What is the ACG System? The ACG™ Airway Centric® System is the first fully integrated day and night oral appliance approach to solving airway issues by integrating Airway and Sleep with TMJ. The system includes six appliances that complement the traditional ProSomnus [IA] Platform.
Common daytime complaints related to the airway include fatigue, difficulty concentrating, mood disorders, acid reflux, headaches and high blood pressure. The day appliances help to balance the nervous system and reduce pain while opening the airway. The system focuses on improving performance and energy levels while decreasing these symptoms.
Opening the airway by advancing the mandible also functions to:
- Alleviate clicking, popping and locking
- Alleviate daytime clenching and reminding the patient to keep the lips together, teeth apart (LTTA) as a cognitive behavioral device
- Relax the masticatory and cervical muscles
- Improve heart rate variability and balance the automatic nervous system
- Create an aesthetic transformation
- Improve lower third facial height, increase lips, and better the chin
- “Non- surgical facelift”
- Improve nasolabial folds
- Correct facial asymmetry, placing the chin back to the middle of the face
The ACG™ Day is a lower milled repositioning device which covers the canines and establishes canine guidance while opening the airway during the day. It involves no clasps and is thinner lingually, allowing better speech which is essential for a daytime appliance. In addition, covering the canines and the lingual ribbon of milled PMMA prevents the intrusion of teeth.
ACG™ Day Full
The ACG™ Day Full is intended for patients with an anterior open bite. This lower repositioning appliance with full coverage establishes anterior contact and anterior guidance all while opening the airway. It transfers the bite force from the posterior teeth to the anterior teeth, which in a class 3 lever system relaxes the masticatory muscles.
ACG™ Functional (Juvabite®)
The ACG™ Functional is a lower anatomic device taken in an airway and TMJ friendly bite. This appliance is often prescribed after treatment with an ACG™ Day or ACG™ Day Full as a transitional appliance prior to restorative dentistry. For patients who may require a less bulky anatomic appliance capable of light chewing and clearer speech, this is an excellent option. While opening the airway and decompressing the TMJ, the ACG™ Functional also restores the lower third of the face for transformative aesthetic effects.
ACG™ Night Appliances
The main focus of the night appliances is to alleviate obstructive sleep apnea (OSA) and snoring and improve oxygenation, promoting more restorative sleep. These appliances stop the lower jaw from dropping back at night, preventing a collapse of the airway during sleep.
The ACG™ Night appliance is an anti-retrusion appliance with either the same repositioning bite as the ACG™ Day or a slightly increased vertical and protrusive bite. The anterior guide ramp prevents the jaw from retruding.
The ACG™ Night is indicated for individuals presenting with TMJ complains prior to using the ProSomnus [IA] or HERS.
ACG™ Lower Retainer
The ACG™ Retainer was added to the system in response to three occasional issues:
- Discomfort of the lower anterior teeth in the morning following nighttime clenching against the anti-retrusion ramp
- Mobility of the lower anterior teeth with short conical roots following trauma against the anti-retrusion ramp
- Shifting and crowding of the lower anterior teeth
The ACP Position Paper on Oral Devices points out recent research demonstrating that traditional flat plane nightguards often close the airway and worsen OSA and snoring. To avoid liability, the dentist needs to use a different device with the bite taken in a more protruded jaw position. The ACG™ Brux-Pad is an excellent option for the patient to stop bruxing without closing the airway. All dentists are advised to screen bruxism patients for airway and sleep disorders. If a disorder is found, the patient may be upgraded to a ProSomnus IA or ACG™ HERS.
ACG™ Select IA
The ACG™ Select IA was designed for women and men with smaller mouths and large tongues who are not able to tolerate other sleep and airway appliances. Lip seal is accomplished by thinning the labial surfaces and decreasing vertical dimension. The lingual-less design also enhances treatment efficacy.
ProSomnus® Splint Combined Rx
Download the ProSomnus® Splint Combined Rx Slip (PDF).
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Dr. Michael Gelb, DDS, MS is a world-renowned TMJ and Sleep Specialist with practices in both New York City and White Plains. He received his D.D.S. degree from Columbia University College of Dental Medicine and his M.S. from SUNY at Buffalo School of Dental Medicine. Dr. Gelb is the co-author of GASP: Airway Health- The Hidden Path to Wellness, and the co-founder of both The Foundation for Airway Health and The American Academy of Physiological Medicine and Dentistry.
The Gelb Center was founded over 30 years ago by Dr. Michael Gelb’s father, Dr. Harold Gelb. Since then, Dr. Michael has taken his father’s findings to the next level through his Airway Centric® integrated therapy. He invented the ACG™ Airway Centric® System with the help of ProSomnus Sleep Technologies. The ACG System is the first day and night dental appliance solution that offers an integrated approach to addressing airway issues.
Dr. Michael Gelb is dedicated to improving his patients’ health by reducing pain, restoring refreshing sleep and transforming lives.
He really impressed me at my first two visits and he came very highly recommended. My mom was treated for TMJ by his dad and insisted that I only see Dr. Gelb since her results were 100% satisfactory.
… I am so thankful for this man for renewing the lease on my life! You are without a doubt one of Gods Angels on earth.
I stopped snoring like a bear and rarely get migraines like I used to quite frequently … This man is amazing … I love you Dr.Gelb and forever thankful to you.
Thankyou Dr. Gelb. Wait – let me say it one more time: Thank you Dr. Gelb … thankfully the tri-state area has the Gelb Center.
I cannot say enough positive good things about Dr. Gelb and his staff. I came to him and he turned my life around for the better almost immediately.
Simply stated, Dr. Gelb is stellar! I can’t recommend him enough and can’t wait until I am free, with his help, from dealing with this chronic health issue.
He makes you feel so comfortable and confident in your health. I would recommend Dr. Gelb to anyone who has had any TMJ/jaw pain issues. He is simply the best.
I am an Obstructive Sleep Apnea patient and Dr. Gelb literally changed my life, and maybe even saved it.
Class Act. Cured my TMJ. Wish I could give a higher review. Delivers on his promises.
By far the best doctor in NYC. I highly recommend people see him because TMJ can be solved and linked to so many daily problems!
From the moment I walk into the time I leave, Dr. Gelb and his staff are compassionate, helpful and genuinely interested in making my jaw, and life, better.
His reputation as a leading specialist in this area is well-deserved. I highly recommend his services for these treatments.
I intend to continue my treatment with the Dr and would recommend other migraine/TMJ sufferers to see Dr. Gelb, as finding a good practice is hard to come by.
It has been almost a year since you and your wonderful staff changed my life. By the time you all had reset the order of my bite and removed the pain in my jaw with your night and daytime appliances, my C-PAP machine for my “severe” sleep apnea was no longer needed and my sleep became quiet again. After I graduated from your excellent care, Dr. Barone recommended that I return to spend the night at the Weill Cornell Center for Sleep to get the definitive read on how well your reconstructive work had mastered my serious sleep apnea. In layman’s terms, the score for quality of my breathing while sleeping was something like a “1” and was the lowest score the Center had ever seen. I forwarded that report to you at that time. I do not expect to ever return to my C-PAP machine. Your and all your staff are truly masters of your craft!! I would recommend you heartily to anyone who has jaw, bite, or sleep apnea issues. You are the best in the business!
Best hands down… They care about your total well-being! Highly recommend the Gelb Center if you are suffering from TMJ or sleep apnea!
Dr. Michael Gelb is one of the movers and shakers in the field of research and developmen