FREQUENTLY ASKED QUESTIONS

FREQUENTLY ASKED QUESTIONS

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Find here the most frequently asked questions on SICAT Air and OPTISLEEP.

SICAT AIR and OPTISLEEP

What is the OPTISLEEP therapeutic appliance used for?

OPTISLEEP can be used to relieve snoring and mild to moderate obstructive sleep apnea (AHI values between 5 and 29). In certain cases, the OPTISLEEP can also be used for more severe cases of OSA especially if the patient is intolerant of the CPAP.
The AHI stands for apnea-hypopnea index. This index indicates the severity of the sleep apnea and is calculated from the number of nocturnal breathing pauses of the patient longer than 10 seconds within one hour. It is determined in the course of the sleep study examination. All therapeutic appliances represent long-term treatment and must therefore be worn every night.
If the symptoms do not improve with other interventions, this may be the case for the rest of the patient’s life.

How can I order a duplicate OPTISLEEP?

Make sure that the patient’s clinical situation still matches the original order. The second OPTISLEEP will be a duplicate of the original OPTISLEEP. Place your order as used to right from the SICAT Air software, reuse the patient data of your original order and note “duplicate OPTISLEEP” in the comment field.
There is a discount available for all duplicate OPTISLEEP. This discount is valid for all orders that do not require a change to the OPTISLEEP design, e.g. if the life span of two years has expired, a second appliance for the travel bag is requested or if the appliance must be replaced due to self-inflicted damage to the original one. For more information please contact our support at [email protected].

Requirements for the patient’s dentition

The retention of the appliance and thus the therapeutic value relies on a relatively secure fit on the teeth.
The patient’s dentition should fulfil the following requirements:

  • no removable partial or full dentures
  • no loose teeth, no pronounced periodontitis
  • no new restorations planned (crowns, bridges etc.)
  • no temporary prosthetics
  • if possible, no missing teeth in the area of the connector pins (tooth areas 13-15, 23-25, 36-38, 46-48 or in the American dental notation 4-6, 11-13, 17-19, 30-32).
  • sufficient remaining teeth, at least 3 teeth in the area of the premolars and molars
  • second premolar must not be the terminal tooth in the mandible
  • sufficient usable undercuts on clinical crowns to provide retention (crown margins, dental ridges, poor buccal fillings etc. cannot be used).
  • If possible, no elongated teeth.

To be considered:

  • Elongated teeth in the posterior region can lead to the splint having to be shortened or exaggerated vertical blocking. This may result in a lack of retention areas, so that placing a longer connector is not possible or generate discomfort during the use of the appliance.
  • The midline deviation of the therapeutic position should not exceed 2.5 mm.

Intraoral Scan:

  • During intraoral scanning, the complete clinical crown and in particular 3 mm beyond the gingival line must be included to ensure retention. Interdental spaces are important as well.
  • Verify proper alignment of 3D X-ray and optical surface data within SICAT Air.
  • If the terminal teeth are to be completely covered by the OPTISLEEP, their entire distal surface must be scanned correctly.
  • After completion of the intraoral scan, it is important to rescan the areas indicated as ‘inaccurate’ by the software.
How do I position my patient for the CBCT?

For the CBCT scan used for the analysis of the upper airway, center the patient’s chin on the chinrest and stabilize the patient’s head. The patient should gently bite onto a bite stick or some cotton rolls without cramping. The tongue should lie loosely on the palate. Please select the appropriate exposure setting to show the airway.
For the second CBCT scan, used to fabricate the OPTISLEEP with the patient in therapeutic position, the patient should carefully bite on a George Gauge bite fork with registration material which brings him in a therapeutic position. Center the patient using the chin rest to stabilize the patient’s head.
Please note it is important not to cut off any dentition in this CBCT.

Are two CBCT scans necessary to order an OPTISLEEP appliance?

No, you don’t have to take two CBCT scans. Two CBCT’s allow for an airway comparison and show your patient how the treatment with OPTISLEEP will open the airway.
If you want to proceed without two CBCT scans just conduct a CBCT scan with the patient in therapeutic position as indicated by using your choice of bite fork, e.g. the George Gauge

Can I use a CBCT scan without the patient being in protrusion to order an OPTISLEEP?

The CBCT does not necessarily have to be performed in protruded position, however It should show the final therapeutic position for your patient’s treatment, and the vertical opening must be 5mm between anterior teeth and 2.5 overall. The grade of protrusion can be the normal bite position to only prevent the mandible from falling back during sleep. However, it is important to ensure the required vertical opening, which can be achieved with the George Gauge or another bite fork.

What is the required CBCT volume size?

In order to capture the airway, the recommended minimal volume size is 11×10. It is not mandatory to capture the airway or the TMJ for fabrication of the OPTISLEEP. To order an OPTISLEEP appliance without analysis of the upper airway, a volume size of 8×8 is sufficient but it is required to capture the entire dentition for fabrication of the OPTISLEEP.

