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When AP advancement isn't enough, now you can titrate vertically. Gergen's 3D Advanced Dorsal, coming soon.

Dental sleep medicine

Custom oral appliances for snoring and sleep apnea

We have been making sleep appliances longer than almost any lab in the country, and it shows in the fit. Every appliance is built by hand to the bite you send, in the design and material you choose, and checked before it leaves. Your patients get an appliance they will actually wear. You get a lab that answers the phone.

Herbst-Type

The workhorse. Strong, adjustable and comfortable, with the longest track record of any sleep appliance.

  • Sleep Herbst fabricated by Gergen's Orthodontic Lab

    Sleep Herbst

    • Mechanism: Bilateral telescoping rod-and-tube arms, no midline connection
    • Advancement: 1/8 mm per full turn of the protrusion collar, up to 4 mm from the built position
    • Vertical opening: Typically 5 mm, with limited lateral freedom retained
    Learn more
  • Snap Fit Herbst in purple acrylic with snap-fit telescopic arms

    Snap Fit Herbst

    • Mechanism: Bilateral telescoping arms with snap-fit assembly, no midline connection
    • Material: Hard acrylic only
    • Anterior hooks: Optional — specify on the Rx
    Learn more

Dorsal

Two separate pieces, so patients can talk, drink and open their mouth while wearing it.

  • Dave's Dorsal (DD) in purple and clear hard acrylic with the dorsal fin and advancement screw

    Dave's Dorsal (DD)

    • Designed by: David Gergen with Cory Carmen of Leone
    • Material: Hard processed acrylic, for strength and durability
    • Mechanism: Dorsal fin design, in the pattern of a Herbst-level result
    Learn more
  • Dorsal appliance in blue acrylic on white models, side view with the advancement screw

    Dorsal

    • Mechanism: Acrylic dorsal fins on the lower engaging inclined ramps on the upper
    • Advancement: Screws set in the upper acrylic, adjusted chairside
    • Materials: Hard acrylic, or hard acrylic with a soft liner
    Learn more
  • Gergen's 3D Advanced Dorsal, front view: clear printed upper and lower arches on white models3D printed

    Gergen's 3D Advanced Dorsal

    • Titration: Dual-dimension: anteroposterior and vertical, set independently
    • Design: Two independent arches with dorsal fins and keyed titration blocks
    • Material: Metal-free printed resin; no screws or wires
    Learn more

TAP

One simple adjustment at the front that patients can make themselves, with plenty of range.

  • dreamTAP, side view showing the hook and the two arches

    Dream TAP

    • Generation: Fifth generation of the TAP appliance
    • Mechanism: Single-point anterior advancement
    • Materials: Hard acrylic, or hard acrylic with a soft liner
    Learn more
  • TAP3: product photograph coming soon

    TAP3

    • Construction: Custom made, two-piece mandibular advancement device
    • Hooks: Interchangeable, for Class I, II and III bites
    • Adjustment: Wide range of precise degree adjustment
    Learn more
  • TAP3 Elite sleep appliance with the low-profile anterior hook, on white models

    TAP3 Elite

    • Hardware: TAP 3 Elite, single-point midline adjustment
    • Material: Hard acrylic or soft liner
    • Adjustment: Patient-adjustable, readable setting
    Learn more

EMA

Small elastic straps hold the jaw forward and let it move naturally from side to side.

  • EMA fabricated by Gergen's Orthodontic Lab

    EMA

    • Advancement: Nine elastic strap lengths, incremental
    • Movement: Patented design permits free lateral mandibular movement
    • Adjusted by: The patient — straps are changed without a lab visit
    Learn more
  • Printed EMA in nylon on a printed honeycomb model3D printed

    Printed EMA

    • Workflow: Fully digital, from intraoral scan to printed appliance
    • Advancement: Nine elastic strap lengths, changed by the patient
    • Records: Intraoral scan and a construction bite
    Learn more

Printed Nylon

Designed from the scan and printed in nylon. Light, low-profile appliances, including Panthera.

  • Panthera D-SAD printed nylon sleep appliance3D printed

    Panthera D-SAD

    • Material: Type 12 polyamide, a resistant, biocompatible nylon
    • Design: CAD design from a 3D scan of the model or an intraoral scan
    • Titration: Replaceable rods, changed by the dentist in 0.5 mm steps
    Learn more
  • Panthera X3 printed nylon sleep appliance on a grey model3D printed

    Panthera X3

    • Material: Printed medical-grade nylon (polyamide 12)
    • Design: Dorsal fin with a clip-on titration system
    • Metal: None
    Learn more

Snore Guards

A simple, comfortable appliance for patients who snore but do not need adjustment.

