articles+ search results

Open source software, Public software -- Analysis, and Rapid prototyping -- Analysis

Keywords: Dynamic optimization; Dynamic simulation; Pyomo; Process control; Williams-Otto process Abstract With ongoing digitalization, fast simulation of process dynamics offers new opportunities for model-based control schemes. This is eased by the availability of high-level, open-access, easy-to-use software able to simulate and optimize chemical processes, making rapid prototyping possible also for the chemical engineer. In this study, the capabilities of the Python-based open-source software package Pyomo towards industrial application is illustrated in modeling and comparing different control schemes for a simple Williams-Otto process. It is shown how to simulate the process dynamics and how to compute optimal control trajectories for minimizing waste and maximizing yield. Two approaches to setpoint tracking are compared: one based on proportional-integral feedback control and one based on optimal open-loop control. Byline: Julia Riese, Jochen Schmid, Katrin Teichert, Moncef Chioua, Thorsten Schindler, Michael Bortz

Rapid prototyping and Autografts

Keywords: digital dentistry; endodontics; laboratory technology; oral surgery; pain Abstract Objective To describe a method to fabricate donor tooth replica to assist surgeons in preparation of recipient socket during tooth autotransplantation. Materials and Methods A total of 28 compromised molars in 27 patients were transplanted with third molars using computer-aided rapid prototyping (CARP) technique. Surgery time and extra-alveolar time were documented. Postoperatively, the distance between cervix of transplanted tooth and the alveolar wall was measured. The degree of postoperative pain experienced was assessed with visual analog scale at day 1, 3, and 7. Results From 28 clinical cases, the average extra-alveolar time and surgery time were 2.5 minutes ([+ or -]1.3) and 44minutes ([+ or -]6.8), respectively. Postoperatively, the average distance between cervix of transplanted tooth and the alveolar wall was 0.87mm ([+ or -]0.15) at the mesial-cervix, 0.95mm ([+ or -]0.17) at the distal-cervix, 0.88mm ([+ or -]0.18) at the buccal-cervix, and 0.95mm ([+ or -]0.13) at the lingual-cervix. The value of visual analog scale score significantly decreased from day 1 to day 3. Conclusions CARP is a reliable technique for fabrication of tooth like surgical replicas in conventional autotransplantation. Clinical Significance CARP technique minimized extra-oral time, reduced iatrogenic damage, and consequently increased the survival rate of tooth autotransplantation. Byline: Jia-jia Xia, Zi-yu Ge, Xiao-hui Fu, Yan-zhen Zhang

Computer-aided design -- Analysis, Implants, Artificial -- Analysis, Prosthesis -- Analysis, and Rapid prototyping -- Analysis

Abstract Statement of problem Although closed hollow obturator prostheses provide the benefit of minimized weight, they also pose challenges. They are complex to fabricate, and contaminated water can easily enter the hollow section through the joined part, making them unsanitary and leading to malodor and increased weight. Purpose The purpose of this in vitro study was to investigate the hermeticity and durability of a hollow obturator model fabricated by using computer-aided design (CAD) and rapid prototyping (RP) techniques and to evaluate the possibility of its clinical use. Material and methods Leak testing was used to evaluate the hermeticity and durability of hollow spherical obturator specimens with an outer diameter of 30 mm and 2 different wall thicknesses (1.5 and 2.0 mm). Six specimens were fabricated for each of the wall thicknesses by using CAD and RP techniques. The accumulation of fluids in the hollow obturator specimens was evaluated every day by using megascopic observation with photoirradiation from the base of the specimens. The amount of water absorption and the rate of increase in the weight of the 2 specimens were calculated and compared. Statistical analysis was performed by using the Mann-Whitney U test ([alpha]=.05). Results The application of CAD and RP techniques made it possible to fabricate a hollow obturator model specimen with completely unified parts. The 1.5-mm specimen showed an absorption rate (2.61%) that significantly exceeded that of the 2.0-mm specimen (2.53%) on day 130 (P=.006). By the end of the observation period, the 1.5-mm specimen exhibited large amounts of water absorption and destruction. The 1.5-mm-thick wall had reduced hermeticity than the 2.0-mm-thick wall. Conclusions A fully unified hollow obturator model with 2.0-mm-thick walls was fabricated by using CAD and RP techniques. The absence of any joints prevented fluid accumulation, making this method suitable for the fabrication of hollow prostheses. Author Affiliation: (a) Associate Professor, Maxillofacial Prosthetics Clinic, Tohoku University Hospital, Sendai, Japan (b) Assistant Professor, Maxillofacial Prosthetics Clinic, Tohoku University Hospital, Sendai, Japan (c) Assistant Professor, Maxillofacial Prosthetics Clinic, Tohoku University Hospital, Sendai, Japan (d) Assistant Professor, Maxillofacial Prosthetics Clinic, Tohoku University Hospital, Sendai, Japan (e) Professor, Division of Advanced Prosthodontics, Graduate School of Dentistry, Tohoku University, Sendai, Japan * Corresponding author: Dr Shigeto Koyama, Tohoku University Hospital, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, JAPAN Byline: Shigeto Koyama, DDS, PhD [koyama@dent.tohoku.ac.jp] (a,*), Naoko Sato, DDS, PhD (b), Takehiko Mito, DDS, PhD (c), Kuniyuki Izumita, DDS, PhD (d), Keiichi Sasaki, DDS, PhD (e)