How should I have the patient act during the 3D scan?

Center the patient in the CBCT machine using the chin rest to stabilize the patient. Instruct your patient to breath normally and rest his/her tongue loosely at the palate behind the anterior teeth without swallowing during the capture phase.

Where can I purchase a George Gauge bite fork?

To learn more about pricing and how to purchase George Gauge bite forks, please inquire with your local dental supply representative. You can also use other methods or systems of establishing the therapeutic position as long as the vertical opening is a minimum of 5mm between the anterior teeth and 2.5mm overall. If possible, you should be able to measure the degree of protrusion.

Why does the vertical clearance between the anterior teeth need to be 5mm?

The OPTISLEEP must fit between both arches. It features a flat plane of blocking comparable to a plastic disk between the teeth.
To make a quick test of the necessary opening between the anterior teeth in order to ensure the requested clearance of 2.5mm overall the arch, you might put a plastic plate of 2.5mm thickness between the patient’s teeth.
Measure the distance between the front teeth. Place the bite fork between the teeth and add sufficient registration material between the front teeth to achieve the appropriate incisal clearance previously measured.

What is the recommended degree of protrusion during the scan?

Which degree of protrusion to choose is at your discretion as the dentist, if necessary, in consultation with a sleep physician. Many factors, such as anatomical conditions, severity of the AHI or tolerance of the patient are taken into account for this selection. For some patients, it may be sufficient to hold the jaw in its normal position and only prevent it from falling back. A sleep study exam should be performed after beginning MAD treatment, after which the protrusion may need to be adjusted.
The OPTISLEEP can be adjusted by changing the connectors.

What is the minimum age the OPTISLEEP appliance may be used?

The therapeutic appliance is approved for patients 18 years and older and is not indicated for children.

Can I use an OPTISLEEP therapeutic appliance for an edentulous case?

No, the OPTISLEEP appliance is tooth-borne and not indicated for patients who wear removable partial or full dentures.
A detailed list of requirements that a patient’s denture must meet in order for an OPTISLEEP to be fabricated can be found under the question Requirements for the patient’s dentition.
For further information, please note the Instructions for use for the medical professional which is available in the download area.

Will health-insurance cover the treatment?

In many cases the treatment is covered by medical insurances. Patients should contact their health insurance company to evaluate if the OPTISLEEP appliance is covered. If OSA is diagnosed, the examination and a DVT scan should be covered by the statutory health insurance. Patients should contact their health insurance company to find out whether the costs of OPTISLEEP treatment are covered.

Where can I learn more about the OPTISLEEP workflow?

The SICAT OPTISLEEP workflow is described on the OPTISLEEP page of this website as well as in our manual. The manual is available for download in the download area as well as on www.optisleep.com.

What is required for ordering an OPTISLEEP?
  • SICAT Air Software
  • 3D CBCT system (note volume depending on use, OPTISLEEP order min 8×8, airway analysis min 10×11)
  • George Gauge or other bite fork with determination of the degree of protrusion and as bite block for the CBCT scan
  • Optical scans of entire upper and lower jaw or latest stone models sent to our laboratory
Which optical impressions can I use?

All optical data in stl, ssi or sixd format can be imported into SICAT Air.

Where can I learn more about the OPTISLEEP workflow?

The SICAT OPTISLEEP workflow is described on the OPTISLEEP page of this website as well as in our manual. The manual is available for download in the download area as well as on www.optisleep.com.

What is the turnaround time for an OPTISLEEP?

General turnaround for OPTISLEEP appliance is 10 working days in our laboratory and 2 days shipping.

Can I do measurements within the software?

Yes, you can carry out distance and angle measurements manually. The relevant values for the airway comparison such as volume and smallest cross-sectional area are automatically calculated within SICAT Air.

How can I adjust the grade of protrusion for OPTISLEEP?

You can adjust the grade of protrusion for OPTISLEEP with the help of exchangeable connectors at any time. The connectors that accompany the OPTISLEEP come in 10 different sizes 0-9 (1 mm increments) and can be reordered from the SICAT Store online. This is described in detail in the Instructions for use for the medical professional which you can download in the download area.

Is it possible to reorder connectors?

Yes, you can reorder the complete set of connectors from the SICAT Store.

Can all patients be treated with SICAT OPTISLEEP?

No. OPTISLEEP therapeutic appliances cannot be used in the following cases:

  • Central sleep apnea
  • Severe respiratory diseases
  • Loose teeth
  • Advanced periodontal disease
  • Persons under 18 years
  • Edentulous or partially edentulous jaw

For any further questions concerning OPTISLEEP please refer to the OPTISLEEP manuals: Application and care information (for patient) and the Instructions for use for the medical professional which you can download in the download area.

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Find detailed information on the Sleep Medicine sub-page.

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Last Update: 2021-11-30

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