Cam synthesis applied to the design of a customized mandibular advancement device for the treatment of obstructive sleep apnea

Mandibular Advancement Devices (MAD) have proved to be effective in the treatment of slight to moderate Obstructive Sleep Apnea (OSA). These devices open the upper airways by keeping the jaw forward with respect to its resting position. To date, none of the available devices have taken into account the kinematic behavior of each patient's mandible. This work presents a customized MAD for the treatment of OSA. A study of the mandible kinematics is carried out to determine the relationship between mouth opening and mandible advancement. The device includes two cams, one on each side, to make the mandible move forward. The cam profile is designed using a Bezier cubic curve that is optimized by means of an evolutionary algorithm. The kinematics of each patient's mandible is taken into account to ensure that the jaw does not move backwards at any time while opening the mouth. A real case study is presented to validate the proposed methodology. (C) 2018 Elsevier Ltd. All rights reserved.