history

My exclusive dental sleep medicine practice began “from scratch” 21 years ago following 27 delightful years of general practice in Alaska. I soon encountered few guidelines and literature and many diverse opinions. The sleep medicine community was skeptical and early generation devices shared some common design features that limited their success. I couldn’t find a repeatable protocol for diagnosis, prognosis and treatment that educates the patient from start to finish through their treatment. I was both humbled and inspired with profound lifestyle changes that would occur and how a simple intra-oral device and how those changes rippled out among the patient’s family who were unaware of their adaptation to my patient’s slow decline and accommodation until the cause was eliminated.

Unlike general dentistry, examinations included the measurable, the “guesstimated” and the vague. I could feel my airway change when I moved my mandible, but it wasn’t a repeatable metric protocol that would help fill in the “blanks”. Some 7 years ago I began shaping small plastic pieces with notches for my incisors so I could repeat a mandibular position in several different combined A-P and Vertical positions. As modification after modification consumed many hours I became increasingly encouraged at each step that a system could be developed that was simple, time efficient, repeatable, predictable, easy to learn and enabled patient placement. What you see today has small resemblance to the early pieces. During the past 7 years I have recorded almost 6,000 Pharyngometry scans including about 2,500 of those involved with the system’s development. Some 280 records include data from the patients’ diagnostic PSG through treatment and the final sleep study with their oral device.

THE AIRWAY METRICS SYSTEM HAS TWO COMPONENTS: The Snore Screener (SS) uses the snore sound to identify a comfortable general mandibular position with increased airway. The Mandibular Positioning Simulators (MPS) consist of 15 units that enable 45+ positioning options to more closely define a comfortable target airway position for prognosis and treatment. It has universal application for any device selected. A Bite Fork and handle are quickly attached to the selected MPS for the bite registration in the desired position.

An additional accessory has 9 Vertical Titration Keys (VTK) ranging from 3-11 mm in 1 mm increments for final vertical titration of any device that opens in the anterior such as the Herbst, Somnomed and Suad. The units fit in a case for quick selection and storage. Three colors enable quick sorting for re-use after cold sterilization. It is an enhancement for any protocol and is quickly interfaced with Pharyngometry with a minor in-office mouthpiece modification. Most of all it is simple and easy to learn. I hope it will enhance your practice as it has mine.

Robert L. Horchover, D.D.S.