Custom built devices or mandibular advancement devices can be made on patients who have no teeth in the Aboriginal, or maxilla. But lower jaws or mandibles must have at least a couple of implants, or a couple of good solid teeth. We utilize a special technique to duplicate your existing upper denture, then we use that to take your impression and your bite. That then goes to the lab to be used in the fabrication of your custom device. If you have no teeth at all, no implants, then you are not a candidate for a custom MRD. You may be a candidate for a tongue stabilizing device.