Biomechanical analysis of a mandibular advancement device (MAD) with various implant placements in complete edentulous patients

Patients with obstructive sleep apnea (OSA) mainly prefer non-surgical treatments such as behavior modification, continuous positive airway pressure (CPAP), and oral appliance therapy, for long-term treatment. A mandibular advancement device (MAD), which is applied orally, is generally recommended for patients that do not respond to CPAP. Most OSA patients are partial dentures or edentulous. Completely edentulous patients have a MAD retained by implants. However, studies on the biomechanical analysis of edentulous patients with a MAD on implant site are scarce. Hence, this study analyzes the stability of a MAD with various implant placements. Based on the finite element analysis results, we derive optimal conditions in implant placements. Furthermore, we computationally analyze the von Mises stress fields on the implant and minimum principal stress on cancellous bone. The results show that the MAD had enhanced stability with four implants in each maxilla and mandible.