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

IF 8.1 1区医学 Q1 ENGINEERING, BIOMEDICAL

Bio-Design and Manufacturing Pub Date : 2024-08-27 DOI:10.1007/s42242-024-00288-0

Juan A. Cabrera, Alex Bataller, Sergio Postigo, Marcos García

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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.

Graphic abstract

Abstract Image

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下颌前突装置（MAD）的运动学：为什么有些下颌前突矫正器在张口时会向后移动下颌？

下颌前突矫正器（MAD）是一种广泛用于治疗阻塞性睡眠呼吸暂停的方法。下颌前突矫正器的功能是推进下颌以打开上气道。为了提高患者的舒适度，大多数患者都允许张开嘴巴。然而，并非所有的系统都能在张口时将下颌保持在向前的位置，这就导致了后缩，从而有利于上气道的塌陷。此外，由下颌骨-装置组件形成的机制的运动行为取决于下颌骨的形态。这意味着，在张口过程中，有些装置会导致某些患者的下颌骨前突，而另一些患者则会导致下颌骨后缩。在这项研究中，我们报告了目前市场上知名装置的行为。为此，我们开发了下颌装置组件的运动学模型。使用高分辨率摄像系统对所有分析过的装置进行了验证。我们的结果表明，这里分析的一些装置在患者张口时没有产生正确的行为。

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来源期刊

Bio-Design and Manufacturing Materials Science-Materials Science (miscellaneous)

CiteScore

13.30

自引率

7.60%

发文量

148

期刊介绍： Bio-Design and Manufacturing reports new research, new technology and new applications in the field of biomanufacturing, especially 3D bioprinting. Topics of Bio-Design and Manufacturing cover tissue engineering, regenerative medicine, mechanical devices from the perspectives of materials, biology, medicine and mechanical engineering, with a focus on manufacturing science and technology to fulfil the requirement of bio-design.