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Evidence-Based Bite Registration Techniques in Dental Sleep Medicine

Dr. John Viviano

Join Dr. John Viviano, a diplomate of the American Board of Dental Sleep Medicine, and Steve Kenson for a comprehensive webinar exploring the science and the mythology behind bite registration for Mandibular Advancement Devices (MADs). If you are treating Obstructive Sleep Apnea (OSA), this presentation offers evidence-based insights designed to improve patient outcomes and build stronger, trust-based referral relationships with sleep physicians.

Dr. Viviano challenges the traditional clinical “recipes” often used in dental sleep medicine, advocating instead for protocols backed by scientific literature. This comprehensive review evaluates the actual clinical utility of popular bite registration methods, comparing traditional tools like the George Gauge against phonetic bites, snore bites, and acoustic pharyngometry.


Key clinical concepts covered in this webinar include:

  • Managing Vertical Dimension of Occlusion (VDO): Discover why literature generally supports minimizing VDO to prevent upper airway collapsibility, and how to tailor vertical adjustments based on specific patient phenotypes, such as gender and BMI.

  • Optimum Advancement & Adaptive Capacity: Learn why the principle is to advance a patient’s mandible “as much as necessary, but as little as possible”. Dr. Viviano explains how starting at a conservative advancement (such as Panthera Sleep’s 60% start position protocol) keeps patients within their natural adaptive capacity, reducing joint stress, side effects, and early treatment dropout.

  • Streamlining Lab Communication: Understand the importance of capturing a precise starting position the first time. Sending accurate range-of-motion data prevents the laboratory from having to guess or artificially open the bite on a virtual articulator, saving you from chairside adjustments during delivery.

Watch the full video to transition your practice toward an evidence-based approach, ensuring you deliver comfortable, effective, and predictable sleep apnea therapy to your patients.


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