Craniofacial morphology/phenotypes influence on mandibular range of movement in the design of a mandibular advancement device

Abstract

Background. The mandibular opening path movements have different directions according to the craniofacial morphology of the patient but always downward and backward, therefore increasing the collapse of the upper airway. The aim of this work is to determine if there is a relationship between the craniofacial morphology and the mandibular movement to help understand the impact on the mandibular position. Methods. 52 students with full permanent dentition aged 19 to 23 years (mean 21.3 SD 1.7; 29 females and 23 males), participated in the study. Each subject had a lateral cephalometric radiograph taken. The opening angle was determined for two levels of vertical openings at 5 and 10 mm. Results. The opening angle showed a greater variability between subjects ranging from 63,15 to 77,08 for 5 mm angle and from for 61,65 to 75,72 for the 10 mm angle. Differences of facial phenotypes was evident when comparing the individual dissoccluding angle of the low angle horizontal pattern and high angle vertical pattern. Conclusions. The opening angle is related to craniofacial morphology with higher vertical anterior and shorter anteroposterior faces having a more horizontal path of mandibular movement than shorter vertical anterior and longer anteroposterior subjects who have a more vertical path.

Role of craniofacial phenotypes in the response to oral appliance therapy for obstructive sleep apnea

“…A recent study shows that craniofacial phenotypes influence the mandibular range of movement in the design of a mandibular advancement device. 24 In our latest study, we systematically investigated the change of MAD treatment efficacy along with gradually increased mandibular protrusion 25 and noticed that the inter-individual response curve varies greatly. We hypothesize that the craniofacial features, especially the vertical facial pattern may play a role in the different reactions to mandibular protrusion.…”

“…Meta‐analysis showed that OSA patients tend to have clockwise rotated mandible and high mandibular plane angle, 20–23 which is an important risk factor in the development of OSA and may in return affect the upper airway dilation when the mandible moves forward. A recent study shows that craniofacial phenotypes influence the mandibular range of movement in the design of a mandibular advancement device 24 …”

Diseño de un dispositivo intraoral para el tratamiento de la apnea obstructiva del sueño con levas optimizadas para adaptarse a la cinemática de la mandíbula del paciente mediante algoritmos evolutivos

“…Los sistemas de unión entre las dos piezas más extendidos son barras y levas (ver Figura 1). Diversos estudios demuestran la relación entra la morfología craneofacial y el nivel de retrusión de la mandíbula al abrir la boca [4], [5]. Por lo tanto, la efectividad de un mismo DAM dependerá de la morfología de cada individuo.…”