inform the patient of the design of the instrument:

- The EMA uses up to 5 different lengths of elastic straps to increase gradually the mandibular advancement.

Hardness -4 these elastic, may increase the tension in the muscles of the patient.

- The EMA design allows the jaw to move laterally

- The passage of air through the larynx is increased with the advance and / or jaw opening.

Thermoadapted  splints to the shape of the teeth, prevent

teeth from moving.


Step 2.

Taking impressions and bite registration

-Take the impression of both jaws, which should reach beyond the gingival margin of the teeth

-Take a wax bite position, with an aper-

ture of 8 to 10 mm.en anteriorly.

-Send these records to our laboratory authorized by myesson, Ortoteam.


Step 3.

Delivery of the device to the patient

-Place both  splints patient's mouth without silicone strips to check any area of ​​ischemia. The patient may notice pressure during the first 5 to 10 minutes, lift the splints.

-Moisten two silicon strips of the same color and length, the lower fsplint should fit  byrotating the strip on the anchor button. The EMA logo strip face to the splint. Repeat on  the top.

Put first the splint-top and have the patient progress the lower jaw, pressing until it fits the lower splint. Ask the patient about the convenience of fitting splints .

Check theposterior bite plane  If a higher side, wear slightly until both sides contact, with strips in and placed in advance.

-To avoid unnecessary visits to the clinic, give the patient extra strips to reposition worn or in case of loss.

-Instruct patient to chew sugarless gum, the morning after twearing the set to get back to the condyles to its rest position.

EMA elastic straps

Each color comes in 5 lengths

Strip length Progress

(In mm.) (In mm.)

# 1 21.0   6.0

# 2 19.0   8.0

# 3 17.0   10.0

# 4 15.5   11.5

# 5 14.0   13.0


Step 4

Patient follow-up

-Instruct the patient to call the next day to the clinics taking the set at night, side effects include

anterior teeth pain, tenderness in the TMJ, increased flow of saliva, pressure ......., these symptoms should diminish or disappear in

about ten days.

If you see TMJ pain, place strips softer or longer

(Eg white yellow 1 to 1).

-If the patient has a single  joint pain, you must adjust the posterior bite planes, maybeone of them is high.

-If there is pain in both joints, the patient should stop wearing the appliance  and go to the Clinics.

-If after wearing it , a tooth hurts, that area will be alleviated with a proper burr

Step 5

Titracción (Drive) and vertical movement.

-If an elastic strip is 1/8 inch is longer than that  by wear, it will be changed to the new color and length thereof.

-If the patient does not improve or fewer episodes of apnea or lesser intensity of snoring. And if the patient feels that his jaw can be advanced more without pain in the joints

We can:

1 - Put new strips of the same color and shorter.

2 - Put tougher new strips of another color, but in a longer length.

3 - Increasing the vertical dimension, adding 3-4 acrylic on the occlusal surface of the backplane.

Forward mandibular central 6 mm.

Steps to adjust the appliance

Steps to a patient a candidate for mandibular advancement prosthesis. Index apnea or snoring light

1. Make sure the patient is apt to wear a quick review prótesis.Analyse  dental level, parodnthics , and prosthetic joints.

Patient no candidate would be:
- Toothless total.
- In the case of partially edentulous, if less than 8 pieces per arch.
- In the case of requiring treatment of teeth, tthat will beprior to placement of the prosthesis of advance.
- In the case of parodontosis, requires treatment by your regular dentist, prior to placement of the device.

- Cysts and ulcers ditto.
- Temporomandibular joint patient with pain, restricted mobility, maximum protrusion of less than 5 mm.

ema silencer

EMA1 silencer

figure 3

Steps to follow when a patient fits a prosthetic mandibular advancement device.

