0545 Optimizing Access to Oral Appliances for OSA: Decrease Cost and Increase Availability with 3D Printing

Abstract

Abstract Introduction Mandibular advancement devices (MAD) for obstructive sleep apnea have traditionally been a prohibitive therapy for a large number of patients due to high out-of-pocket expense and access to dentistry. This study examined if an increasingly more accessible and user-friendly technology, 3D printing, may provide a cost-effective in-office workflow to increase access to MAD use. Methods Available pricing data was sourced via PubMed articles searching keywords “oral appliance”, “sleep apnea”, “mad” and “cost”. Additional price point data was compiled from publicly available information from the largest dental insurance provider in the United States, Delta Dental. Computer Aided Design (CAD) software Fusion360 was used to prototype a MAD and Stereolithography (SLA) printing using FormLab’s 3B+ printer was performed by a University-run 3D printing lab. Results Traditional cost per MAD ranges from 400USD – 2,450USD with a mean of 933USD (based on the only available 1997 pricing data). The total cost of the one-off MAD used in this study was 150USD (consumable cost of 2.66USD, labor cost of 147.34USD). This excluded the one-time 3D printer cost of 3,750USD. At 1 device printed per day over 1 year, total cost per printed device would be estimated at $22, which is 5% of the traditional cost of MAD. Total print time is estimated at 54 minutes, post processing time is estimated at 25 minutes, with a total MAD delivery to patient time of 1.3 hours. Conclusion Point-of-care 3D printed oral appliances are a feasible and inexpensive workflow to expand the use of MADs in the treatment of mild to moderate sleep apnea. Multiple barriers remain in integrating this workflow into patient care, including integration with dentistry. Support (if any)