Rapid prototyping, Proteins, Genetic research, Mail-order industry, Fluorescence, Protein biosynthesis, Genes, Escherichia coli, and DNA synthesis

Byline: Jared Lynn Dopp, Samuel Michael Rothstein, Thomas Joseph Mansell,Nigel Forest Reuel Keywords: cell-free protein synthesis; linear template; rolling circle amplification Abstract In this study, we present a minimal template design and accompanying methods to produce assayable quantities of custom sequence proteins within 24hr from receipt of inexpensive gene fragments from a DNA synthesis vendor. This is done without the conventional steps of plasmid cloning or cell-based amplification and expression. Instead the linear template is PCR amplified, circularized, and isothermally amplified using a rolling circle polymerase. The resulting template can be used directly with cost-optimized, scalably-manufactured Escherichia coli extract and minimal supplement reagents to perform cell-free protein synthesis (CFPS) of the template protein. We demonstrate the utility of this template design and 24hr process with seven fluorescent proteins (sfGFP, mVenus, mCherry, and four GFP variants), three enzymes (chloramphenicol acetyltransferase, a chitinase catalytic domain, and native subtilisin), a capture protein (anti-GFP nanobody), and 2 antimicrobial peptides (BP100 and CA(1-7)M(2-9)). We detected each of these directly from the CFPS reaction using colorimetric, fluorogenic, and growth assays. Of especial note, the GFP variant sequences were found from genomic screening data and had not been expressed or characterized before, thus demonstrating the utility of this approach for phenotype characterization of sequenced libraries. We also demonstrate that the rolling circle amplified version of the linear template exhibits expression similar to that of a complete plasmid when expressing sfGFP in the CFPS reaction. We evaluate the cost of this approach to be $61/mg sfGFP for a 4hr reaction. We also detail limitations of this approach and strategies to overcome these, namely proteins with posttranslational modifications. CAPTION(S): Supplementary information

3D printing -- Methods

1. Introduction Microfabrication techniques have revolutionized the way biologists and medical scientists conduct studies in the last few decades [1]. The well-developed semiconductor workflow enables not only the creation of [...]
C[O.sub.2] laser manufacturing has served as an enabling and reliable tool for rapid and cost-effective microfabrication over the past few decades. While a wide range of industrial and biological applications have been studied, the choice of materials fabricated across various laser parameters and systems is often confounded by their complex combinations. We herein presented a unified procedure performed using percussion C[O.sub.2] laser drilling with a range of laser parameters, substrate materials and various generated microstructures, enabling a variety of downstream tissue/cellular-based applications. Emphasis is placed on delineating the laser drilling effect on different biocompatible materials and proof-of-concept utilities. First, a polydimethylsiloxane (PDMS) microneedle (MN) array mold is fabricated to generate dissolvable polyvinylpyrrolidone/polyvinyl alcohol (PVP/PVA) MNs for transdermal drug delivery. Second, polystyrene (PS) microwells are optimized in a compact array for the formation of size-controlled multicellular tumor spheroids (MCTSs). Third, coverglass is perforated to form a microaperture that can be used to trap/position cells/spheroids. Fourth, the creation of through-holes in PS is validated as an accessible method to create channels that facilitate medium exchange in hanging drop arrays and as a conducive tool for the growth and drug screenings of MCTSs. Keywords: C[O.sub.2] laser; rapid prototyping; microneedle; multicellular tumor spheroids; microwells; hanging drops

