A Numerical Simulation Approach to Study the Effects of MADs Embedded with Elastic Bands in OSA Treatment

Obstructive Sleep Apnea (OSA) is a nocturnal respiratory disorder characterised by recurrent episodes of partial or total obstruction of the upper airways due to the collapse of the pharyngeal tissue. Mandibular Advancement Devices (MADs) restore regular breathing during sleep by advancing the lower jaw in a controlled way to increase the upper airway volume. However, the relaxation of muscle tone that naturally occurs during sleep induces a vertical mouth opening that impairs the efficacy of the treatment. Thus, elastic bands are recommended to keep the mouth firmly closed. Despite successfully treating OSA, inadequate evidence exists about the effects of MADs supported by elastic bands on teeth and Periodontal Ligaments (PDLs). This study aims to develop a numerical simulation approach through the finite element method to evaluate the behaviour and the effects (displacement and stress fields) of MADs embedded with intermaxillary elastics on PDLs and teeth of patients suffering from OSA. Findings confirm the efficacy of elastics in controlling the mouth opening and reveal a stress increase at the anchorage regions. Thus, their use should be advised to patients who do not suffer from periodontal problems in the anterior region of the mouth.