LIP AND CHEEK EXPANDERS

Description

[0001] The invention relates to an improved lip and cheek expander in the form of a covering device for covering the lips and corners of the mouth and for keeping the lips, cheeks and corners of the mouth away from the rows of teeth in the mouth of a patient.

[0002] Covering devices for keeping the lips, cheeks, and corners of the mouth away from the rows of teeth in a patient's mouth are known as cheek retractors, retractor hooks, or spreader clamps. Furthermore, WO 03 / 051185 A1 and DE 10 2014 109 023 A1 describe a device that not only keeps the lips, cheeks, and corners of the mouth away from the rows of teeth in a patient's mouth, but also covers the lips and corners of the mouth at the same time. Such devices are marketed, for example, under the brand name OptraGate ®< by Ivoclar Vivadent AG and feature two flexible rings as tensioning frames that are connected to one another by a cover film. One of the two tensioning frames is inserted completely into the vestibule oris to secure the cover film intraorally.

[0003] The document DE 10 2014 109 023 A1 relates to a film tensioning element. The film tensioning element has a lip ring and a vestibular ring.

[0004] The document US 2008 / 153058 A1 relates to a lip and cheek expander for use in performing dental medical, dental hygiene, or dental documentation activities. An inner tensioning frame is connected to an outer tensioning frame via film-like means.

[0005] Such covering devices serve, among other things, to facilitate access to the inside of the mouth for the dentist. The patient's lips are spread and pulled apart by the combined action of ring-shaped tensioning elements and a film extending between them, significantly enlarging the mouth opening without the patient having to open their mouth wider.

[0006] Such state-of-the-art covering devices often lead to painful pressure sores on the mucosa of the alveolar bone, especially in the area of ​​the canines, because the intraoral clamping element is pressed against the alveolar bone by the strong lip pressure. This is particularly true for the lower jaw, but such pressure sores can also occur in the upper jaw.

[0007] Another problem with the production of lip and cheek expanders, or in our local terminology, covering devices according to the state of the art, is the multitude of sizes that must be available for the different mouth sizes of the patients. The "Optragates" are delivered shrink-wrapped. Due to the special requirements of the film (stretchability, flexibility, material thickness, tear resistance), their shelf life is limited, even in a shrink-wrapped state, and can be as little as a few months.

[0008] This results in regularly procured and stored Optragates becoming unusable after the maximum storage time and having to be disposed of. Even with the provision of only three or four sizes, this leads to unnecessary costs and unnecessary disposal problems.

[0009] In contrast, the present invention is based on the object of creating an improved generic covering device in which pressure points on the mucous membrane of the alveolar bone are prevented or significantly reduced and thus the wearing comfort of the device is significantly increased, so that the acceptance of the covering device is increased and / or the storage costs are minimized.

[0010] The present invention solves the underlying technical problem by a covering device according to claim 1.

[0011] A covering device for covering the lips and corners of the mouth and for keeping the lips, cheeks, and corners of the mouth away from the rows of teeth in a patient's mouth is provided, comprising an elastic lip-tensioning element for external application to the mouth opening, at least one elastic vestibular-tensioning element for insertion into the vestibule oris of the patient's mouth, and a film connecting the tensioning elements. The tensioning elements are arranged along two opposite end regions of the film, so that the inserted covering device is open towards the oral cavity. Preferably, the film offers essentially no resistance to bending, in contrast to stretching.At least one intraoral section of the vestibular tensioning element is suitable for being inserted in an elastically deformed state into a region of the patient's oral vestibule and for fixing the film intraorally, so that when the covering device is inserted, the film runs between the extraoral lip tensioning element and the essentially intraoral vestibular tensioning element in contact with the lips and corners of the mouth and is suitable for exerting essentially uniformly distributed pressure forces on the lips and corners of the mouth, which forces push the lips, cheeks, and corners of the mouth away from the teeth and the alveolar bone and pre-tension the mouth opening circularly into an open position. The covering device also allows the mouth to be closed when inserted.The vestibular tensioning element has at least one section that, when the covering device is in place, runs in a sagittal direction anterior to the oral vestibule, particularly anterior to the occipital fold of the oral vestibule, or also anterior to the labial frenulum. Reference to "anterior to the oral vestibule" here refers, of course, to the lowest point of the oral vestibule, i.e., the occipital fold.

[0012] It is provided that the vestibular tensioning element has at least one section curved towards the lip tensioning element, in particular in the anterior direction, which, when the covering device is inserted, runs in particular anterior to the fold of the vestibule oris and / or anterior to the frenulum of the lip.

[0013] Preferably, the at least one section of the vestibular tensioning element which, when the device is inserted, runs in the sagittal direction anterior to the fold of the vestibule oris, is a section which is bent in the anterior direction, i.e. which extends closer to the lip tensioning element.

