FAQs

for Providers

We want to help – if you have a question that’s not answered here, please contact us.

MATRx plus Testing | At Home

Implementation in my Practice

How does Zephyr support me and my team during MATRx plus implementation?

Zephyr’s Customer Support team provides installation, team training and a Welcome Kit which includes an implementation plan, marketing suggestions and OSA screening tools. We will help you delineate the roles within your office and provide simple tips to keep you and your team on track. Our Technical Support hotline is available 24/7 for you and your patients.

Will my patients find MATRx plus easy to use?

We make it easy! MATRx plus technology is designed to keep it simple. Instructional videos and step-by-step software on our user interface guide patients through all the necessary steps. We also provide a 24/7 Technical Support hotline for your patients.

If I start a MATRx plus testing program in my practice, do I have to use a specific oral appliance?

No. The predicted target protrusion can be converted to a therapeutic position on any mandibular repositioning appliance. The appliance you recommend to your patient will be based on your experience with the device, your patient’s history and preference.

Can I provide oral appliance therapy for sleep apnea without a physician’s prescription?

No. Sleep apnea is a medical condition therefore a physician is required to prescribe treatment. In addition, a physician’s prescription may be required for medical insurance reimbursement of the oral appliance.

Utilization

How is the MATRx plus test different than other home sleep tests?

Other standard home sleep tests only aid in the diagnosis of obstructive sleep apnea. MATRx plus is a multi-functional device capable of performing both a standard home sleep test and an oral appliance study, which predicts therapeutic outcome with a custom-fitted oral appliance.

Can children have a MATRx plus test?

No, MATRx plus is not to be used by patients under the age of 18.

Economic Benefits

I already provide oral appliance therapy in my practice, why would I want to use the MATRx plus?

We know that oral appliance therapy (OAT) doesn’t work for everyone; efficacy of OAT ranges from 50-70%. MATRx removes the guesswork; a binary prediction of responder or non-responder is provided, along with a target protrusion for the custom-fitted appliance. Knowing who to treat and their target, in advance, should increase your oral appliance success rates, decrease the time-to-therapy and minimize the risk of over-titration.

Will MATRx plus reduce my chair time for oral appliance therapy?

Yes. You will eliminate fitting and titrating oral appliances on patients who are determined to be non-responders to oral appliance therapy. For those who are responders, the patient’s mandible, in many cases, can be moved immediately to the prescribed target protrusive position eliminating the need for multiple office visits.

The Oral Appliance Study

When do I use the MATRx plus Oral Appliance Study?

For any patient who has been diagnosed with OSA and is interested in oral appliance therapy. The test will tell you who to treat and their target protrusive position, prior to fabrication of the appliance.

Does my patient need to be diagnosed with sleep apnea before having a MATRx plus Oral Appliance Study?

Yes, a diagnosis of sleep apnea is required before an Oral Appliance Study can be performed.

The Baseline Study

When do I use the MATRx plus Baseline Study?

If your patient has a positive screen for OSA, you can recommend a MATRx plus Baseline Study. A Sleep Physician will provide an interpretation of the study results, confirming an OSA diagnosis. The Baseline study can also be used to confirm the severity of sleep apnea in a patient that has already been diagnosed and as a therapeutic follow-up study after the patient’s oral appliance has been fit. Check the guidelines of your governing body for details.

Does my patient’s Baseline Study need to be interpreted?

Yes. Only a sleep physician can interpret the study for the purpose of providing a diagnosis of obstructive sleep apnea. All of your patient’s study data will be available on your MATRx plus Patient Information Portal. The physician can log into the Portal to review the raw data and/or the study report or your office can generate a report and send it directly to the interpreting physician. Contact us for more info.

Do I have to refer my patients to a sleep physician before I can perform a MATRx plus study for the diagnosis of obstructive sleep apnea?

Please check with your provincial healthcare programs, medical and dental associations since regulations may vary.

MATRx Testing | At a Sleep Lab

Utilization

How well is my patient going to be able to sleep with the titration trays and attached mandibular positioner (i.e. motor) in their mouth?

The motor is not placed in the patient’s mouth; only the trays. The trays are attached to mounting brackets extending from the front of the trays to the motor outside of the patient’s mouth. The custom-fitted dental titration trays are comfortable and the patient is unaware of the light-weight motor attached to the trays.

To date, the device has been well tolerated by patients involved in clinical studies. The quiet, small incremental movements performed during the study night rarely wake the patient.

Do I need to use a nasal pressure cannula and a thermistor and/or thermocouple sensor?

Yes, the AASM standards require the use of a nasal pressure cannula and an oro-nasal thermocouple device.

Can the MATRx device be used on patients that normally breathe through their mouths?

The MATRx system may not be comfortable for patients who are unable to breathe comfortably through their nose during sleep.

Is follow-up testing required for successful oral appliance patients after their MATRx study and fitting of their appliance?

