An appliance and methods are described that include embodiments of a mandibular advancement or positioning device which can use elastic bands to pull the jaw forward. The appliance has an upper plastic tray conforming to the patient's upper teeth and including 3D printed sets of retention hooks coupled to the upper plastic tray via being encased in plastic, one on the right and one on the left anterior buccal portion of an upper plastic base. The appliance also has a lower plastic tray conforming to the patient's lower teeth including mandibular dentition, and includes having a 3D printed bite pad which opens the bite vertically. The lower tray also has a set of 3D printed plastic retention hooks encased in plastic extending outwardly from the teeth, one on the right and one on the left of the posterior buccal portion of the lower plastic base. Elastic bands of different lengths and strengths are attached to both the top and bottom retention hooks on both sides of the trays to pull the mandible forward for treatment.