ResMed Narval CC Professionell-Gebrauchsanweisung Seite 9

Setting process for elastic bands
1. Disassemble the connecting rod from the upper splint by
rotating the rod until it is perpendicular to the splint (bow-tie
shapes aligned) and pushing it out with your thumb.
2. Insert the head of the connecting rod in the elastic band.
3. Reassemble the connecting rod on the splint by aligning the
bow-tie shapes and pressing the connecting rod back into place.
4. Place the elastic band in the slot in the lower splint.
Follow these steps for each side of the Narval CC appliance.
The elastic must only be set in place, replaced or changed
by a dental practitioner.
Device titration
IMPORTANT
The Narval CC appliance is a traction-based appliance. Consequently, the protrusion is increased
by shortening the connecting rods.
Titration is the process of adjusting the protrusion of the device and the mandible to find the best
balance between efficacy and comfort.
MAD therapy has a well proven non-linear dose response to the level of protrusion until the efficacy
plateau is reached. This means that the greater the protrusion, the more efficient the MAD will be
(up to a limit - the efficacy plateau). However, as the protrusion increases, the pressure on the teeth
and TMJ also increase, making the MAD less comfortable for the patient.
How to determine the right protrusion
The initial mandibular protrusion of the Narval CC appliance is set at approximately 60% of the
patient's maximum protrusion, unless you provided a bite registration. If you provided a bite
registration, the initial setting corresponds to the position indicated by the registration.
In most cases, the initial setting will not correspond to the optimal protrusion for your patient
and you will need to progressively adjust and find the right protrusion based on ongoing symptoms
such as:
• Snoring frequency and intensity
• Tiredness
• Daytime sleepiness and tendency to fall asleep
• Quality of sleep and nocturia
Protrude
Retrude
ENGLISH 9