No. MATRx gives you the effective protrusive position; iterative testing is not required.

Is an outcome study required after a MATRx study?

The AASM guidelines recommend an outcome study with the final therapeutic device. A polysomnographic study is the gold standard however when a polysomnographic study is not available, an AASM compliant portable sleep recorder can be used.

How do I clean the MATRx device between patients?

Cleaning procedures for the MATRx system follow standard cleaning procedures approved for use in Sleep Laboratories.
Contact us for more info.

Titration trays: are for single patient multi-use for one study only; please refer to your User Manual for tray cleaning instructions before and after taking impressions. Reuse of the trays for more than one study may compromise the system’s accuracy.

Mandibular Positioner (motor) and cables: can be reused between patients; please refer to your User Manual for pre-cleaning, cleaning and disinfection procedures.

Titration Procedure

Is the MATRx dental titration procedure difficult for sleep techs to learn and master?

No. The MATRx titration procedure is very similar to that used for CPAP titrations. Remote installation and training are included in the price of the product. In addition, every MATRx lab has access to resource documents and manuals that review the titration procedure. Our technical support representatives are also available 24/7 at 1 (877) 227-9832.

During a MATRx study, how do I know when I’ve reached a therapeutically effective protrusive distance for my patient?

This is called the patient’s target protrusive position. Your patient has reached this “target” when you observe elimination of apneas and/or hypopneas during REM sleep in the supine position, if possible.

What is the MATRx target protrusive position?

This is the mandibular protrusive position that will result in effective treatment of the patient’s OSA with a custom oral appliance (mandibular repositioning appliance). The sleep physician determines the patient’s target protrusive position when performing the MATRx study interpretation (i.e. 1 or less apneas and/or hypopneas during 5 minutes of REM sleep supine; REM lateral can be used if the patient is a confirmed side sleeper). The sleep dentist will use the target protrusive position to fabricate the patient’s custom oral appliance to their therapeutic position.

How accurate is the target protrusive position provided from the MATRx study in predicting the therapeutic position for an oral appliance?

In the most recent clinical study (n=67) the efficacy of the MATRx target protrusion position was 93% in patients correctly predicted to be therapeutically successful.

Ecnomic Benefits

What is the primary benefit of using MATRx compared to the conventional approach for fitting and titrating custom oral appliances?

The MATRx study allows the sleep physician to determine, in advance, which patients will be effectively treated with an oral appliance and also provides the sleep dentist with a therapeutic target protrusive position prior to fabrication of the custom-fitted oral appliance. This allows the dentist to improve the efficiency of appliance fitting at target, decrease the time-to-therapy and minimize the risk of over-titration.

Will MATRx reduce my chair time for oral appliance therapy?

Yes. You will eliminate fitting and titrating oral appliances on patients who are determined to be non-responders to oral appliance therapy. For those who are responders, the patient’s mandible, in many cases, can be moved immediately to the prescribed target protrusive position eliminating the need for multiple office visits.

Titration Tray Use

During the patient’s dental appointment for titration tray fitting, does the dentist need to conduct full exams and x-rays?

No. At the initial visit you will need to perform an oral exam to determine if the patient is a suitable candidate for an oral appliance. Once candidacy is confirmed, you will: 1) fit the patient’s titration trays 2) prepare impressions to customize the patient’s bite within the trays and ensure adequate tray retention 3) record the patient’s scale readings (i.e. this will be the range of motion used by the sleep tech when conducting the study).

Can a sleep tech take the impressions and fit the titration trays?

Yes. The temporary titration trays can be fit by a sleep tech that has been trained by a sleep dentist to perform tray fitting.

How can I learn how to fit titration trays?

Please visit Resources for instructional videos on Titration Tray use.

Can I use any type of impression material?

No. The titration trays have been designed for use with a fast setting impression material (e.g. Henry Schein Blu-Bite HP Fast Set), which sets in approximately 20-30 seconds.

What is the vertical separation adjustment of the titration trays?

The vertical separation is 3-4mm, depending on the amount of bite registration material used.

Can the patient’s titration trays be used as the bite registration?

Yes they can, however, we recommend taking a new bite registration to optimize accuracy.

How do I convert the MATRx target to a protrusive distance on the therapeutic appliance?

Since the edge-to-edge position varies between 9mm – 11mm, record this position (known as the tray’s Reference Number) before taking impressions.

Conversion Example: MATRx Target of 14.0mm

Tray’s Reference Number (Edge-to-Edge) 10.5 mm
Prescribed MATRx Target Protrusion 14.0 mm
Difference (14.0 mm – 10.5 mm) 3.5 mm
George Gauge (Edge-to-Edge) 0.0 mm
George Gauge Target Protrusion for appliance (0 mm + 3.5 mm) 3.5 mm

 

For more information, download the MATRx Dental Applications Guide.