Magnetization and Rapid prototyping

Byline: Jon-Fredrik Nielsen, Douglas C. Noll Keywords: pulse sequence programming; pulse sequence prototyping; platform-independent; open source; open MRI Purpose To introduce a framework for rapid prototyping of MR pulse sequences. Methods We propose a simple file format, called 'TOPPE', for specifying all details of an MR imaging experiment, such as gradient and radiofrequency waveforms and the complete scan loop. In addition, we provide a TOPPE file 'interpreter' for GE scanners, which is a binary executable that loads TOPPE files and executes the sequence on the scanner. We also provide MATLAB scripts for reading and writing TOPPE files and previewing the sequence prior to hardware execution. With this setup, the task of the pulse sequence programmer is reduced to creating TOPPE files, eliminating the need for hardware-specific programming. No sequence-specific compilation is necessary; the interpreter only needs to be compiled once (for every scanner software upgrade). We demonstrate TOPPE in three different applications: k-space mapping, non-Cartesian PRESTO whole-brain dynamic imaging, and myelin mapping in the brain using inhomogeneous magnetization transfer. Results We successfully implemented and executed the three example sequences. By simply changing the various TOPPE sequence files, a single binary executable (interpreter) was used to execute several different sequences. Conclusion The TOPPE file format is a complete specification of an MR imaging experiment, based on arbitrary sequences of a (typically small) number of unique modules. Along with the GE interpreter, TOPPE comprises a modular and flexible platform for rapid prototyping of new pulse sequences. Magn Reson Med 79:3128-3134, 2018. [c] 2017 International Society for Magnetic Resonance in Medicine. Supporting information: Additional Supporting Information may be found in the online version of this article Additional Supporting Information may be found in the online version of this article. CAPTION(S): Fig. S1. Pulse sequence diagram for the k-space trajectory measurements shown in Figure 3. Fig. S2. Example of a TOPPE sequence with multiple (64) different gy and gz waveforms associated with one .mod file. Only two of the waveforms are shown. All 64 waveforms are loaded into scanner memory during sequence prescription. During sequence execution, the particular waveform to be played out is selected on-the-fly according to the corresponding entry in scanloop.txt. In this example, each waveform is of duration 40 ms. We successfully ran this sequence and switched the waveforms during sequence execution (not shown), according to the instructions in scanloop.txt. With the possibility of up to 20 different .mod files, each containing multiple waveforms, we believe TOPPE will be sufficiently flexible for most applications. However, we have observed that there appears to be a limit on total waveform memory allowed by our GE scanner: for example, the multi-waveform .mod file shown here appears to nearly reach the total memory limit. Fig. S3. Example of a relatively complex pulse sequence that is not easily implemented using traditional programming techniques: Arterial Spin Labeling with stack-of-spirals readout. Following a (velocity-selective) spin tagging pulse and a transit delay of a1/41.3 sec, a train of alternating RF excitation and data readout modules are played out (total duration a1/40.7 sec). kz (partition) encode ordering is center-out (not shown). The flip angle is increased to maintain constant signal following each excitation. For a given readout repetition interval and assuming tissue T1 of gray matter at 3T, we obtained the optimal flip angle schedule using the Matlab function fmincon. Implementing such a sequence using traditional programming techniques would be relatively laborious, and would in any case likely require the ASL tagging pulse, flip angle schedule, and perhaps the spiral readouts to be loaded from external files. Fig. S4. Another example of a relatively complex pulse sequence that is not easily implemented using traditional programming techniques: A set of 12 triangular readout gradients used to measure gradient impulse response function, as implemented in (15). Although the waveforms differ only by their time to peak (ranging from 50 to 160 I1/4s in 10 I1/4s increments), there is no direct way to encode these waveforms programmatically during run-time. In TOPPE, one can either associate each waveform with its own .mod file, or load all 12 waveforms into a single module (after zero-padding to ensure equal waveform duration).