[0014] Surprisingly, it was found that a corresponding design of the vestibular tensioning element, in which a section of the vestibular tensioning element is shaped so that it runs anterior to the occipital fold of the oral vestibule or anterior to the labial frenulum in the sagittal direction, and is preferably curved in the anterior direction, results in this section not pressing on the mucous membrane of the alveolar bone, thus preventing pressure sores and irritation at the corresponding locations. At the same time, the tensioning sections of the vestibular tensioning element running intraorally and remaining in contrast are sufficient to adequately secure the covering device intraorally. This applies not only to an open mouth, but even to a closed mouth.

[0015] In a preferred embodiment, the at least one section of the vestibular tensioning element, when the covering device is inserted, still lies just intraorally or extraorally or in between, e.g. on the patient's lip, in the transition area between intraorally and extraorally.

[0016] In a preferred embodiment, the at least one section of the vestibular tensioning element rests on the lip or outside the lip when the device is inserted.

[0017] Unless otherwise stated, "at least one section of the vestibular tensioning element" in this description refers to the section of the vestibular tensioning element that, when the covering device is in place, runs anterior to the lateral fold of the vestibular oris in the sagittal plane and is preferably curved in an anterior direction. This section of the vestibular tensioning element therefore does not run in the deepest region of the vestibular oris, but rather, due to the plastic shaping of the vestibular tensioning element, runs offset from the course of the vestibular oris, for example, along the lip or outside the lip.

[0018] It can therefore be provided that this section, which is designed as an indentation, does not run in the deepest region of the oral vestibule, but rests against the inner region of the lip and is thus still positioned intraorally. Alternatively and preferably, it can be provided that the at least one section runs extraorally. In this embodiment, the vestibular tensioning element therefore has at least one intraorally running section and at least one extraorally running section. In this embodiment, the course of the vestibular tensioning element thus crosses the lip, or at least rests on it over a large area.

[0019] Especially when the mouth is wide open, there is a risk of contact between the vestibular tension element and the jaw mucosa.

[0020] Even if, for example, in this condition, the mucous membrane of the lip (ventral border of the vestibular oris), the occipital fold, and the mucous membrane of the jawbone (dorsal border of the vestibular oris) lie closely together, the indentation, a protrusion of the vestibular tension element, and especially a bridge, prevents the vestibular tension element from touching the mucous membrane of the jawbone in the anterior region. Therefore, pressure sores can never occur there.

[0021] The protrusion of the vestibular tension element deforms the elastic lip at this point in a holding manner, i.e. in an anterior direction.

[0022] A particular advantage arises from the formation of the indentation at a point where the state-of-the-art covering devices extend into the occipital fold and may rest there: The indentation displaces the relevant part of the tensioning element diagonally upwards or toward the mouth opening / anteriorly. The labial mucosa is very elastic there, so it tends to deflect anteriorly, which pushes the tensioning element further away from the alveolar process mucosa.

[0023] An "anteriorly curved section" is preferably understood to mean that the profile extends in the direction of the lip tensioning element, since this element, when inserted into the covering device, is located entirely outside the mouth and thus anterior to the vestibular tensioning element. The "lip tensioning element" is understood to mean the tensioning element that is positioned entirely extraorally. The "vestibular tensioning element" is understood to mean the tensioning element that is positioned at least partially intraorally.

[0024] Preferably, the at least one section of the vestibular tensioning element extends in the region of the incisors when the cover device is inserted. Particularly preferably, the at least one section of the vestibular tensioning element extends in the region of the canines and incisors when the cover device is inserted.

[0025] It has been shown that the pressure exerted by prior art tensioning elements is particularly high in the area of ​​the canines and incisors, and that pressure wounds on the mucosa develop particularly quickly and severely here. Therefore, at least one section of the vestibular tensioning element, which, when the covering device is in place, runs essentially in a sagittal direction anterior to the vestibular fold, is preferably positioned in such a way that it runs in the area of ​​the incisors, particularly preferably in the area of ​​the incisors and canines, thus relieving pressure on the otherwise particularly heavily stressed pressure points of the mucosa adjacent to the alveolar bone.

[0026] The at least one section of the vestibular tensioning element and thus preferably the entire covering device preferably advantageously does not touch the mucous membrane covering the jawbone in the frontal area.

[0027] Surprisingly, it was found that despite this beneficial pressure relief, there was no increase in pressure in the other areas of the vestibular tension element, especially not in the areas located in the area of ​​the vestibule oris.

[0028] The mucosal areas not backed by bone are used more intensively for the supporting and storage function of the covering device, which is not perceived as unpleasant by the patient.

[0029] In this respect, the acceptance of the covering device is significantly increased, which allows the dentist better access to the treatment area and less time stress.