2. Get patient compliance on the overall treatment he will receive. It is important that the patient understands and agrees with the treatment of mandibular advancement he is going to receive, which includes:
- Making records and measures necessary to place the splints (mandibular advancement prosthesis).
- Placement of the prosthesis with 12months warranty, against any breakage, and its proper use.
- Up to 3 visits for adjustments to optimize comfort and efficiency of the splint.
- The regular price for this type of service is usually from 1200 euros for the entire delivery, with 50% of laboratory costs and 50% of

3. Taking alginate or silicone register
- The impressions of both dental arches, upper and lower dentures will be taken to put into the mouth
- Review carefully the correct reproduction of all parts present.
- Pour the impressions, hard plaster.

figura4 figure.5

Figure7 figura6

figure 8

4. Evaluate the amount of mandibular advancement possible. To find the position where the prosthesis is to be manufactured we use, the recording instrument George Gauge (Figure 3), comprising: constructive bite for producing the  DAM in an anteriorly advanced  mandible, the scope should be determined by the maximum  protrusive of each patient. The maximum advance of the lower jaw is, on average, 8 to 12 mm. To zoom to maximum effect the "back room airflow" and thus avoid interruptions in , mandibular advancement should be
at least half or if possible  possible three-quarters-of maximal protrusion  position. Further progress is not usually tolerated by the patient .
This adjustment of the mandibular position is available from the articulator itself, from the central mounting and using the "screw protrusion"
. However, the most accurate way to get this record is the system invented by George Gauge, , consisting of a millimeter guide with  an  integrated bite fork. The measuring instrument gives us the construction bite, the position of both condyles and an interincisal opening of 2 or 5 mm.

The measuring instrument is plastic and consists of 3 parts:
- Slot-mobile part to the lower incisors bite.
- Box with engraved millimeter scale and retaining screws to the movable lower jaw, and bite slot.
- Slot-bite fork to the upper incisors.
Using the measuring instrument George (Figures 4-8):
- Adaptation of the part of the mandible and the incisors slot.
- Introduction of the bite fork.
- Biting in a focused and position.
- Advancement to the maximum protrusion.
- Place the desired mandibular advancement indicating millimeters (outside the mouth).
- Set the position of the mandible using clay or polyvinyl silicone injected.

5. Prepare the case in transport boxes provided by your sleep lab, filling the prescription sheet attached detailing the identification of each patient and the approximate date on which the app  is required

General information for the patient

Your doctor has recommended the use of a prosthetic mandibular advancement for treatment of snoring and / or sleep apnea. Here are some tips and answers to
Frequently Asked Questions:

What must I do to have an appliance as a mandibular advancement device?
Only a specialist in dentistry, dental or oral surgeon can perform this process. The quickest option is to arrange a visit with one of these specialist  for the proper diagnosis and, when  appropriate,taking regsitrations

Ask for the list of specialists in the development of mandibular advancement splints, or ask your regular dentist, you should contact us to be informed of the steps.

How soon I can start treatment?

TheMAD is a prosthesis with a prescription healthneeded  for Ortoteam. It will take a minimum of two visits by the
dentist and an interval of about 15 days, until you have the MAD in place.

At the first appointment, the dentist makes sure that you can take the MAD and then take the necessary records.
You may ask your dentist who will perform a series of treatments prior to placement of the prosthesis that your regular dentist

might precribe..

On the second visit, after placement of the MAD , the dentist will perform a series of adjustments to improve function and comfort of the device.
Subsequent visits, may be necessary to optimize the effectiveness of the MAD.

What is the level of effectiveness of the MAD?

The clinical experience of the last 3 years, with several hundred patients, gives the following results:
- Reduction of episodes of apnea - hypopnea at an average rate of 65% in patients who meet the protocol.
- Improvement of symptoms of daytime sleepiness.
- Effective in reducing snoring in more than 80% of cases.

Will it cause me harm to sleep with the DAM on?

The DAM is specifically designed to optimize comfort and efficiency through the following innovations:

- Made only with soft and elastic.
- A little bulky.
- Results achieved by retaining the jaw in a forward position within limits of 60 to 90% of its physiological propulsion.
Most patients wear the MAD all night and they take it off when you wake up and may experience a slight feeling of discomfort or tooth joint, which disappears in about 20 minutes, doing simple exercises.

How much does a MAD cost?

The dentist will set the price at which you receive benefits that include orthotics, the initial visit, making records and settings
The price is 1200 euros. Considering that the average length of theMAD is two years

What should I do after installing the MAD?

Tell the doctor who recommended the use of the MAD, the start of treatment. If you suffer from sleep apnea, a sleep log, control, lets make sure that the MADis snug enough so you can judge the effectiveness of treatment. The orthosis is adjustable and the dentist can adjust it , feel free to contact if you think that comfort or efficiency can be improved.