Italy

Byline: Vincenzo Abbate, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit Naples, University of Naples 'Federico II,' Naples; Giorgio Iaconetta, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit Naples, University of Naples 'Federico II,' Naples; Luigi Califano, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit Naples, University of Naples 'Federico II,' Naples; Antonio Pansini, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit Naples, University of Naples 'Federico II,' Naples; Paola Bonavolonta, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit Naples, University of Naples 'Federico II,' Naples; Antonio Romano, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit Naples, University of Naples 'Federico II,' Naples; Giovanni Salzano, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit Naples, University of Naples 'Federico II,' Naples; Teresa Somma, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit Naples, University of Naples 'Federico II,' Naples; Luca D'Andrea, Neurosurgery Department Salerno, University of Salerno, Fisciano, Italy.; Giovanni Dell'Aversana Orabona, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit Naples, University of Naples 'Federico II,' Naples Abstract BACKGROUND:: Restoring the orbital cavity integrity in orbital floor defects is a challenging issue due to the anatomical complexity of the floor's surface. This is a showcase for technical description of a novel 'in house' rapid prototyping protocol aimed to customize implant for orbital floor reconstruction. METHODS:: The authors present 4 cases to show our Computer-aided-design and Computer-aided-manufacturing digital workflow. The system was based on a 3D-printed press that; through a virtually designed mold, was used to conform a patient specific titanium mesh for orbital floor reconstruction. RESULTS:: The merging procedure analysis by iPlan Cranial 3.0 (Brainlab, Munich, Germany) highlighted a 0.71 [+ or -] 0.23 mm (P <0.05) discrepancy in a point-to-point superimposition between the digital planned reconstruction and the real in vivo result. CONCLUSIONS:: The authors expect that this technique will reduce operative time and cost however further study and larger series may better define the applicability in everyday surgical practice.

Cheek-bone -- Injuries, Cheek-bone -- Care and treatment, Postoperative care -- Patient outcomes, and Face shields -- Testing

Byline: Giovanni Dell'Aversana Orabona, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit; Vincenzo Abbate, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit; Fabio Maglitto, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit; Umberto Committeri, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit; Giovanni Improta, Department of Public Health, University of Naples 'Federico II,' Naples, Italy.; Paola Bonavolonta, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit; Alfonso Reccia, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit; Teresa Somma, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Neurosurgery Unit, University of Naples 'Federico II,' Naples; Giorgio Iaconetta, Neurosurgery Department, University of Salerno; Luigi Califano, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit Abstract Zygomatic fractures account for 10% to 15% of all facial fractures. The surgical management of isolated zygomatic arch fractures usually requires open reduction treatment without fixation through an intraoral access. Therefore, the main problem in the non-fixed treatment of zygomatic arch fractures is related to the difficulty in obtaining a stable reduction for a period long enough to guarantee the physiological bone healing process. We propose an innovative 'in-house' rapid prototyping (RP) protocol for the 3D-zygoma mask manufacture of a patient-specific protective device to apply after zygomatic arch fracture reduction. Our study includes 16 consecutive patients who underwent surgical open reduction for an isolated zygoma fracture without fixation between January 2017 and February 2018. The patients received regular postoperative checks at weeks 1 and 2. Before the device was removed, a multiple choice questionnaire was administered to measure the degree of wearability of the mask. The estimated cost of the production is around &OV0556;5 per case and the construction time is around 90 minutes. Based on the encouraging results, obtained in our experience, we hope that other studies can be conducted to confirm our procedure and improve its functionality in the field of facial trauma.

