MAMA-Mandibular Advancement Magnetic Appliance: A Digital Workflow and a CAD-CAM Development of a New Mandibular Advancement Device for the Treatment of Obstructive Sleep Apnea Syndrome.

Mandibular advancing devices (MADs) are removable intraoral apparatuses to use during sleep that modify the spatial position of the mandible, increasing airway patency and improving respiratory function at night in patients with obstructive sleep apnea syndrome (OSAS). In this work, a new mandibular advancement device useful for mild-to-moderate OSAS patients is presented. It is developed through a CAD-CAM process and involves a passive propulsion of the mandible thanks to the attraction of rare-earth magnets positioned in the thickness of two thermally molded PET-G devices. The use of a PET-G device compared to traditional resin ones offers several clinical advantages related to the innovative characteristics of this polymer, which allows the fabrication of thinner devices, with high resistance to fluid corrosion, resulting in less bulk inside the oral cavity. The innovative feature of the device proposed by the authors is that mandibular propulsion induced by the attraction of the magnetic jigs is not affected by a patient's mandibular posture during sleep. The original apparatus proposed by the authors determines a mesializing movement of the jaw through a different mechanism to traditional MADs and presents the great advantage of a digital and CAD-CAD workflow that can be developed directly by the clinicians in the practice.