[0030] If only one section of the vestibular tensioning element is provided, which, when the covering device is in place, runs in a substantially sagittal direction anterior to the fovea of ​​the oral vestibule, i.e., closer to the lip tensioning element, this section can be positioned either in the lower jaw or upper jaw area. This section is preferably positioned in the lower jaw area, as the risk of pressure sores developing there is greater when using conventional covering devices than in the upper jaw area. Of course, positioning in the upper jaw area is also possible.

[0031] In a preferred embodiment, the at least one section of the vestibular tensioning element runs in the area of ​​the incisors of the lower jaw when the covering device is inserted.

[0032] In a preferred embodiment, the vestibular tensioning element has two sections which, when the covering device is inserted, run anterior to the fold of the vestibule oris, particularly when viewed in the sagittal direction.

[0033] In a preferred embodiment, the at least one section of the vestibular tensioning element runs in the area of ​​the canines and incisors of the lower jaw when the covering device is inserted.

[0034] Preferably, the covering device comprises a vestibular tensioning element having two sections which, when the covering device is in place, run in a substantially sagittal direction anterior to the occipital fold of the oral vestibule, in particular which are curved in an anterior direction. Preferably, one section, which runs in a sagittal direction anterior to the occipital fold of the oral vestibule, runs in the region of the incisors, preferably the canines and incisors, of the lower jaw, and the other section, which, when the covering device is in place, runs in a sagittal direction anterior to the occipital fold of the oral vestibule, runs in the region of the incisors, in particular in the region of the canines and incisors, in the region of the upper jaw.

[0035] In a preferred embodiment, when the cover device is inserted, the first section runs in the area of ​​the canines and incisors of the lower jaw and the second section runs in the area of ​​the canines and incisors of the upper jaw.

[0036] In a further preferred embodiment, the vestibular tensioning element is designed as a tensioning frame, in particular as a tensioning ring, which is plastically three-dimensionally shaped.

[0037] The three-dimensional shape allows the vestibular tensioning element, as well as the lip tensioning element, to be shaped precisely, whereby the elastic material of the tensioning elements makes them flexible enough for the covering device to be used in and on the mouth.

[0038] In a preferred embodiment, the vestibular tensioning element is 0 mm to 30 mm away from the lip tensioning element in the region of the at least one section when the covering device is inserted.

[0039] In a preferred embodiment, the vestibular tensioning element is 0 mm away from the lip tensioning element when the cover device is inserted, so the tensioning elements lie against one another at one or two points or are even connected to one another at these one or two points.

[0040] In a preferred embodiment, when the covering device is in place, the vestibular tensioning element is more than 0 mm to 30 mm away from the lip tensioning element in the region of at least one section. In a preferred embodiment, when the covering device is in place, the vestibular tensioning element is 0.1 mm to 30 mm away from the lip tensioning element in the region of at least one section. In a preferred embodiment, when the covering device is in place, the vestibular tensioning element is at most 25 mm away from the lip tensioning element in the region of at least one section. In a preferred embodiment, when the covering device is in place, the vestibular tensioning element is at most 20 mm away from the lip tensioning element in the region of at least one section. In a preferred embodiment, when the covering device is in place, the vestibular tensioning element is at most 15 mm away from the lip tensioning element in the region of at least one section.

[0041] In a preferred embodiment, the vestibular tensioning element is located up to 30 mm away from the lip tensioning element in the region of the at least one section when the covering device is inserted.

[0042] In a preferred embodiment, the lip tensioning element has at least one section which, when the covering device is inserted, is curved in the sagittal direction in the direction of the at least one section of the vestibular tensioning element.

[0043] When the covering device is in place, such a section of the lip-tensioning element is preferably located at the top or bottom, i.e., in the area of ​​the nose or chin. This has the advantage that the covering device does not cover the nose or chin. This section of the lip-tensioning element is therefore preferably located opposite the at least one section of the vestibular-tensioning element.

[0044] In a particularly preferred embodiment, the lip tensioning element has two sections which, when the covering device is inserted, are curved in a substantially sagittal direction in the direction of the at least one section of the vestibular tensioning element, which are therefore preferably concave indentations.

[0045] When the covering device is in place, the two sections of the lip-tensioning element are preferably located at the top and bottom, i.e., in the area of ​​the nose or chin. This has the advantage that the covering device does not cover the nose and chin. These sections of the lip-tensioning element are therefore preferably located opposite the two sections of the vestibular-tensioning element.

[0046] Thus, the sections of the vestibular tensioning element and the lip tensioning element preferably approach each other. In a preferred embodiment, these sections approach each other to a distance of 0 mm to 30 mm, in particular from 0.5 mm to 25 mm. In a preferred embodiment, the sections can also meet, i.e. have a distance of 0 mm, and can particularly preferably also be connected, in particular firmly connected, which increases the stability of the covering device. Due to the elasticity of the tensioning elements, the covering device nevertheless remains flexible enough for use. Despite such a connection of the tensioning elements, the covering device also remains flexible enough to be packaged in a space-saving manner.

