{"title":"用于阻塞性睡眠呼吸暂停的新型下颌推进装置的研制：通过有限元研究分析力分布和变形。","authors":"Supanigar Ruangsri, Kittipit Srisanoi, Chanissara Thanachaisakul, Pincha Santivivattanaphong, Yotsakorn Pratumwal, Poonsak Pisek","doi":"10.1111/joor.14029","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is a sleep-related breathing disorder involving repeated airway collapse during sleep. Mandibular advancement devices (MADs) serve as an effective alternative treatment for treating mild to moderate OSA, yet many commercially available devices remain unaffordable.</p><p><strong>Objectives: </strong>The study aimed to: (1) survey clinicians' and patients' preferences for MAD characteristics, (2) design a novel MAD (KKU-MAD) accordingly, and (3) analyse stress distribution and deformation in the MAD under four simulated scenarios.</p><p><strong>Methods: </strong>Preferences were gathered from dental sleep clinicians and OSA patients via survey. A 3D skull model was constructed from dental CBCT data. KKU-MAD, fabricated from polymethyl methacrylate (PMMA), underwent finite element analysis (FEA) in scenarios involving mandibular protrusion, protrusion with clenching, protrusion with lateral grinding at 50% and 100% protrusion under maximal contraction of relevant muscles.</p><p><strong>Results: </strong>Survey results indicated clinicians preferred custom-made, duobloc, and titratable MADs, while patients prioritised comfort and affordability. FEA revealed consistent von Mises stress concentration at the medial aspect of the lateral fins and anterior corners of the protrusive buttons, peaking during lateral grinding (77.40 MPa) at 100% protrusion. Lower stress levels were recorded during protrusive clenching (61.62 MPa) and protrusion alone (49.46 MPa), with stress reductions of over 50% at 50% protrusion. Deformation was greatest at the lower anterior aspect of the mandibular splint during lateral grinding at 100% protrusion (0.68 mm). Despite elevated stress during complex movements, all values were below PMMA's tensile strength.</p><p><strong>Conclusions: </strong>KKU-MAD exhibits favourable biomechanical resilience against clenching and grinding, though further studies on effects to teeth, alveolar bone and temporomandibular joint are necessary before clinical trials in OSA patients.</p>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Development of Novel Mandibular Advancement Device for Obstructive Sleep Apnea: Analysing Force Distribution and Deformation Through Finite Element Study.\",\"authors\":\"Supanigar Ruangsri, Kittipit Srisanoi, Chanissara Thanachaisakul, Pincha Santivivattanaphong, Yotsakorn Pratumwal, Poonsak Pisek\",\"doi\":\"10.1111/joor.14029\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is a sleep-related breathing disorder involving repeated airway collapse during sleep. Mandibular advancement devices (MADs) serve as an effective alternative treatment for treating mild to moderate OSA, yet many commercially available devices remain unaffordable.</p><p><strong>Objectives: </strong>The study aimed to: (1) survey clinicians' and patients' preferences for MAD characteristics, (2) design a novel MAD (KKU-MAD) accordingly, and (3) analyse stress distribution and deformation in the MAD under four simulated scenarios.</p><p><strong>Methods: </strong>Preferences were gathered from dental sleep clinicians and OSA patients via survey. A 3D skull model was constructed from dental CBCT data. KKU-MAD, fabricated from polymethyl methacrylate (PMMA), underwent finite element analysis (FEA) in scenarios involving mandibular protrusion, protrusion with clenching, protrusion with lateral grinding at 50% and 100% protrusion under maximal contraction of relevant muscles.</p><p><strong>Results: </strong>Survey results indicated clinicians preferred custom-made, duobloc, and titratable MADs, while patients prioritised comfort and affordability. FEA revealed consistent von Mises stress concentration at the medial aspect of the lateral fins and anterior corners of the protrusive buttons, peaking during lateral grinding (77.40 MPa) at 100% protrusion. Lower stress levels were recorded during protrusive clenching (61.62 MPa) and protrusion alone (49.46 MPa), with stress reductions of over 50% at 50% protrusion. Deformation was greatest at the lower anterior aspect of the mandibular splint during lateral grinding at 100% protrusion (0.68 mm). Despite elevated stress during complex movements, all values were below PMMA's tensile strength.</p><p><strong>Conclusions: </strong>KKU-MAD exhibits favourable biomechanical resilience against clenching and grinding, though further studies on effects to teeth, alveolar bone and temporomandibular joint are necessary before clinical trials in OSA patients.</p>\",\"PeriodicalId\":16605,\"journal\":{\"name\":\"Journal of oral rehabilitation\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-05-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of oral rehabilitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/joor.14029\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of oral rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/joor.14029","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
Development of Novel Mandibular Advancement Device for Obstructive Sleep Apnea: Analysing Force Distribution and Deformation Through Finite Element Study.