Rapid prototyping -- Analysis, Valves -- Analysis, and Yuan (China) -- Analysis

Byline: Sheng Yan, Sheng Yan, Shi-Yang Tang, Yuxing Li, Qianbin Zhao, Dan Yuan, Guolin Yun, Jun Zhang, Shiwu Zhang, Shiwu Zhang Keywords: Capillary microfluidics; Laser ablation; Rapid prototyping; Ur Abstract Proteinuria is an established risk marker for progressive renal function loss and patients would significantly benefit from a point-of-care testing. Although extensive work has been done to develop the microfluidic devices for the detection of urinary protein, they need the complicated operation and bulky peripherals. Here, we present a rapid, maskless 3D prototyping for fabrication of capillary fluidic circuits using laser engraving. The capillary circuits can be fabricated in a short amount of time (<10 min) without the requirements of clean-room facilities and photomasks. The advanced capillary components (e.g., trigger valves, retention valves and retention bursting valves) were fabricated, enabling the sequential liquid delivery and sample-reagent mixing. With the integration of smartphone-based detection platform, the microfluidic device can quantify the urinary protein via a colorimetric analysis. By eliminating the bulky and expensive equipment, this smartphone-based detection platform is portable for on-site quantitative detection. Article Note: These authors contributed equally to this work. Additional corresponding author: Prof. Weihua Li E-mail: weihuali@uow.edu.au Color Online: See the article online to view Figs. 1-5 in color. CAPTION(S): Supporting information

Theater -- Theater reviews, Rapid prototyping, Medical research, Medicine, Experimental, and CT imaging

Purpose Rapid prototyping and intraoperative computed tomography (CT) are increasingly used in orbital reconstruction when placement of implants is indicated and accurate anatomic restoration is mandatory. The purpose of this study was to review the outcomes of orbital reconstructions at a single institution and the influence of intraoperative CT and rapid prototyping on the rate of return to the operating theater. Materials and Methods A retrospective cohort analysis was performed from 2013 through 2016 to assess whether rapid prototyping and intraoperative imaging were used and the need for further revision surgery. Clinical notes were reviewed and data were collected for patient gender, age, fracture pattern, preoperative diplopia, and enophthalmos. Also noted were whether rapid prototyping and intraoperative imaging were used, the number of 'spins' required, plating systems, postoperative diplopia and enophthalmos, restoration of orbital form, and the need for further surgical intervention. Patients were excluded if no orbital implants were inserted or if they were lost to follow-up. Results Three hundred thirty-one cases of orbital trauma were reviewed (248 male and 83 female patients; age range, 7 to 96 yr; mean age, 37.5 yr). In total, 154 orbital reconstructions were performed from 2013 through 2016. Five cases required a return to the operating theater for implant revision. All 5 cases did not use intraoperative imaging (P = .0016), and 4 did not have a rapid prototype bio-model (P = .006). Twenty-five of 110 cases (22.7%) using intraoperative CT required intraoperative revision. Conclusion The present study shows improved outcomes for patients treated for orbital fractures when intraoperative imaging and rapid prototyping bio-modeling are used. As a result, postoperative imaging and the morbidity of revision surgery can be avoided. These technologies should be available and considered standard of care to any surgeon performing reconstruction of orbital fractures. Author Affiliation: (*) Consultant, Oral and Maxillofacial Surgery, Christchurch Public Hospital, Canterbury District Health Board, Christchurch, New Zealand ([Dagger]) Registrar, Oral and Maxillofacial Surgery, Christchurch Public Hospital, Canterbury District Health Board, Christchurch, New Zealand ([double dagger]) Head of Unit, Oral and Maxillofacial Surgery, Christchurch Public Hospital, Canterbury District Health Board, Christchurch, New Zealand (s.) Consultant, Oral and Maxillofacial Surgery, Christchurch Public Hospital, Canterbury District Health Board, Christchurch, New Zealand * Address correspondence and reprint requests to Dr Nguyen: Oral and Maxillofacial Surgery, Floor 5, Riverside Building, Christchurch Public Hospital, Canterbury District Health Board, Christchurch, New Zealand Article History: Received 5 January 2019; Accepted 4 February 2019 (footnote) Conflict of Interest Disclosures: None of the authors have any relevant financial relationship(s) with a commercial interest. Byline: Edward Nguyen, BDSc (Hons), MBBS (Hons), FRACDS (OMS) [edwardnguyen168@gmail.com] (*), Jamie Lockyer, BDS, Jason Erasmus, BChD, MBChB, MChD (OMS), Christopher Lim, BDSc, MBBS, FRACDS (OMS)