{Tab} = Apnea


It is a widespread problem treated by surgery or CPAP mask ventilation at hospital level. There are alternative treatments with intraoral appliances to moderate cases. The devices are fabricated on individual patient models and adapted according to the relationship of the jaws (construction bite) necessary to prevent snoring. To do this, you must cause a mandibular replacement lingual down and forward. Through the modification of the structure of the upper airway, extends the air channel and avoids the tendency to collapse of the soft parts involved, as an additional effect, decreases the snoring noise. Ortoteam offers you treatment with intraoral appliances custom made or the possibility to buy the kits.

Snoring} {tab =


For many ,snoring is the expression of a deep sleep. But for many others it is a threatening condition between the couple and also very dangerous to health. Snorers are often alone but not lonely. 60% of men and 40% of women aged 60 years and 10% of men and 5% of women in their thirties, snore. Snoring occurs during sleep because the airway narrows due to relaxation of the tongue and pharynx. Occur during breathing vibrations of the soft tissues of the throat that cause the typical sound of snoring. When the jaw is in a relaxed position, the tongue falls into the pharynx causing the narrowing of the airway or even collapse thereof.

Appliance} {tab =

All intraoral appliance designs that exist so far, intend to open the airways, increasing the vertical dimension and jaw forward, altering the position of the tongue and / or by traction of the soft palate.

When you send impressions to make a mandibular advancement device, it is essential that the models do not have imperfections because they are two splints  that rely on the entire surface of both dental arches. The construction bite was taken with the instrument George Gauge, designed for this purpose. Lets take the patient's jaw to 50% of the maximum protrusive and in position to set the fork using the interocclusal space with silicone fluid. Only send this fork indentations etched in silicon, the milimetric guide will be saved for another patient.


Diagnosis of sleep apnea: Warning Signs.

People with sleep apnea stop breathing when sleeping. The main figure is the nightly loud snoring is interrupted by pauses and is followed by gasping noise, this indicates that the person does not receive enough oxygen during sleep and complain of daytime fatigue, difficulty concentrating, are irritable, nervous or depressed.

Performing polysomnography or sleep log.

After an analysis, decide whether the dentist, with placement of a dental device "snoring therapy" designed to measure, may provide some improvement, especially in patients who fail to adapt to CPAP or unwilling to undergo surgery.

Making intraoral appliances:

* Taking impressions.
* With the measuring instrument (Gauge George) is calculated by the patient's mandibular protrusion needed to make the device.
* Set the device in the mouth.
* Monthly Checks to find the position comfortable for the patient and there is a decrease in snoring. Then you need to continue monitoring the patient to avoid possible alterations of the TMJ.


27 YEARS AT YOUR SERVICE. A young family business

Ortoteam, founded in 1985 as a dental laboratory specialized

in orthodontics and maxillofacial orthopedics, by Tessa Llimargas

has evolved over time into a Company that gives  service with a

wide range of products, looking forward to satisfy  the needs and

desires of our customers.

Quality is our main objective, and try to get it ,with the help of our

team of professionals, working both at our headquarters in

Matadepera and from each one of the external service working

points directly with Ortoteam.

Innovation and quality

The wide range of services offered by  Ortoteam today

include not only the highest quality product , but also training

courses, where you can learn the latest techniques to help you

make the most of purchased product. Thermoforming machines,

articulating  systems, accessories for easy development of

prosthetic devices, and recording, accessories to enhance t

he orthopedic and orthodontic treatment and appliances


to treat sleep disorders, all accompanied by detailed procedure

manuals and service "on-line" highly specialized.

The future starts now

Our new facility in Matadepera, fully equipped for the reception,

storage and shipping of packages quickly and efficiently aswell

as"classroom" course equipped with the newest audiovisual

technologies,the new showroom for the latest processes work

and permanent exhibition  of  material, make Ortoteam a must

for those wishing toimprove their skills working with the latest

technology at your fingertips.



Ortoteam se ha especializado a lo largo de los años en el diseño

de aparatología intraoral de avance mandibular y lingual.

Para ello ha creado Ortoteamsleep , la parte de Ortoteam

especializada en ronquido y apnea del sueño leve o moderada.

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