Novel mandibular protraction appliance and digitization-based manufacturing method thereof

Abstract

According to the novel mandibular protraction appliance and the digitization-based manufacturing method thereof, a vestibular shield is arranged on the lip side of the lower anterior teeth of the mandibular protraction appliance, and the appliance can effectively seal the oral cavity and improve the dry mouth symptom possibly occurring when a traditional mandibular protraction appliance is worn; the common mouth breathing problem of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) is solved, and the limitation of lip inclination of lower anterior teeth caused by a traditional mandibular advancement appliance is reduced more remarkably.

Description

Technical Field

[0001] The present invention belongs to the technical field of mandibular advancement appliances, and in particular relates to a novel mandibular advancement appliance and a digital manufacturing method thereof. Background Art

[0002] Obstructive sleep apnea and hypopnea syndrome (OSAHS) is characterized by repeated upper airway obstruction during sleep, causing apnea, hypopnea and sleep disorders, manifested as snoring, hypoxemia and daytime sleepiness, which seriously affects the patient's health and quality of life. At the same time, patients with this disease often also have severe mouth breathing. The use of mandibularadvancement device (MAD) to treat OSAHS is a recognized mature technology with the advantages of being non-invasive, effective and low-cost. Figure 5 As shown in the figure, there are many problems when patients wear traditional mandibular advancement appliances. The first is that they are often accompanied by dry mouth when worn. At the same time, the mouth breathing problem that is often associated with OSAHS patients is difficult to solve. In addition, patients with excessive lip inclination of the lower front teeth are often unable to accept the treatment of the appliance. Summary of the invention

[0003] In order to overcome the deficiencies of the above-mentioned prior art, the purpose of the present invention is to provide a mandibular advancement appliance and a digital manufacturing method thereof, which can not only effectively close the oral cavity, improve the dry mouth symptoms that may occur when wearing a traditional mandibular advancement appliance, and the common mouth breathing problem of patients with obstructive sleep apnea hypopnea syndrome (OSAHS), but also significantly reduce the limitation of the lip inclination of the lower front teeth caused by the traditional mandibular advancement appliance.

[0004] In order to achieve the above object, the technical solution adopted by the present invention is: A method for manufacturing a new mandibular advancement appliance based on digitalization comprises the following steps: Step 1: Digital acquisition of the patient's dentition and mandibular protrusion: Use an intraoral scanner to scan the patient's complete dentition, gums, and lip-cheek frenulum information; the patient's mandible is protruded to the maximum protrusion position, and then retracted to 2 / 3 of the maximum protrusion position. The vertical distance between the upper and lower anterior teeth incisors is opened by 4-5mm. Use an intraoral scanner to record the relationship between the upper and lower jaw dentition at this position; import the acquired patient dentition and mandibular position data into the 3D design software; Step 2: 3D design and printing of the new mandibular advancement appliance: In the 3D design software, a vestibular shield is set on the labial side of the mandibular anterior teeth braces, so that the vestibular shield is separated from the maxillary anterior teeth braces and is only tightly connected to the labial side of the mandibular anterior teeth braces. The vestibular shield is extended in the mesiodistal direction to the posterior teeth connector, and its vertical direction slightly covers the gums of the upper and lower anterior teeth, while a certain thickness is ensured in the labiolingual direction. Finally, a 3D printer is used to print the model, and the orthodontic appliance is pressed out on the model using a hot pressing process. It is then used after cutting, polishing, cleaning and disinfection.

[0005] Compared with the prior art, the present invention has the following beneficial effects: The design of this appliance combines the advantages of traditional mandibular advancement appliances and vestibular shields. It can not only effectively seal the oral cavity and improve the dry mouth symptoms that may occur when wearing traditional mandibular advancement appliances, as well as the common mouth breathing problem in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), but also significantly reduce the limitations of lip inclination of the lower front teeth caused by traditional mandibular advancement appliances. BRIEF DESCRIPTION OF THE DRAWINGS

[0006] Figure 1 These are scans of the upper and lower jaw dentition and the mandibular protrusion position of the present invention, wherein Figure a is a scan of the right mandibular protrusion position; Figure b is a scan of the mandibular protrusion position from the front; Figure c is a scan of the left mandibular protrusion position; Figure d is a scan of the maxillary dentition; and Figure e is a scan of the mandibular dentition.

