A Novel Mandibular Advancement Device for Treatment of Sleep-Disordered Breathing: Evaluation of Its Biomechanical Effects Using Finite Element Analysis

Abstract

Stress or pressure induced by the use of a mandibular advancement device (MAD) to treat sleep-disordered breathing can cause side effects including occlusal changes, pain, and discomfort. In this paper, we describe and use finite element (FE) analysis to evaluate a novel MAD that can reduce the stress and side effects associated with these devices. The MAD includes a protruding part that enables rostral movement of the lower tray, providing a wider upper airway and a supporting shield that helps uniformly distribute the concentrated stress. After assembling the three-dimensional model for the MAD and the upper oral structures, a designated force was applied to evaluate the stress distributions of a conventional MAD and the proposed design. FE analysis showed that the stress applied to the upper front teeth and the gingival area near the upper incisors differed between the newly developed and conventional MAD. Concentrated stress was relieved by inserting such a shield, helping to distribute the stress from the front teeth to the gingival area. Our proposed MAD reduced the concentrated stress on the front teeth by distributing it over the gingival area.

Computational Biomechanics of Sleep: A Systematic Mapping Review

“…By studying the biomechanics of the upper airway, researchers were able to gain a better understanding of the source of the collapse and devise effective measures. Barbero et al [ 24 ] evaluated how the positioning of a mandibular advancement device could better improve the upper airway volume and inspiratory pressure gradient, whereas Yoon et al [ 25 ] and Zhiguo et al [ 26 ] aimed to quantify the abnormal stress and thus adverse effects of mandibular advancement devices on teeth and periodontal ligaments and pave the way for better design.…”