A Procedure for Analyzing Mandible Roto-Translation Induced by Mandibular Advancement Devices

Abstract

Background: Sleep-Related Breathing Disorders are characterized by repeated episodes of complete or partial obstruction of the upper airway during sleep. Mandibular advancement devices represent a non-invasive treatment in reducing the number of respiratory events and in decreasing symptoms. The advancement extent of these devices is responsible for the mandibular roto-translation and its effects on the temporomandibular joint. Methods: This study defined a systematic method to assess the mandible roto translation that is caused by MADs according to a scan-to-CAD approach. Starting from a closed mouth position and simulating the oral appliance at different settings it was possible to define a local reference system that is useful for the evaluation of the mandibular roto-translation. This latter was then applied to evaluate the movements of the condyle and the mandibular dental arch. Results: MAD1 resulted in a reduced mouth opening and protrusion, while MAD2 enabled a higher degree of motion of the mandible useful for patients who need an important protrusion. Conclusions: The two devices present different dynamics. Results that are achievable employing this method can be directly used by practitioners in comparing MADs, as well as by researchers in evaluating MADs effects.

Resolution of a Severe Grade of Obstructive Sleep Apnea Syndrome with Mandibular Advancement Device: A Case Report

“…This study wants to show that the effectiveness of the therapy with OA should be compared with the use of CPAP, at the moment considerate the gold standard therapy. Moreover Marklund et al suggest that mandibular advancement devices show a lower efficiency on severe cases with respect to the milder and the reason is unknow, maybe because patients with severe OSAS have large obstruction from the soft palate to the tongue base or epiglottis than patients with mild OSAS [9][10][11][12][13]. This study shows a resolution of a severe case of OSAS with oral device.…”

"Comparison of Two Mandibular Advancement Devices in the Treatment of Obstructive Sleep Apnea: The Effect of the Vertical Mouth Opening"

“…For that, it could be better in patients with deep vertical overbite, the use devices whose design opens less the vertical dimension. Moreover, the degree of vertical mouth opening may also affect the device efficacy [10,26,27]. Excessive increase of the vertical dimension may induce posterior rotation of the mandible compressing the upper airway and worsening the treatment outcomes.…”

A Multicenter Prospective Study on the Use of a Mandibular Advancement Device in the Treatment of Obstructive Sleep Apnea

“…One explanation could be the differences in the vertical mouth opening. Several studies have observed that increasing the vertical mouth opening may reduce the MAD efficacy [13,36,37]. The increase in the vertical mouth opening would induce a mandibular rotation in a posterior direction and would reduce the upper airway space.…”