Department of Industrial Engineering and Mathematical Sciences, Università Politecnica delle Marche, 60131 Ancona, Italy.
Department of Management, Information and Production Engineering, University of Bergamo, 24044 Dalmine (BG), Italy.
J Biomech. 2021 Apr 15;119:110298. doi: 10.1016/j.jbiomech.2021.110298. Epub 2021 Feb 4.
Obstructive sleep apnoea (OSA) is a disorder characterised by complete or partial occlusion of the upper airway during sleep. Muscles relax during sleeping and collapse into the airway, closing the throat and prohibiting air flowing into the lungs. Different solutions have been adopted to manage the pathology to improve the life quality of affected patients. Mandibular advancement devices (MADs) are proven to be a compliant and successful therapy in the forward repositioning of the mandible to increase the upper airway volume. However, this method has some long-term adverse events that may affect the teeth and periodontal ligaments. This paper presents a finite element model to evaluate the MADs effects (displacement and stress) on teeth and periodontal ligaments, by varying the design, the point of application of the force and the material. The modelled bodies have been reconstructed through a Reverse Engineering approach and computer-aided design tools starting from tomographic images of anatomic bodies and from laser scans of a physical MAD. The results suggest that a central connection mechanism could affect mostly the anterior teeth. In contrast, a lateral connection mechanism provides a more uniform distribution of the load on teeth.
阻塞性睡眠呼吸暂停（OSA）是一种以睡眠期间上气道完全或部分阻塞为特征的疾病。在睡眠过程中，肌肉放松并塌陷到气道中，关闭喉咙并阻止空气流入肺部。已经采用了不同的解决方案来治疗这种病理情况，以提高受影响患者的生活质量。下颌前伸装置（MADs）被证明是一种顺应性和成功的治疗方法，可通过将下颌向前重新定位来增加上气道容积。然而，这种方法有一些长期的不良事件，可能会影响牙齿和牙周韧带。本文通过有限元模型，通过改变设计、力的作用点和材料，来评估 MADs 对牙齿和牙周韧带的影响（位移和应力）。通过对解剖体的断层图像和物理 MAD 的激光扫描进行逆向工程和计算机辅助设计工具，对建模体进行了重建。结果表明，中央连接机制可能主要影响前牙。相比之下，侧向连接机制可以更均匀地分布牙齿上的负载。
