Sleep Bruxism

ResMed Narval CC: The Force Awakens!

Since it’s introduction to North America in 2012, the Narval CC has experienced a number of design enhancements, all based on clinician requests. In keeping with the ResMed commitment to innovate based on end user feedback, this month, an “Anterior Contact Design” was added to the regular lineup of Narval CC offerings.

This new design provides full contact to the anterior teeth without actually engaging them retentively. Specifically, it provides contact to the facial and lingual surfaces of the central and lateral incisors on both the upper and lower arches, providing added surface coverage, without actually engaging the anterior teeth. Of course, the amount of anterior surface coverage varies based on dental anatomy.

I have had the opportunity to place a number of these full contact appliances during the controlled product launch period and experienced absolutely no issues on insertion or post insertion appointments. Although this design is being offered in response to the suggestion that full contact would aid in preventing or minimizing tooth movement, whether this was actually a concern, and whether the full contact design will provide protection in this regard, remains to be seen. Personally, I continue to prefer the non-contact lingual band with cap over to the labial, which protects the teeth from tooth tilting tongue pressures and also provides additional rigidity, enhancing retention.

However, I am excited about this new full contact design for a particular reason. Last year, Panthera added an anterior mid-point stop option (anterior discluding ramp) to their D-SAD appliance line up. Since its introduction, I have expressed concern about the implications of that design, which has no contact at all on the anterior teeth, resulting in the forces from the anterior mid-point stop to be transferred “exclusively” onto the cuspids and posterior dentition. It seems to me that ResMed’s new full contact appliance can incorporate an anterior midpoint stop design that results in a more even distribution of forces onto the mandibular teeth. I look forward to this enhancement from ResMed and understand that it is in the works.

ResMed offers two full anterior contact designs: “Full Coverage” and a “Lingual Band with extended Cap onto the Labial”. A new order form is now available that includes these new designs. Below, you see the original 5 designs and the new full contact additional designs (in blue below).

Narval choices



Since the introduction of 3-D printed Nylon appliances to North America, both the Panthera D-Sad and ResMed Narval CC have experienced many enhancements and additional design offerings, all of which demonstrate the benefits of working in a CAD-CAM environment. These are exciting times for OSA appliance therapy. As these two companies continue to outdo each other regarding features and design offerings, we as clinician’s and ultimately the patient’s continue to benefit. The Star Wars Saga continues!



John Viviano B.Sc. DDS Diplomate ABDSM

John Viviano B.Sc. DDS Diplomate ABDSM

John Viviano B.Sc. DDS Diplomate ABDSM; from Mississauga ON Canada,obtained his credentials from U of T in 1983, he provides conservative therapy for snoring and sleep apnea and Sleep Bruxism in his clinic, Limited to the Management of Breathing Related Sleep Disorders. A member of various sleep organizations, he is a Credentialed Diplomate of the American Board of Dental Sleep Medicine, and has lectured internationally regarding management of Sleep-Disordered Breathing and the use of Acoustic Reflection. Dr Viviano has also conducted original research, authored articles and established protocols on the use of Acoustic Reflection for assessing the Upper Airway and its Normalization. For more info or to contact Dr Viviano click: Website SleepDisordersDentistry LinkedIn Discussion Group

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