Myobrace and Nighttime Wear: What Do Studies Tell Us About Adaptation to Removable Orthodontic Appliances?
Research on Myobrace provides useful insight into how patients adapt to nighttime oral appliances — and raises relevant questions for clear aligners, SyncSplint® and the Jaw By Jaw™ concept.
With removable orthodontic appliances, treatment planning is only one part of the equation. The other is whether the patient can actually adapt to the appliance and wear it consistently. Research involving Myobrace® is particularly interesting because the system uses a removable intraoral appliance that engages both dental arches and is commonly prescribed for nighttime wear.
Why Is Myobrace Relevant When Discussing Appliance Adaptation?
Myobrace is a prefabricated myofunctional orthodontic appliance. Depending on the treatment protocol, patients may be instructed to use it for a period during the day and throughout the night.
This makes Myobrace useful when studying how patients adapt to a removable appliance that occupies space between the upper and lower dental arches during sleep.
From a patient-experience perspective, this creates some practical points of comparison with SyncSplint®. Both involve an intraoral appliance engaging the relationship between the upper and lower arches, and nighttime use may form part of the prescribed wearing protocol.
Important distinction: Myobrace and SyncSplint® are not the same type of appliance. They differ in design, clinical purpose, treatment philosophy, and biomechanics.
Myobrace research can therefore provide comparative information about adaptation to nighttime intraoral appliances, but it does not provide direct clinical evidence for SyncSplint®.
What Do the Studies Show?
Experienced early appliance detachment
In one study, 12 of 30 children experienced Myobrace detachment during sleep within the first two weeks.
Adaptation period
In a randomized clinical trial, the authors reported that most children required approximately two months to achieve the required daily wear time.
Did not complete the protocol
In a study of 75 children, nine did not perform the exercises or wear Myobrace and were lost to follow-up.
40% Experienced Appliance Detachment During the First Two Weeks of Sleep
A retrospective study evaluated 30 children treated with Myobrace for anterior crossbite in the early mixed dentition.
The prescribed protocol included two hours of daytime wear, daily myofunctional exercises, and nighttime appliance use.
According to the study, 12 of 30 children, or 40%, experienced appliance detachment during sleep within the first two weeks.
Importantly, the authors reported that the incidence of the appliance falling out during sleep gradually decreased over time and eventually stopped.
This distinction matters: 40% early detachment does not mean that 40% failed to adapt. It describes an initial adaptation problem during the first two weeks.
The publication's compliance table records nighttime wear for all 30 participants. The discussion section, however, separately refers to 93.3% full-duration nighttime wear. Because of this internal inconsistency, the study should not be used to claim a universal 100% nighttime adaptation rate.
Most Children Required About Two Months to Reach the Required Wear Time
In this randomized clinical trial, 26 children aged 9–12 years with developing skeletal Class II were allocated to either Myobrace or Twin-block treatment, with 13 patients in each group.
Myobrace use was introduced gradually. During the first week, wearing time increased progressively. Beginning in the second week, patients were instructed to wear the appliance overnight for at least eight hours.
By the end of the first four weeks, the prescribed protocol included at least one to two hours of daytime wear plus overnight use.
The authors specifically noted that most children required approximately two months to adapt to Myobrace and achieve the required daily wear time.
This is particularly relevant when discussing removable appliances: difficulty during the first days or weeks does not necessarily predict long-term inability to wear the appliance.
All 26 participants in the trial completed the study period. However, completion of the trial should not be interpreted as proof of perfect adherence every night.
Sleep-Related Difficulty Appears to Decrease After the Initial Period
Another study compared 18 patients treated with Myobrace and 18 patients treated with Twin-block.
In addition to cephalometric changes, the investigators examined factors that could influence patient compliance and ease of appliance use.
Patient-reported difficulty associated with nighttime use was greater during the early period and decreased at later follow-up visits.
This does not provide a direct percentage of patients who successfully adapted, but it supports the broader observation that patient experience with a removable functional appliance may improve over time.
Nine of 75 Children Did Not Continue the Myobrace Protocol
This study included 75 children with functional mouth breathing in the myofunctional treatment group.
The children were instructed to wear Myobrace for two hours during the daytime and during sleep, together with prescribed orofacial muscle exercises.
Nine of the 75 children, or 12%, did not perform the muscle training or wear Myobrace and were lost to follow-up.
The remaining 66 children completed the study.
This can be described as approximately 88% remaining in the treatment group, but it should not be interpreted as an 88% nighttime adaptation rate, because the study combined appliance wear and exercise compliance and did not separately quantify successful nighttime adaptation.
What Does the Adaptation Process Look Like?
When the available studies are considered together, a clinically relevant pattern emerges.
The appliance may feel unfamiliar. Patients may experience discomfort, difficulty retaining the appliance, or nighttime displacement.
With repeated use, tolerance may improve and the patient may become more successful at keeping the appliance in place.
For some patients, nighttime appliance wear gradually becomes part of the normal daily routine.
Myobrace and SyncSplint®: Where Is the Comparison Relevant?
