TAP (Thornton Adjustable Positioner)

The TAP (Thornton Adjustable Positioner) is a custom mandibular advancement device for obstructive sleep apnea. Its defining feature is an anterior midline hook-and-bar mechanism with a screw-driven adjustment that provides the most precise and easiest titration among all MADs — 0.5mm per turn, up to 15mm total advancement.

• Upper Tray — Hard polycarbonate shell with soft inner liner, anterior metal hook • Lower Tray — Hard polycarbonate shell with soft inner liner, anterior metal bar/receptacle • Adjustment Screw — Midline screw on the lower tray, 0.5mm per turn, 15mm range • Soft Inner Liner — 1.0mm medical-grade silicone for comfort and retention • Interchangeable Hooks — Three sizes for extended range adjustments

The upper hook engages the lower bar at the midline. Turning the adjustment screw forward pulls the lower bar — and the mandible — forward. The single-point midline connection allows lateral jaw movement. The soft inner liner provides retention without requiring clasps. The screw mechanism allows both dentist and patient to make precise adjustments for optimal AHI reduction.

1. Receive intraoral scans and protrusive bite (60-70% of maximum protrusion) 2. 3D-print working models 3. Thermoform hard polycarbonate outer shells (upper and lower) 4. Inject soft silicone inner liner (1.0mm) into each shell 5. Install TAP hardware — upper hook, lower bar, adjustment screw 6. Trim excess material, polish edges 7. QC: Verify screw mechanism, hook-bar engagement, liner thickness

• Outer Shell: Medical-grade polycarbonate, 1.5mm thickness • Inner Liner: Medical-grade silicone, 1.0mm, Shore A 40-60 • Hook/Bar: Surgical stainless steel (316L) • Screw: Titanium alloy, 0.5mm pitch, 15mm total travel • FDA: 510(k) cleared, Class II medical device • QC: Screw function test, hook-bar alignment, liner bond strength