Development of a fully digital design process for customized mandibular advancement and its precision additive manufacturing

This study aims to develop a fully digital workflow for the fabrication of customized mandibular advancement devices (MAD). MADs are used to treat obstructive sleep apnea and typically require 8–10 days to fabricate as per the patient's specifications. The currently designed digital methodology considerably shortens this timescale to 2–3 days, providing a viable alternative to traditional methods. The process integrates digital intraoral scanning, computer-aided modeling, and additive manufacturing using DD guide material through digital light processing technology. Along with the integration, the workflow also optimizes scanning accuracy, printing orientation, precision, and usability. The precision of fabrication was examined by scanning the fabricated part with the stereolithography file. The root mean square value of 0.0287 mm indicates that the fabricated device is within the clinical accuracy and thus can be used for mandibular advancement. Furthermore, the analysis indicates that printing orientations of 0° and 45° deliver higher precision and surface quality, with the 45° proving to be most cost-effective for grinding and post-processing. The post-processing greatly reduced the surface roughness thereby increasing the comfortability and hygiene. The durability of the fabricated MADs was proved through the unaffected mechanical properties even after washing >1000 times (equivalent to 3 years). Contributing to the wider adoption of digital procedures in dental clinics and coinciding with current market trends toward patient-specific solutions, this study highlights the viability of an efficient, adaptable, and hygienic digital workflow for MADs.