For the Jaw By Jaw™ concept, Myobrace research is interesting not because the two appliances are equivalent, but because they raise a similar practical question:
Can a patient adapt to an appliance that engages both dental arches and is used for an extended period during sleep?
| Characteristic | Myobrace | Jaw By Jaw™ / SyncSplint® |
|---|---|---|
| Appliance type | Prefabricated myofunctional appliance | Individually designed component used with clear aligners |
| Arch involvement | Engages the upper and lower dental arches | Engages the relationship between the upper and lower arches |
| Nighttime use | Commonly part of the prescribed protocol | May form part of the individually prescribed protocol |
| Main treatment concept | Myofunctional orthodontics and functional habit correction | Additional support during sequential clear aligner treatment |
| Individual manufacturing | Prefabricated, selected by size | Individually designed for the patient |
| Published adaptation data | Several pediatric studies provide indirect compliance information | Device-specific prospective adaptation studies are needed |
Can Myobrace Adaptation Rates Be Applied Directly to SyncSplint®?
No.
Doing so would go beyond what the available evidence supports.
The Myobrace studies discussed here mainly involve children. The appliances have different designs, treatment objectives, retention characteristics, wearing schedules, and biomechanical purposes.
It would therefore be incorrect to say that because a certain percentage of patients adapt to Myobrace, the same percentage will necessarily adapt to SyncSplint®.
What the literature does support more cautiously is the idea that adaptation to a relatively substantial removable oral appliance used during sleep may improve gradually after an initial accommodation period.
Why This Matters for Clear Aligner Treatment
In clear aligner treatment, patient behavior is an important part of the treatment system.
Digital planning can define the intended tooth movements, but removable appliances only act when they are actually worn.
This makes adaptation, comfort, wear time, and long-term adherence relevant questions in modern orthodontics.
The Myobrace studies illustrate why early patient experience should not be evaluated only as a simple “tolerates / does not tolerate” outcome.
Adaptation may have a time component.
How Should SyncSplint® Adaptation Be Studied?
To determine adaptation specifically for SyncSplint®, prospective device-specific clinical monitoring is needed.
A useful study protocol could record:
- the proportion of patients able to use the appliance on the first night;
- whether the appliance remains in place during sleep;
- adaptation at 7 and 14 days;
- actual daily and nighttime wear duration;
- continued use at 30 and 90 days;
- patient-reported comfort;
- reasons for temporary or permanent discontinuation;
- the relationship between measured wear time and planned orthodontic tooth movement.
Objective wear-time monitoring would be particularly useful, because it could distinguish between perceived comfort, reported compliance, and actual appliance use.
What Is the Practical Message from the Myobrace Studies?
The most useful conclusion is not a single percentage.
The evidence instead suggests that adaptation is a process.
Some patients experience difficulties during the first days or weeks. Some lose the appliance during sleep. Others may require several weeks before reaching the prescribed duration of use.
In many patients, however, these initial difficulties appear to decrease over time.
How Does This Relate to the Jaw By Jaw™ Philosophy?
Jaw By Jaw™ Aligners approaches treatment as more than a sequence of digitally planned tooth movements.
The concept considers the interaction between treatment mechanics, function, anchorage, and patient behavior.
During one stage, one dental arch is actively aligned with clear aligners, while the opposite arch is stabilized and, through SyncSplint®, is intended to contribute additional support.
Once the planned position of the first arch is achieved, the roles are reversed.
One Anchoring Arch.
Then Switch.
Patient adaptation to the appliance is therefore an important question that should be measured independently from the biomechanical objectives of treatment.
Conclusion
Published Myobrace studies do not provide one universal percentage showing how many patients successfully “get used to” the appliance at night.
They do, however, present a consistent clinical picture: nighttime appliance use can be difficult during the initial adaptation period, while tolerance and retention may improve over the following weeks and months.
This makes Myobrace an interesting comparative model when discussing patient adaptation to other removable appliances involving both dental arches, including SyncSplint®.
The actual adaptation rate for SyncSplint®, however, must be established through dedicated prospective clinical data.
Scientific References
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Pham TT, Tran BC,
Pham TTH, et al.
Effectiveness of Myobrace Therapy in Correcting Anterior Crossbite in Early Mixed Dentition: A Retrospective Study.
International Journal of Clinical Pediatric Dentistry. 2025;18(10):1243–1248.
DOI: 10.5005/jp-journals-10005-3281.
PMCID: PMC12592865. -
Madian AM, Elfouly D.
Cephalometric changes in pharyngeal airway dimensions after functional treatment with twin block versus myobrace appliances in developing skeletal Class II patients: a randomized clinical trial.
BMC Oral Health. 2023;23:998.
DOI: 10.1186/s12903-023-03701-9.
PMID: 38093237. -
Büyükbayraktar Z,
Camcı H.
Dentoalveolar, skeletal, pharyngeal airway, cervical posture, hyoid bone position, and soft palate changes with Myobrace and Twin-block: a retrospective study.
BMC Oral Health. 2023;23:53.
PMCID: PMC9887833. -
Habumugisha J,
Cheng B,
Ma SY, et al.
A non-randomized concurrent controlled trial of myofunctional treatment in the mixed dentition children with functional mouth breathing assessed by cephalometric radiographs and study models.
BMC Pediatrics. 2022;22:506.
DOI: 10.1186/s12887-022-03559-w.
PMID: 36008795.