[0047] In a preferred embodiment, the at least one section of the vestibular tensioning element forms a concave indentation, wherein the concave indentation is at least partially spanned by a film.

[0048] In a preferred embodiment, the at least one section of the lip-tensioning element forms a concave indentation, wherein the concave indentation is at least partially spanned by a film or the film.

[0049] If the concave bulges of the clamping elements are at least partially covered with a film, this has the advantage that, despite the three-dimensionally shaped clamping elements, the overall covering device retains the basic shape of the previous products and thus the consumer does not have to get used to a new shape.

[0050] In a preferred embodiment, the covering device has the shape of a tube, in which at least one end of the tube has two concave indentations.

[0051] In a further preferred embodiment, the covering device has the shape of a tube with two ends, in which at least the second end of the tube has two concave indentations.

[0052] If the clamping elements are designed as a clamping frame, in particular as a clamping ring, then the vestibular clamping element preferably has a larger diameter than the lip clamping element.

[0053] Preferably, "film" is understood in the broadest sense to mean a flat structure that offers essentially no resistance to bending, as opposed to stretching. Such structures can also be referred to as film-like means. Film-like means can be made of elastically stretchable, but in principle also of non-stretchable material.

[0054] In contrast to the prior art, lip and cheek expanders exert a pressure force on the lips and cheeks, which are to be held away from the rows of teeth, via the foil-like means. The foil-like means are preferably connected at one end to the vestibular tensioning element located at least partially within the oral cavity and at the other end to the outer lip tensioning element resting on the outside of the lips or cheeks.

[0055] Additional foil-like means may also be provided which, for example, at least partially cover the indentations in the lip and / or vestibular tensioning element.

[0056] The foil-like coverings are advantageously thin and elastic. In combination with the two tensioning elements, very simple, extremely flexible, and widely applicable lip and cheek expanders, or covering devices, can be created. When the expander is applied, the foil-like coverings distribute pressure forces over a large area and create a circular pattern around the mouth opening. This allows the patient to comfortably hold the mouth opening wide open in a circular pattern while simultaneously gently holding the lips and cheeks away from the teeth.

[0057] In addition, the preferred three-dimensional shape of the lip tensioning element can also advantageously prevent the film from disturbingly covering the nose.

[0058] Suitable materials for the clamping elements and the film are known to those skilled in the art, for example, from WO 03 / 051185 A1 or DE 10 2014 109 023 A1, both of which are incorporated by reference in this context. A preferred material is plastic. The covering devices can preferably be manufactured by injection molding or 3D printing.

[0059] The material thickness and shape, i.e., the cross-section of the tensioning elements, in particular the vestibular tensioning element, can be freely selected by the skilled person. It can also be provided that the material thickness and shape of the tensioning elements, in particular the vestibular tensioning element, vary along their length. By varying them, the skilled person can influence the flexibility of a tensioning element in specific areas, i.e., strengthen or weaken it.

[0060] In an alternative embodiment, the vestibular tensioning element can be used for intraoral suction. For example, the vestibular tensioning element can be designed as a hollow tube with openings in the intraorally positioned areas through which oral fluid can be suctioned. The fluid can then be drained, for example, via a bridge that preferably connects the vestibular tensioning element to the lip tensioning element, if this bridge is also tubular. This embodiment advantageously reduces the need for a suction device, or even eliminates the need for a suction device altogether.

[0061] In a preferred embodiment, the vestibular tensioning element is connected to the lip tensioning element via at least one web, in particular via one web or via two webs. Preferably, the at least one web extends in at least one concave recess of the vestibular tensioning element.

[0062] A preferred embodiment is one in which the two concave protrusions of the vestibular tensioning element are connected to the lip tensioning element via a bridge. In the preferred embodiment, two bridges or even several bridges are provided. However, it is also possible to use just one bridge.

[0063] Such webs can either be made of the film material or of another suitable material.

[0064] Ribs can also be used as webs. These can be simply created by thickening the film material into ribs. These can also be curved to increase the tensile strength and strength of the film, particularly at the points where the ribs are formed.

[0065] The bars are preferably bendable, but less stretchable than the foil. The bars can advantageously further prevent the inner ring from slipping onto the gums and the associated pressure pain. The lip tensioning element is preferably more stable and advantageously pulls the lip tensioning element away from the gums via the non-stretchable bars. The bars can advantageously prevent the foil from stretching in the central lip region, so that stretching occurs primarily in the lateral areas. The width of the bars can be freely selected by the specialist. As an alternative to the bars, grooves or bands can also be provided, and the non-stretchable or compressible bars can define a distance between the two rings in the front region of, for example, 18 mm to 20 mm.