Fingers -- Injuries, Fingers -- Care and treatment, 3D printing -- Usage, Splints (Surgery) -- Design and construction, and Splints (Surgery) -- Usage

Keywords Ring orthosis; Rapid prototyping; 3D scanning; 3D printing Highlights * More esthetic orthosis was produced. * A three-dimensional scanner was used for designing. * A three-dimensional printer was used in production. * Production required a very short time. * Production was inexpensive. Abstract Study Design In this study, ring orthosis design and manufacturing was performed by using rapid prototyping technology. Introduction Swan neck and boutonniere deformities may occur because of various reasons such as tendon injuries, sharp object injuries, or rheumatic diseases. Although the ring orthoses are the most commonly used conservative treatment method for swan neck and buttonhole deformities, they cannot be widely used because they are both difficult to produce and esthetically unsatisfied with the patients. Purpose of the Study In this study, it was aimed to manufacture with an orthosis design that is fully compatible, more esthetic, faster, and easily produced. Methods 3D printing technologies are used in design and manufacturing. The 3D scanner is used in the measurement process, and the 3D printer is used in the manufacturing process. Results As a result of the study, a more esthetically pleasing and comfortable orthosis was made faster. Discussion and Conclusions As a result of the study, the thickness of the material should not be less than 5 mm. Author Affiliation: (a) Industrial Design Engineering, Institute of Science, Gazi University, Ankara, Turkey (b) Department of Industrial Design Engineering, Faculty of Technology, Gazi University, Ankara, Turkey (c) Defense Industries Research and Development Institute, Tubitak, Ankara, Turkey (d) Department of Occupational Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey * Corresponding author. Industrial Design Engineering, Institute of Science, Gazi University, Ankara, Turkey. Article History: Received 10 February 2019; Accepted 28 February 2019 (footnote) This study was published as a summary at the 16th National Congress of the Turkish Society for Surgery of the Hand and Upper Extremity and 5th National Congress of the Hand Therapist Society Abstract Supplement May 6 to 9, 2018, Pamukkale, Denizli, Turkey. Byline: Mehmet Ismail Sari, MSc [mismailsari@gmail.com] (a,*), Ismail Sahin, PhD (b), Harun Gokce, PhD (c), Cigdem Oksuz, PhD, PT (d)

Time to market, Product development, Thermoplastics, Sleep apnea syndromes, and Home appliances

Obstructive Sleep apnea is a public health problem. This disease is associated with daytime sleepiness, increased motor vehicle accidents, heart failure and stroke. Treatment options include weight loss, positive airway pressure, pharyngeal and orthognatic surgery. However, selected patients have good response to oral appliances devices that intended to protrude and stabilize the mandible mechanically during the night in order to reduce the collapsibility of the upper airway. Selection of patients includes primary snoring, mild, moderate and positional apnea. The perfect mandibular advance device has not yet been designed. For these reasons, the objective of this paper is to present a new thermoadjustable chair-side oral appliance. Device integrates the best characteristics of custom made and boils and bite previous designs and minimizes inconveniences and possible side effects. The device is a titratable mandibular advancement appliance. It consists of two independent prefabricated trays adaptable to the shape of adult dental arch and linked to each other by a protrusion mechanism. Each tray contains a hard outer shell and a soft thermoplastic resin inner body. The position of the jaw can be adjusted by moving an aluminum rack into, or out from, the guide so the ratchet may get locked into a certain position ensuring the length of the mechanism. The protrusion mechanism is fixed to the splint using small rings that are articulated over a 't' button. Our prototype satisfies the requirements of an effective oral appliance, in terms of retention, comfort, safety and efficacy. It is easy to fit, durable, low cost, quickly titratable, not bulky and easy cleaning. Thermoplastic appliances are specially used like a predictor of treatment response in apnea patients. The device described is a cost-effective introduction to mandibular advancement technology. A qualified dentist or trained sleep doctor could mitigate dental side effects and reduce their incidence.