[0007] Figure 2 This is a front view schematic diagram of the 3D design of the mandibular advancement appliance of the present invention.

[0008] Figure 3 This is a schematic diagram on the left side of the 3D design of the mandibular advancement appliance of the present invention.

[0009] Figure 4 This is a schematic diagram of the maxillofacial design of the mandibular advancement appliance of the present invention in 3D.

[0010] Figure 5 It is a mandibular advancement appliance commonly used in clinical practice.

[0011] Figure 6 Sleep monitoring data for patients before wearing.

[0012] Figure 7 Intraoral photo of a patient wearing a new digital mandibular advancement appliance.

[0013] Figure 8 The sleep monitoring data were reviewed one month after the patients wore the appliance.

[0014] Fig. 9 Compare the sleep monitoring data of patients before and after wearing.

[0015] Fig.10 Subjective evaluation of patients after wearing the orthodontic appliance. DETAILED DESCRIPTION

[0016] The present invention is further described below in conjunction with embodiments and drawings.

[0017] like Figure 1 , 2 As shown in , 3 and 4, a novel mandibular advancement appliance comprises a mandibular advancement appliance, characterized in that a vestibular shield is provided on the labial side of the lower front teeth of the mandibular advancement appliance.

[0018] The vestibular shield is separated from the maxillary anterior teeth brace and is only connected to the labial side of the mandibular anterior teeth brace.

[0019] The vestibular shield extends mesiodistal to the posterior teeth connector and slightly covers the gums of the upper and lower front teeth vertically.

[0020] The vestibular shield has a certain thickness in the labiolingual direction. Example

[0021] Preparation and use of a new digital mandibular advancement appliance Before deciding to use oral appliances for treatment, the patient's general condition must generally be evaluated by an ENT specialist, and after a diagnosis is confirmed by polysomnography, a written diagnosis report and treatment recommendations must be provided. The orthodontist should formulate an appropriate treatment plan based on the diagnosis report and combined with an oral specialist examination related to the upper airway. After 2 to 3 months of regular use, the patient should undergo a PSG review and fill out a subjective questionnaire to evaluate its objective efficacy.

[0022] Step 1: Digital acquisition of the patient's dentition and mandibular protrusion. The specific steps are: Use an intraoral scanner to scan the patient's complete dentition, gums, and lip-cheek frenulum information; the patient's mandible is protruded to the maximum protrusion position, and then retracted to 2 / 3 of the maximum protrusion position. The vertical distance between the upper and lower anterior teeth incisors is opened by 4-5mm. Use an intraoral scanner to record the relationship between the upper and lower jaw dentition at this position; import the acquired patient dentition and mandibular position data into the 3D design software; Step 2: 3D design and printing of the new mandibular advancement appliance. The specific steps are: In the 3D design software, an innovative design was made based on the traditional mandibular advancement appliance. On the labial side of the mandibular anterior teeth braces, a vestibular shield was designed, which separated the vestibular shield from the maxillary anterior teeth braces and was only tightly connected to the labial side of the mandibular anterior teeth braces. This ensures that the force of the labial and cheek muscles on the vestibular shield can directly act on the lower anterior teeth, thereby exerting a lingual force on the lower anterior teeth. At the same time, the mesiodistal direction of the vestibular shield is extended to the posterior tooth connector, and its vertical direction slightly covers the gums of the upper and lower anterior teeth, and a certain thickness is guaranteed in the labial and lingual direction to prevent deformation under the action of the labial and cheek muscles. Finally, we used a 3D printer to print out the model, and used the appliance on the model using a hot pressing process. It was cut, polished, cleaned and disinfected before use.

[0023] Wearing and precautions of mandibular advancement appliance: When the appliance is put into the patient's mouth, the patient's mandible is forced to protrude. Observe whether the appliance fits the upper and lower teeth and whether it compresses the oral mucosa. Instruct the patient to gradually adapt to the appliance when wearing it for the first time, such as increased saliva, morning bite discomfort, and soreness and swelling in the temporomandibular joint area. If the discomfort symptoms are not relieved, return to the doctor in time.