[0066] According to a further aspect, the vestibular tensioning element has four outwardly facing bulges that protrude convexly outward from a pointed oval or oval, and the shape of the vestibular tensioning element is incongruent or geometrically dissimilar to the pointed oval or oval. This solution surprisingly allows for the use of significantly fewer sizes of the covering device, thus simplifying inventory and minimizing the associated costs.

[0067] A patient's mouth, when half-open, forms a pointed oval, i.e., a pointed oval or an oval with a tapered edge. With the aforementioned features, the vestibular tensioning element is shaped so differently from the patient's mouth that a single covering device can accommodate even very different mouth sizes.

[0068] This not only significantly reduces storage costs, but also manufacturing costs, as it is only necessary to produce one injection molding tool, not 3 or 4.

[0069] The vestibular tensioning element is provided with bulges extending radially outward from the circular shape. Each bulge has a round outer shape with a radius smaller than the radius of a standard vestibular ring, for example, between 0.1 cm and 5 cm, preferably 2 to 3 cm. This radius can also be selected in any other way, e.g., between 0.3 cm and 4 cm, or even between 0.8 cm and 2.5 cm.

[0070] The vestibular tensioning element provided in this form is therefore approximated to a rectangular shape and preferably appears like a rectangle with rounded corners.

[0071] The lines, which run counter to the oval of the mouth, represent a unique feature. The diverging areas, especially the bulging corners, serve to support the vestibular tension element inside the patient's mouth. The critical areas in the sagittal plane, i.e., the area of ​​the labial frenulum, and in the horizontal plane are deliberately avoided, and no support pressure is exerted there.

[0072] The "support areas" of the vestibular tensioning element at the bulge corners, i.e. left / top, left / bottom, right / top and right / bottom, lie inside the mouth and provide support even if the size of the tensioning element is quite large or quite small for the patient's mouth.

[0073] If the clamping element is quite large for the patient, the bulge corner will move distally along the inside of the cheek. If the clamping element is quite small, the bulge corners will still provide support due to the shape difference or incongruity with the oval or pointed oval of the mouth opening.

[0074] This allows several Optragate sizes to be covered.

[0075] It is preferable to shape the vestibular tensioning element so that it rests on four points—top right, bottom right, bottom left, and top left—to prevent slippage. However, it is also possible to vary the number of these points, for example, 2, 3, 5, or 6.

[0076] A request outside the areas or positions described here could also be considered.

[0077] The corresponding lip tension element can also be shaped in the same way, i.e. congruent to the vestibular tension element, or oval or circular

[0078] A particular advantage of this design with the curved corners is that the spreading effect is particularly directed laterally and outward. This makes the vestibular areas on the molars, which are important for scanning, particularly accessible.

[0079] A scanning head can then be inserted particularly well laterally to scan the vestibular area of ​​the molars, as generous spaces are left there.

[0080] The bulges should preferably be round; the optimal radius or, if necessary, the curve can be adapted to the requirements within a wide range.

[0081] Due to the curved section, retention is lost at the indentation there. This is advantageously compensated for by the bulges elsewhere, the "wings" or "ears," i.e., the bulge corners.

[0082] According to an advantageous embodiment of this solution, the vestibular tensioning element is slightly curved around a vertical axis located posterior to this tensioning element. For smaller mouth openings, the bulging corners shift distally into the flexible cheek area. However, the bulging corners still provide support for larger mouth openings.

[0083] A covering device is used to cover the lips and corners of the mouth and to keep the lips, cheeks and corners of the mouth away from the rows of teeth in the mouth of a patient, comprising an elastic lip tensioning element for external application to the mouth opening, at least one elastic vestibular tensioning element for insertion into the vestibule oris of the patient's mouth and a film connecting the tensioning elements, wherein the tensioning elements are arranged along two opposite end regions of the film so that the cover device used is open towards the oral cavity, wherein: the film offers essentially no resistance to bending, in contrast to stretching, and at least one intraoral section of the vestibular tensioning element is suitable for being inserted in an elastically deformed state into an area of ​​the patient's oral vestibule and for fixing the film intraorally, so that when the covering device is inserted, the film runs between the extraoral lip tensioning element and the vestibular tensioning element in contact with the lips and corners of the mouth and is suitable for exerting compressive forces on the lips and corners of the mouth, which are distributed substantially evenly over the area and which push the lips, cheeks and corners of the mouth away from the teeth and the alveolar bone and pre-tension the mouth opening circularly into an open position, wherein the covering device allows the mouth to be closed, and wherein the vestibular tensioning element is connected to the lip tensioning element via at least one web, in particular via one web or via two webs,is connected. ,

[0084] According to a first preferred embodiment, it is provided that the lip tensioning element and / or the film exert a force on the vestibular tensioning element, by means of which the contact pressure of the vestibular tensioning element on the mucosa covering the alveolar bone is reduced.

[0085] According to a second preferred embodiment, it is provided that when the covering device is inserted, the vestibular tensioning element lies at least partially flat against the mucosa covering the alveolar bone.

