FEM simulation of a novel medical device for TMJ therapy
Authors: Kwieciński K. , Żmudzki J. , Chladek G. , Popielski P. , Kowalczyk M. , Duraj E. , Sołtysiak-Niedziela M. 
Published: September 2023

Temporomandibular disorders (TMD) are one of the leading health problems in dentistry. The work aimed to evaluate, using FEM, the influence of the material elastic properties of the flexible obstacle of the tongue trainer on the range of deflection and strength.In prototyping the trainer tongue, the starting point was real models with different extents of the tongue obstacle. moulded from dental wax on a dental stone model. Then versions were tested intraorally for the perception of the space occupied by the tongue. The models were scanned on a 3D scanner, and then a parametric CAD model (NX Siemens) was made on their basis. Finally, in order to take into account, the anatomical aspects, the two extreme ranges of the tongue obstacle, named "Long " and " Short ", were developed. Simulation deflection and material strength tests were made using FEM in the linear range (NX Siemens). Calculations were made for materials with Young's modulus equal to 8 MPa, 80 MPa and 800 MPa. The interaction of the tongue with the force of 5N was assumed. The support was provided by the retention surface on the teeth, with the support of the posterior edge of the obstacle on the palate (palatal variant) or lack of support, i.e., the obstacle freely bending in this area (free variant), was additionally tested. In order to assess the drop or retention of the trainer on the teeth, the second type of simulation was performed with the assumption of horizontal (anteriorly directed) tongue pressure with the force of 10N for the condition of rigid support in the area of the teeth and the periodontal zone from the lingual side. In this variant, a simulation was adopted for a material with a modulus of elasticity E=80 MPa.The stress values of the flexible obstacle of the trainer were obtained, allowing for the selection of potentially valuable materials for the trainer's construction. The results obtained in the simulations indicate the possibility of using ethylene vinyl acetate (EVA) and its blends. The accumulation of saliva inside the sealed obstacle was found, which indicated the need to look for an area to perforate without losing the load capacity of the obstacle. The structural feasibility of solving the problem of saliva accumulation without a significant change in the load capacity and stiffness of the obstacle was confirmed by simulation.Simplifying the model to a linear range does not allow buckling analysis. In addition, the assumption of a linear material further limits the possibility of analysing materials with softening and plateau characteristics, where the compliance of the structure leads to elastic buckling.The range of deflections and stresses for different stiffness of the elastic element of the trainer was determined in order to select the appropriate material for the medical device (MD). Polyurethanes or silicones provide the range of deflection and strength, but in the case of manufacturing prefabricated trainers thermoformed in the patient's mouth (maximum temperature 75C), the material that can be used is ethylene vinyl acetate (EVA).Simulation tests made it possible to determine the range of deflections and stress for different stiffness of the flexible obstacle of the trainer in order to select the appropriate material for the medical device.