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Bio-Design and Manufacturing  2024 Vol.7 No.5 P.637-650

http://doi.org/10.1007/s42242-024-00288-0


Kinematics of mandibular advancement devices (MADs) Why do some MADs move the lower jaw backward during mouth opening?


Author(s):  Juan A. Cabrera, Alex Bataller, Sergio Postigo, Marcos García

Affiliation(s):  Mechanical Engineering Department, University of Malaga, 29071 Malaga, Spain.

Corresponding email(s):   jcabrera@uma.es

Key Words:  Mandibular advancement devices, lower jaw kinematics, sleep apnea


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Juan A. Cabrera; Alex Bataller; Sergio Postigo; Marcos García. Kinematics of mandibular advancement devices (MADs) Why do some MADs move the lower jaw backward during mouth opening?[J]. Journal of Zhejiang University Science D, 2024, 7(5): 637-650.

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Abstract: 
mandibular advancement devices (MADs) are widely used treatments for obstructive sleep apnea. MADs function by advancing the lower jaw to open the upper airway. To increase patient comfort, most patients allow the mouth to be opened. However, not all systems maintain the lower jaw in a forward position during mouth opening, which results in the production of a retrusion that favors the collapse of the upper airway. Furthermore, the kinematic behavior of the mechanism formed by the mandible-device assembly depends on jaw morphology. This means that, during mouth opening, some devices cause lower jaw protrusion in some patients, but cause its retraction in others. In this study, we report the behavior of well-known devices currently on the market. To do so, we developed a kinematic model of the lower jaw device assembly. This model was validated for all devices analyzed using a high-resolution camera system. Our results show that some of the devices analyzed here did not produce the correct behavior during patient mouth opening.

西班牙马拉加大学Juan A. Cabrera等 | 下颌前伸矫治器运动学研究:为何部分下颌前伸矫治器在张嘴时导致下颌后移?

本研究论文聚焦下颌前伸矫治器运动学研究。下颌前伸矫治器(MADs)是广泛使用的治疗阻塞性睡眠呼吸暂停的方法。MADs通过前伸下颌来打开上气道。为了提高患者的舒适度,大多数患者可以张开嘴巴。然而,并非所有装置在张口时都能保持下颌的前移位置,这导致下颌后缩,从而增加上气道塌陷的风险。此外,下颌-装置组合构成的机制的运动行为取决于下颌形态。这意味着在嘴巴张开时,一些装置会导致部分患者下颌前突,而导致另一部分患者下颌后缩。本文报告了目前市场上已知装置的运动行为。为此,作者开发了一个下颌装置组合的运动学模型。该模型通过高分辨率摄像系统对所有分析的装置进行了验证。结果表明,本文分析的一些装置在患者嘴巴张开时并未产生正确的运动行为。

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