What can be done if the my attempt at custom moulding is unsuccessful because the mandibular advancement device has excess filling material (as with the SomnoGuard 3, for instance)?
Excessive material may be carefully removed with the aid of a knife or scissors (this may require reheating). If necessary, the moulding may then be repeated.
Furthermore, prior to remoulding, it is important to smooth the old dental impressions in the MAD out, so that you bite into a smoothed surface during the remoulding.
The moulding should not be based on old dental impressions (as this comes with the risk of the MAD fitting even more loosely). As far as the procedure is concerned, you should warm up the MAD as you would for an initial fitting, followed by smoothing the old dental impressions, let it cool down and, finally, reheat the MAD. If you attempt to complete the “smoothing” and moulding in one go, there is the risk of the MAD may harden too soon and the dental impression may, therefore, not being deep enough. Consequently, the MAD may be too loose fitting.