[0086] According to a third preferred embodiment, it is provided that the lip tensioning element has a greater material thickness than the vestibular tensioning element.

[0087] According to a fourth preferred embodiment, the film has at least one rib-shaped elevation, in particular a corrugation, running between the lip tensioning element and the vestibular tensioning element.

[0088] According to a fifth preferred embodiment, it is provided that the film has a greater material thickness in the region of the lip tensioning element than in the region of the vestibular tensioning element.

[0089] According to a sixth preferred embodiment, it is provided that the lip tensioning element is less elastic than the vestibular tensioning element.

[0090] According to a seventh preferred embodiment, it is provided that in the non-tensioned state the film has a length between the lip tensioning element and the vestibular tensioning element of at most 2 cm.

[0091] According to an eighth preferred embodiment, it is provided that the film is attached to the vestibular tensioning element at the region or surface of the vestibular tensioning element that points towards the lip tensioning element or is attached to the surface of the vestibular tensioning element that has the largest diameter, or therebetween.

[0092] According to a ninth preferred embodiment, it is provided that the vestibular tensioning element, after manufacture, has no sprue on the surface which, after insertion of the vestibular tensioning element into the vestibule oris of the patient's mouth, rests against the mucosa covering the alveolar bone.

[0093] Preferred embodiments also emerge from the subclaims.

[0094] The present invention is explained in more detail with reference to the following figures and examples, without these being understood as limiting. Figure 1shows a covering device in one embodiment; Figure 2 shows the side view of the cover device from Figure 1 ; Figure 3 shows the two clamping elements of the cover device from Figure 1 ; Figure 4 shows an alternative covering device; Figure 5 shows the side view of the cover device from Figure 4 ; Figure 6 shows the two clamping elements of the cover device from Figure 4 ; Figure 7 shows another alternative covering device; Figure 8 shows the side view of the cover device from Figure 7 ; Figure 9 shows the two clamping elements of the cover device from Figure 7 ; Figure 10 shows the two clamping elements in another embodiment; Figure 11 shows a comparison of the covering device with a prior art covering device during use; Figure 12 shows the cover device Figure 1 with bridges; Figure 13shows the side view of the cover device from Figure 12 ; Figure 14 shows the cover device Figure 4 with bridges; Figure 15 shows a cover device with bars during use; Figure 16 shows a further covering device in a schematic view; Figure 17 shows the embodiment according to Figure 16 in practical application.

[0095] Figure 1 shows a covering device. In Figure 1aThe cover device (100) can be seen, which consists of a lip-tensioning element (110) shaped as a tensioning ring, a vestibular tensioning element (120), and a film (130). While the lip-tensioning element (110) is at least almost flat in terms of its plastic shape, even if it is made of a flexible material and is thus bendable, the vestibular tensioning element (120) has a three-dimensional basic shape with two sections (121, 122) that are directed towards the lip-tensioning element (110) and thus taper the cover device in this area or form concave indentations (124, 125). The curved sections (121, 221, 321) can occupy between 10 percent and 60 percent of the circumference of the vestibular tension element (120, 220, 320), but also between 20 and 50 percent. A preferred value may be approximately 40 percent. The circumference can, for example,30 cm, and the combined length of both indentations is 124.125 14 cm, i.e. between 40 and 50 percent.

[0096] When the covering device (100) is now used, the vestibular tensioning element (120) is inserted into the mouth so that the two areas or tensioning sections (123) of the tensioning element (120) in the area of ​​the molars lie in the vestibule oris and rest against the cheek. Due to the shape shown, however, the other areas (121, 122) are not located in the vestibule oris, but run anterior to the vestibule oris in a sagittal direction. Depending on the shape, the course of the anteriorly curved sections (121 and 122) can be provided intraorally along the lip or extraorally. By running this course outside the vestibule oris in the frontal area, i.e. in the area of ​​the canines and incisors, pressure on the mucous membrane lying against and supported by the jawbone, and thus corresponding pressure sores, are prevented.

[0097] Figure 1b shows the same covering device (100), wherein attention should be paid to the basic design in the form of a tube (101) with two ends (141,142), wherein the ends are formed by said clamping elements and wherein the second end (142) of the tube (101) has two concave indentations (151,152).

[0098] Figure 2 shows the cover device (100) from Figure 1 Side view. The two tensioning elements (110, 120) with the film (130) between them are again visible. In addition to the two intraoral tensioning sections (123), the vestibular tensioning element has a section (121) running between points A and B, which forms a concave indentation (124) and thus represents a section curved in an anterior direction. When the covering device is in place, it runs sagittally anterior to the inguinal fold of the oral vestibule.

[0099] Figure 3shows the two clamping elements (110,120) of the cover device from the Figures 1 and 2 The vestibular tensioning element (120) is divided into four sections, two intraoral tensioning sections (123) and two anteriorly curved sections (121,122).

