Antero-posterior mandibular position at different vertical levels for mandibular advancing device design

Area of Science:

• Dental Science
• Sleep Medicine
• Biomechanical Engineering

Background:

• Mandibular Advancement Devices (MAD) offer an alternative to CPAP for moderate to severe obstructive sleep apnea (OSA).
• MAD design significantly influences treatment efficacy, patient tolerance, and compliance.

Purpose of the Study:

• To investigate the range of mandibular protrusion at varying vertical opening distances (2, 5, 8, 11 mm).
• To assess the impact of vertical dimension on the effectiveness of mandibular advancement in young adults.

Main Methods:

• Fifty-two young adults (19-23 years) with full dentition participated.
• Maximal mandibular protrusion and retrusion were measured using the George Gauge.
• Data were analyzed using descriptive statistics, ANOVA, and paired t-tests.

Main Results:

• Mean mandibular advancement decreased as vertical opening increased: 13.10 mm at 2 mm, 11.98 mm at 5 mm, 11.20 mm at 8 mm, and 9.87 mm at 11 mm.
• A significant reduction in mandibular protrusion was observed with increased vertical dimension.
• No significant differences in protrusion were found across different molar classes (I, II, III).

Conclusions:

• Increased inter-incisal distance negatively impacts effective mandibular protrusion for MAD construction.
• For every 1 mm increase in vertical dimension, mandibular advancement reduces by approximately 0.3 mm due to posterior mandibular rotation.