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A finite element analysis for evaluating mandibular advancement devices.

Manila Caragiuli1, Marco Mandolini1, Daniele Landi2

  • 1Department of Industrial Engineering and Mathematical Sciences, Università Politecnica delle Marche, 60131 Ancona, Italy.

Journal of Biomechanics
|February 27, 2021
PubMed
Summary

Mandibular advancement devices (MADs) treat obstructive sleep apnoea (OSA) by repositioning the jaw. This study models MADs to assess their impact on teeth, finding lateral connections distribute forces more evenly than central ones.

Keywords:
Digital dentistryFinite element methodMandibular advancement deviceObstructive sleep apnea syndromePeriodontal ligament

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Area of Science:

  • Biomedical Engineering
  • Dental Mechanics
  • Sleep Medicine

Background:

  • Obstructive sleep apnoea (OSA) involves upper airway collapse during sleep.
  • Mandibular advancement devices (MADs) are effective OSA treatments, repositioning the mandible to enlarge the airway.
  • Long-term MAD use can cause adverse effects on teeth and periodontal ligaments.

Purpose of the Study:

  • To evaluate the biomechanical effects of MADs on teeth and periodontal ligaments using a finite element model.
  • To analyze how variations in MAD design, force application, and material influence tooth displacement and stress.
  • To compare the load distribution of different MAD connection mechanisms.

Main Methods:

  • Developed a finite element model of the human jaw and teeth.
  • Utilized Reverse Engineering from tomographic images and laser scans of a physical MAD.
  • Simulated MAD forces with varying design parameters (connection mechanism, material, force application point).

Main Results:

  • The finite element model predicted tooth displacement and stress patterns under simulated MAD forces.
  • A central connection mechanism was found to concentrate stress primarily on anterior teeth.
  • A lateral connection mechanism demonstrated a more uniform distribution of mechanical load across the teeth.

Conclusions:

  • MAD design significantly influences biomechanical outcomes on the stomatognathic system.
  • Lateral connection mechanisms in MADs may offer a more favorable load distribution, potentially reducing adverse effects on teeth and periodontal tissues.
  • Finite element modeling is a valuable tool for optimizing MAD design for OSA treatment.