Methodology for evaluating effects of mandibular advancement devices in treating OSAS
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SHORT ORIGINAL PAPER
Methodology for evaluating effects of mandibular advancement devices in treating OSAS Marco Mandolini1 · Manila Caragiuli1 · Daniele Landi1 · Antonio Gracco2 · Giovanni Bruno2 · Alberto De Stefani2 · Alida Mazzoli3 Received: 7 March 2020 / Accepted: 24 September 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Obstructive sleep apnoea syndrome is characterized by an obstruction in the upper airway due to the pharyngeal collapse during sleep. Mandibular advancement devices have gained success and large popularity as a non-invasive treatment for OSAS. Nevertheless, the effects of mandibular advancement devices were poorly investigated in literature. To this aim the paper proposes a procedure to achieve a numerical simulation model useful to assess the stress/strain distribution on the temporomandibular joint and periodontal ligaments caused by the mandibular advancement. The findings suggest that the mandibular roto-translation induced by the MAD provoke high stress on the molars and premolar teeth. Keywords Mandibular advancement device · Temporomandibular joint · Periodontal ligaments · Finite element method · Computer aided design
1 Introduction and literature review Obstructive sleep apnea syndrome (OSAS) is characterized by an obstructed air flow in the upper airway due to the
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Marco Mandolini [email protected] Manila Caragiuli [email protected] Daniele Landi [email protected] Antonio Gracco [email protected] Giovanni Bruno [email protected] Alberto De Stefani [email protected] Alida Mazzoli [email protected]
1
Department of Industrial Engineering and Mathematical Sciences, Università Politecnica delle Marche, Via Brecce Bianche 12, Ancona 60131, Italy
2
Department of Neurosciences, University of Padua, Via Giustiniani 2, Padua 35128, Italy
3
Department of Materials, Environmental Sciences and Urban Planning, Università Politecnica delle Marche, Via Brecce Bianche 12, Ancona 60131, Italy
pharyngeal collapse during sleep. Frequent awakenings, disrupted sleep and daytime sleepiness are some consequences of the disorder. A non-invasive treatment is provided by mandibular advancement devices (MADs) fixed at the dental arches and adjusted to advance the mandible increasing the airway volume. Besides short-term effects associated with the wearing of the device it is interesting to evaluate longterm effects since MAD must be worn for life. Finite element analysis (FEA) has been widely used to evaluate the stress–strain relationship on the temporomandibular joint (TMJ) during jaw movement [4], clenching [11] and mandibular protrusion [10]. FEA allowed to investigate also the role of periodontal ligaments (PDLs) on teeth movement [3, 8] and bone resorption [5]. Poor literature was found about the evaluation of the stress distribution on TMJ and PDL under the advancement of the mandible by means of MADs [1, 2]. However, these studies are only preliminary results which deserve further improvements. The aim of this
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