[0100] The term "anterior" is to be understood as meaning that the course runs in the direction of the lip tensioning element (110), since in the cover device, when inserted, this element is located entirely outside the mouth and thus anterior to the vestibular tensioning element (120).

[0101] The most anterior point of the sections (121,122) of the vestibular tensioning element (120) has a distance of approximately 20 mm from the lip tensioning element (110) when the film is flat but not taut and unstretched.

[0102] Figure 4shows an alternative embodiment of the covering device (200), which again comprises a lip-tensioning element (210), a vestibular-tensioning element (220), and a film (230). The vestibular-tensioning element (220) again has a three-dimensional basic shape with two sections (221, 222) that are directed toward the lip-tensioning element (210), thereby tapering the covering device in this area or forming concave indentations (224, 225) there.

[0103] When the covering device (200) is used, the vestibular clamping element (220) is inserted into the mouth so that the two regions or clamping sections (223) of the clamping element (220) in the area of ​​the molars lie in the vestibule oris and rest against the cheek. Due to the illustrated design, however, the other regions (221, 222) are not located in the vestibule oris, but rather run anterior to the vestibule oris in a sagittal direction. Depending on the design, the anteriorly curved sections (221 and 222) can extend intraorally along the lip or extraorally.

[0104] In addition, the lip-tensioning element (210) also has a three-dimensional basic shape with two sections (211, 212) that are directed towards the vestibular-tensioning element (220), thereby tapering the covering device in this area. This advantageously prevents the nostrils and chin from being covered by the film (230). However, in order to maintain the known basic shape and to provide improved coverage, the concave recesses of both tensioning elements (210, 220) are provided with additional covers (231, 232, 233) that are held by additional thin struts (261, 262, 263). The struts (261, 262, 263) hold the additional covers (231, 232, 233) in a position that does not interfere with either the nose or the chin and also covers the lip.

[0105] Figure 5 shows the cover device (200) from Figure 4in the side view. The two tensioning elements (210, 220) with the film (230) in between are again visible. In addition to the two intraoral tensioning sections (223), the vestibular tensioning element (220) has a section (221) that forms a concave indentation and thus represents an anteriorly curved section that, when the covering device is in place, runs in a sagittal direction anterior to the indentation of the vestibule. The lip tensioning element (210) also has an indentation (211) that is directed in the direction of the indentation (221) of the vestibular tensioning element (220).

[0106] You can also see two additional covers (231, 233) with the corresponding support struts (261, 263).

[0107] Figure 6 shows the two clamping elements (210,220) of the cover device from the Figures 4 and 5The vestibular tensioning element (220) has two intraoral tensioning sections (223) and two anteriorly curved sections (221, 222) provided with retaining struts (261, 262). The lip tensioning element (210) also has two sections (211, 212) curved toward the vestibular tensioning element (220) and provided with retaining struts (263, 264).

[0108] The most anterior point of the sections (221,222) of the vestibular tensioning element (220) has a distance of approximately 12 mm from the lip tensioning element (210) when the film is flat but not stretched.

[0109] Figure 7shows a further alternative embodiment of the covering device (300), which again comprises a lip-tensioning element (310), a vestibular-tensioning element (320), and a film (330). The vestibular-tensioning element (320) again has a three-dimensional basic shape with two sections (321, 322) that are directed toward the lip-tensioning element (310), thereby tapering the covering device in this area.

[0110] When the covering device (300) is now used, the vestibular tensioning element (320) is inserted into the mouth so that the two regions or tensioning sections (323) of the tensioning element (320) in the area of ​​the molars lie in the vestibule oris and rest against the cheek. Due to the shape shown, however, the other regions (321, 322) are not located in the vestibule oris, but run anterior to the vestibule oris in a sagittal direction. Depending on the shape, the course of the anteriorly curved sections (321 and 322) can be provided intraorally along the lip or extraorally, whereby an embodiment for an extraoral course is shown here.

[0111] Additionally, the lip-tensioning element (310) also has a three-dimensional basic shape with two sections (311, 312) directed toward the vestibular-tensioning element (320), thereby tapering the covering device in this area. This advantageously prevents the nostrils and chin from being covered by the film (330). However, to maintain the known basic shape and to provide additional coverage, the concave recesses of both tensioning elements (310, 320) are provided with additional covers (331, 332, 333, 334) held in place by additional thin struts (361, 362, 363, 364).

[0112] Figure 8 shows the cover device (300) from Figure 7in the side view. The two tensioning elements (310, 320) with the film (330) in between are again visible. In addition to the two intraoral tensioning sections (323), the vestibular tensioning element (320) has a section (321) that forms a concave indentation and thus represents an anteriorly curved section that, when the covering device is in place, runs in a sagittal direction anterior to the indentation of the vestibule oris. The lip tensioning element (310) also has an indentation (311) that is directed in the direction of the indentation (321) of the vestibular tensioning element (320).