Background: Obstructive sleep apnea (OSA) is a sleep-related breathing disorder involving repeated airway collapse during sleep. Mandibular advancement devices (MADs) serve as an effective alternative treatment for treating mild to moderate OSA, yet many commercially available devices remain unaffordable.
Objectives: The study aimed to: (1) survey clinicians' and patients' preferences for MAD characteristics, (2) design a novel MAD (KKU-MAD) accordingly, and (3) analyse stress distribution and deformation in the MAD under four simulated scenarios.
Methods: Preferences were gathered from dental sleep clinicians and OSA patients via survey. A 3D skull model was constructed from dental CBCT data. KKU-MAD, fabricated from polymethyl methacrylate (PMMA), underwent finite element analysis (FEA) in scenarios involving mandibular protrusion, protrusion with clenching, protrusion with lateral grinding at 50% and 100% protrusion under maximal contraction of relevant muscles.
Results: Survey results indicated clinicians preferred custom-made, duobloc, and titratable MADs, while patients prioritised comfort and affordability. FEA revealed consistent von Mises stress concentration at the medial aspect of the lateral fins and anterior corners of the protrusive buttons, peaking during lateral grinding (77.40 MPa) at 100% protrusion. Lower stress levels were recorded during protrusive clenching (61.62 MPa) and protrusion alone (49.46 MPa), with stress reductions of over 50% at 50% protrusion. Deformation was greatest at the lower anterior aspect of the mandibular splint during lateral grinding at 100% protrusion (0.68 mm). Despite elevated stress during complex movements, all values were below PMMA's tensile strength.
Conclusions: KKU-MAD exhibits favourable biomechanical resilience against clenching and grinding, though further studies on effects to teeth, alveolar bone and temporomandibular joint are necessary before clinical trials in OSA patients.
期刊介绍：
Journal of Oral Rehabilitation aims to be the most prestigious journal of dental research within all aspects of oral rehabilitation and applied oral physiology. It covers all diagnostic and clinical management aspects necessary to re-establish a subjective and objective harmonious oral function.
Oral rehabilitation may become necessary as a result of developmental or acquired disturbances in the orofacial region, orofacial traumas, or a variety of dental and oral diseases (primarily dental caries and periodontal diseases) and orofacial pain conditions. As such, oral rehabilitation in the twenty-first century is a matter of skilful diagnosis and minimal, appropriate intervention, the nature of which is intimately linked to a profound knowledge of oral physiology, oral biology, and dental and oral pathology.
The scientific content of the journal therefore strives to reflect the best of evidence-based clinical dentistry. Modern clinical management should be based on solid scientific evidence gathered about diagnostic procedures and the properties and efficacy of the chosen intervention (e.g. material science, biological, toxicological, pharmacological or psychological aspects). The content of the journal also reflects documentation of the possible side-effects of rehabilitation, and includes prognostic perspectives of the treatment modalities chosen.
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