The Panthera Appliance

Panthera is a custom, digitally designed and 3D-printed oral appliance (a mandibular advancement device, or MAD) used to treat obstructive sleep apnea and snoring. Instead of a physical mold, your appliance is designed from a digital scan and manufactured with computer precision for a highly accurate fit.

Panthera is known for being thinner, stronger, and more comfortable than many traditional oral appliances, thanks to its digital design and 3D-printed nylon construction. Dr. Boris Zusin, a Diplomate of the American Board of Dental Sleep Medicine, has found it delivers reliable, durable results for patients being treated for sleep apnea and snoring.

Like other oral appliances, Panthera holds your lower jaw gently forward during sleep, which helps keep your airway open by preventing the tongue and soft tissue from collapsing into the back of the throat.

The Panthera X3 is an adjustable version of the Panthera oral appliance that we offer alongside the standard Panthera. The upper part carries small, interchangeable clips; swapping a clip moves the lower jaw forward or back in precise 0.5 mm steps, so the position can be fine-tuned without making a new appliance.

Each clip change advances the lower jaw by 0.5 mm, and the usual pace is one change about every two weeks as you adapt. The clips are designed to be changed easily by the patient at home. Total range is up to 5 mm forward and 1 mm back, in 0.5 mm increments. We set the schedule and the target position for you and check your progress at follow-up visits.

There is good research on custom, adjustable mandibular advancement devices as a class, but we are not aware of published trials of the Panthera X3 itself. Reviews show they reduce AHI and sleepiness and are guideline-preferred over non-adjustable or boil-and-bite devices. CPAP lowers AHI more, while sleepiness and quality of life improve similarly and oral appliances are usually worn more consistently. A sleep study before and after titration confirms results.

Yes, Panthera oral appliances are FDA-cleared for the treatment of obstructive sleep apnea and snoring when prescribed and fitted by a qualified dentist.

Dr. Boris Zusin takes a digital scan or impression of your teeth, which is sent to Panthera's lab for custom fabrication. Once your appliance arrives, we check the fit, make any needed adjustments, and give you instructions for nightly wear.

Rinse it daily in lukewarm water and brush it gently with a soft toothbrush (no toothpaste, which is abrasive), then store it in its case. Twice a week, use an antibacterial, chlorine-free orthodontic cleaning solution — the manufacturer is explicit that chlorine-based products (most denture cleansers, bleach, and even vinegar) should never be used on the device, and water should never be warmer than 45°C/133°F. See our full Panthera care guide for the complete manufacturer instructions. Periodic check-ups let us confirm the fit is still accurate as time goes on.

Many medical (not dental) insurance plans provide some coverage for oral appliance therapy when obstructive sleep apnea is diagnosed. We can help you understand your specific coverage and out-of-pocket costs during your consultation.