This appliance consists of two occlusal splints held together by a bilateral Herbst tube assembly. This set-up allows the mandible to positively be postured forward. Posturing the mandible forward brings the tongue anteriorly to open up the airway. This unique design allows the mandible to move freely in both a vertical and a lateral direction while at the same time preventing the mandible from dropping back during sleep. Because the Herbst tubes are placed buccally to the teeth, there is nothing to interfere with the patient’s tongue position and patients find this design extremely comfortable. Users of this appliance typically provide a construction bite taken with the mandible positioned 75% of the way from maximum intercuspation to maximum protrusive with a 4mm vertical opening in the anteriors. This appliance can also be titrated forward from its initial position by adding shims in 1mm, 2mm, and 3mm increments. The occlusal surfaces of the upper and lower portions of this appliance are carefully milled into full contact. Vertical elastics are used in the cuspid region to create a proprioceptive response that encourages a lip together posture. Maximum retention is achieved through multiple ball clasps on both the upper and the lower portions of the appliance.