[0024] Clinical Cases Patient Luo, male, 45 years old, was diagnosed with severe sleep apnea syndrome (OSAHS) after a portable sleep apnea monitoring (PSG) examination at the Department of Otolaryngology, Xijing Hospital on April 3, 2024. He came to our Orthodontics Department for treatment on June 10, 2024. After X-ray examination, the patient's mandibular retraction, canine molars were in Angle's Class II relationship, accompanied by airway stenosis, and digital mandibular advancement appliance treatment was recommended. According to the sleep monitoring results, it can be found that the new mandibular advancement appliance we designed can significantly reduce the nocturnal airway obstruction of people with sleep apnea, which is in line with our expectations. At the same time, the patient feels comfortable, has good retention, and the effect is obvious.

[0025] Figure 6 Provide sleep monitoring data for patients before wearing. Figure 7 Intraoral photos of patients wearing new digital mandibular advancement appliances. Figure 8 After the patient wore the appliance for one month, the sleep monitoring data was reviewed. Fig. 9 Compare the sleep monitoring data of patients before and after wearing the device. Fig.10 Subjective evaluation of patients after wearing the orthodontic appliance.

[0026] Effect evaluation and follow-up: 1) Apnea and hypopmea index (AHI) is an important indicator for evaluating the efficacy of oral appliances. The AHI for adults should be less than 5 times / h. In addition, the blood oxygen saturation should be raised to a normal level during sleep, the snoring symptoms should be significantly relieved, the sleep quality should be significantly improved, and the patient should be energetic and focused during the day.

[0027] 2) Oral appliances for OSAHS are usually followed up 2 weeks, 1 month, 3 months, 6 months, 1 year, and 2 years after wearing the appliance. This requires examination and evaluation by multiple disciplines including dentistry, neurology, respiratory medicine, and otolaryngology. During the treatment process, comprehensive follow-up monitoring, regular feedback, and timely adjustment of the oral appliance are required to reduce adverse reactions and improve clinical efficacy.

Claims

1. A novel mandibular advancement appliance, including a mandibular advancement appliance, characterized in that: The mandibular advancement appliance is equipped with a vestibular shield on the labial side of the lower anterior teeth.

2. A novel mandibular advancement appliance according to claim 1, characterized in that: The vestibular shield is separated from the maxillary anterior teeth brace and is only connected to the labial side of the mandibular anterior teeth brace.

3. A novel mandibular advancement appliance according to claim 1, characterized in that: The vestibular shield extends mesiodistal to the posterior teeth connector and slightly covers the gums of the upper and lower front teeth vertically.

4. A digital mandibular appliance according to any of the preceding claims, characterized in that: The vestibular shield has a certain thickness in the labiolingual direction.

5. A method for manufacturing a new type of mandibular advancement appliance based on digitalization, characterized in that: The following steps are involved: Step 1: Digital acquisition of the patient's dentition and mandibular protrusion: Use an intraoral scanner to scan the patient's complete dentition, gums, and lip-cheek frenulum information; the patient's mandible is protruded to the maximum protrusion position, and then retracted to 2 / 3 of the maximum protrusion position. The vertical distance between the upper and lower anterior teeth incisors is opened by 4-5mm. Use an intraoral scanner to record the relationship between the upper and lower jaw dentition at this position; import the acquired patient dentition and mandibular position data into the 3D design software; Step 2: 3D design and printing of the new mandibular advancement appliance: In the 3D design software, a vestibular shield is set on the labial side of the mandibular anterior teeth braces, so that the vestibular shield is separated from the maxillary anterior teeth braces and is only tightly connected to the labial side of the mandibular anterior teeth braces. The labial side of the mandibular anterior teeth of the orthodontic appliance is bonded to the vestibular shield using a self-curing orthodontic base polymer. The vestibular shield is extended in the mesiodistal direction to the posterior tooth connector, and its vertical direction slightly covers the gums of the upper and lower anterior teeth, while a certain thickness is ensured in the labiolingual direction. Finally, a 3D printer is used to print the model, and the orthodontic appliance is pressed out on the model using a hot pressing process. It is used after cutting, polishing, cleaning and disinfection.

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