Mandibular Advancement Device Selection: A Clinical Decision Framework

TAP: Anterior midline hook-bar, screw-driven 0.5mm/turn, up to 15mm. Easiest to titrate but forces on maxillary anteriors. EMA: Bilateral elastic straps, 9x4=36 combinations. TMJ-friendly with excellent lateral freedom. Panthera D-SAD: PA12 nylon SLS-printed, 1.0mm wall, metal-free. Thinnest MAD with horizontal force vector. SomnoDent: Avant (3D-printed) and Flex (acrylic). Passive mouth-closing promotes nasal breathing. Decision: Metal allergy = Panthera. TMJ sensitivity = EMA. Precise titration = TAP. Digital workflow = SomnoDent Avant or Panthera. Severe OSA = Herbst-style. Budget = Silent Nite.