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Performance of Mandibular Advancement Devices When Opening the Mouth
Juan A Cabrera1, Alex Bataller2, Pedro Mayoral3
1Department of Mechanical Engineering, University of Málaga, 29071, Málaga, Spain. jcabrera@uma.es.
Annals of Biomedical Engineering
|June 10, 2026
Summary
Mandibular advancement devices (MADs) vary in effectiveness when opening the mouth. Bar-based devices are generally better than fin-based ones, but patient anatomy also plays a crucial role.
Area of Science:
- Biomedical Engineering
- Orthodontics
- Dental Sleep Medicine
Background:
- Mandibular advancement devices (MADs) are crucial for treating obstructive sleep apnea.
- Understanding MAD kinematics during mouth opening is essential for optimizing treatment efficacy.
- Existing research often overlooks the interplay between device design and patient-specific morphology.
Purpose of the Study:
- To evaluate the kinematic behavior of various MADs during mouth opening.
- To analyze how different coupling systems and patient morphology influence MAD performance.
- To provide insights for improved MAD design and patient selection.
Main Methods:
- Studied seven common MADs with diverse coupling mechanisms in 21 patients.
- Utilized validated mathematical MAD models for simulation.
- Simulated lower incisor and chin (apophysis geni) trajectories during mouth opening.
Main Results:
- All MADs maintained mandibular advancement with the mouth closed.
- Significant kinematic variations occurred upon mouth opening.
- Bar-based MADs were more effective than fin-based devices, influenced by bar length and joint position.
- Fin-based devices tended to cause mandibular retrusion during mouth opening.
- Patient facial biotypes influenced mandibular movement patterns.
Conclusions:
- MAD effectiveness is device-specific and cannot be generalized across all models.
- Both the MAD coupling system and patient morphology are critical factors for maintaining mandibular advancement.
- Future MAD designs should incorporate patient-specific anatomical considerations for optimal performance.
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