  • Original Snore Guard, clear dual laminate upper and lower fused with the mandible forward, on white models

    Original Snore Guard

    • Construction: Dual laminate — hard outer shell, soft inside
    • Assembly: Fused in the posterior sections with the mandible forward
    • Records: Upper and lower arches, plus a bite with the mandible advanced
    Learn more

Airway Growth

Worn day and night to widen the arches and open the airway over time. For Vivos-trained providers.

  • Vivos DNA appliance, blue upper plate with expansion screws and springs

    Vivos DNA Appliance

    • Type: Removable, day and night wear
    • Mechanism: Midline and sagittal expansion with a 3-D axial spring
    • Records: Scans or impressions of both arches, bite, Vivos case form
    Learn more
  • Vivos mMrna appliance with cantilever arms, blue acrylic upper and lower with expansion screws and springs

    Vivos mmRNA with Cantilever Arms

    • Type: Removable, day and night, with nighttime mandibular repositioning
    • Advancement: Cantilever arms, set to the construction bite
    • Records: Scans or impressions, construction bite, Vivos case form
    Learn more
  • Vivos mRNA with dorsal arms, blue acrylic upper and lower with dorsal fins and expansion screws

    Vivos mRNA with Dorsal Arms

    • Type: Removable, day and night, dorsal advancement
    • Advancement: Dorsal fins on ramps, titratable
    • Records: Scans or impressions, construction bite, Vivos case form
    Learn more

Herbst® is a registered trademark of Dentaurum GmbH & Co. KG; Gergen’s telescopic sleep designs are fabricated independently and are not affiliated with or endorsed by Dentaurum. TAP, dreamTAP, EMA, Panthera, D-SAD, X3 and Vivos are marks of their respective owners.

Printed nylon

Panthera D-SAD and X3, ordered through Gergen’s

Thin, light appliances designed from the scan and printed in medical-grade nylon, with no metal parts. See how the two compare and how a case works.

Panthera appliances

How a sleep case works

  1. 1

    Physician diagnoses

    The patient's physician confirms the diagnosis and refers for an appliance.

  2. 2

    You take the records

    Scans or impressions, and a bite at the position you choose.

  3. 3

    We build it

    Hand-built or printed to your prescription, checked before it ships.

  4. 4

    You seat and follow up

    You deliver, titrate and keep the patient in follow-up with the physician.

Which appliance

Not sure which one?

A few common starting points. For anything else, call the sleep lab and we will help you choose before you take the bite.

First appliance, wants durability
Sleep Herbst or Snap Fit Herbst
Needs to talk, drink, open
Dorsal or Dave's Dorsal
AP advancement wasn't enough
3D Advanced Dorsal
Patient will titrate at home
TAP3 Elite or dreamTAP
Bruxer with a sleep appliance
EMA, or a Herbst in hard acrylic
Gags on bulk, small mouth
Panthera D-SAD
Snores, no apnea diagnosis
Original Snore Guard
Growing patient, airway focus
Vivos, or see Epigenetics

Common questions

Do you accept scans or impressions?

Both. Send upper and lower scans or impressions with a bite registration. Every sleep case is built from either.

What bite do you need?

A bite registration taken at the forward position and opening you want the appliance built to. If you are unsure where to take it, call the sleep lab before you take the bite.

Can I choose the material?

Yes. Acrylic appliances come in hard acrylic, or hard with a soft liner, and you can add anterior hooks for elastics. Printed appliances are made in medical-grade nylon.

Who adjusts the appliance?

It depends on the design. TAP appliances have an adjustment the patient can make, and most other designs are adjusted by the dentist. Tell us on the prescription how you plan to titrate.

Do you diagnose or prescribe?

No. Diagnosis stays with the patient's physician, and you prescribe and manage the appliance. We build it to your prescription and support your office.

Sending a sleep case is simple.

Send us the scans or impressions and a bite in the position you want, tell us the design and material, and the appliance comes back ready to seat. If anything on the prescription is unclear, we call you before we start.

Scans or impressions
Upper and lower. Either is fine.
Bite registration
Taken at the forward position and opening you want the appliance built to.
Material
Hard acrylic, or hard with a soft liner. Anterior hooks for elastics if you want them.
Sleep prescription
Our sleep slip or the online form. You choose the appliance and manage the patient; we build it.