[0113] You can also see two additional covers (331, 333) with the corresponding support struts (361, 363).

[0114] Figure 9 shows the two clamping elements (310,320) of the cover device from the Figures 7 and 8The vestibular tensioning element (320) has two intraoral tensioning sections (323) and two anteriorly curved sections (321, 322) provided with retaining struts (361, 362). The lip tensioning element (310) also has two sections (311, 312) curved toward the vestibular tensioning element (320) and provided with retaining struts (363, 364).

[0115] The most anterior point of the sections (321,322) of the vestibular tensioning element (320) has a distance of approximately 4 mm from the lip tensioning element (310) when the film is flat but not stretched.

[0116] Figure 10 shows the two clamping elements (410, 420) in a further embodiment, in which the two clamping elements (410, 420) are connected to each other at the respective concave indentations and the two connection points (450, 451) are designed as intersection points. In this embodiment, the two clamping elements (410, 420) can advantageously be manufactured as a single piece.

[0117] Figure 11 shows a comparison of the covering device (500) with a prior art covering device during use. The covering device (500) consists of a lip tensioning element (510), a vestibular tensioning element (520), and a film (530). In prior art covering devices, both tensioning elements are ring-shaped, essentially circular. As a result, the inner tensioning ring lies completely within the vestibule oris and can cause pressure points there. The outer tensioning ring extends to the nose and chin.

[0118] In the embodiment shown, both the outer lip tensioning element (510) and the vestibular tensioning element (520) are shaped so that they approach each other in the upper and lower regions.

[0119] This has two advantages: Firstly, the vestibular tensioning element (520) does not rest on the mucous membrane covering the jawbone in the frontal area, but rather extends anteriorly over the lip to the outside. Secondly, due to the indentations of the lip tensioning element (510), unlike prior art covering devices, the areas under the nose and on the chin (C, D) are not covered by the film (530), thus allowing easy breathing through the nose and preventing the lip tensioning element (510) from pressing on the chin if it is larger.

[0120] Figure 12 shows a covering device (100) as in Figure 1aShown again are the lip tensioning element (110), the vestibular tensioning element (120), and the film (130). The vestibular tensioning element (120) has four sections (121, 122, 123), each of which forms concave indentations (124, 125). In the area of ​​these concave indentations (124, 125), the vestibular tensioning element (120) is connected to the lip tensioning element (110) via webs or bands (171, 172).

[0121] In contrast to the film (130), the webs (171, 172) are not stretchable, so that the webs (171, 172) define a fixed distance between the vestibular tensioning element (120) and the lip tensioning element (110) in the area of ​​the concave indentations (124, 125). The lip tensioning element (110) can use the webs (171, 172) to pull the vestibular tensioning element (120) away from the gums when the covering device (100) is in use.

[0122] Figure 13 shows the cover device (100) from Figure 12in the side view. The two tensioning elements (110, 120) with a film 130 in between are again visible. In addition to the two intraoral tensioning sections (123), the vestibular tensioning element has a section (121) running between points A and B, which forms a concave indentation (124) and thus represents an anteriorly curved section which, when the covering device is in place, runs in the sagittal direction anterior to the fold of the vestibule oris. In this area, the vestibular tensioning element (120) is connected to the lip tensioning element (110) via a bridge (171).

[0123] Figure 14 shows the alternative embodiment of the covering device (200) from Figure 4 . The basic structure focuses on the description of the Figure 4In addition, the covering device (200) has two webs (271, 272) which connect the two clamping elements (210, 220) in the region of the concave indentations (224, 225).

[0124] Figure 15 shows how Figure 11 a comparison of the covering device (500) with a covering device from the prior art during use. The covering device (500) consists of a tensioning element (510), a vestibular tensioning element (520), and a film (530). The two tensioning elements (510, 520) are connected to one another via webs (571, 572) in the central region of the lips, i.e., the concave indentations of the tensioning elements (510, 520). The outer tensioning element (510) pulls the inner tensioning element (520) away from the gums through the webs (571, 572), thus preventing pressure points even better. As with Figure 11 , the areas under the nose and on the chin (C, D) are not covered by the film (530).

[0125] A design is Figure 16 schematically visible. A mouth opening 505 is schematically depicted as a pointed oval. This shape corresponds to a mouth that is approximately one-third to half open. A more widely opened mouth is more likely to be described as an oval. This shape then corresponds more closely to the Figure 11 depicted.

[0126] It goes without saying that the representation and description of the form here are highly schematic. In practice, no, or almost no, natural form corresponds to an exact geometric shape.

[0127] Overlying the mouth opening 505 is a vestibular tensioning element 520 in Figure 16 This is shown in this form in a relaxed state.

[0128] In the center, i.e., in sagittal plane 508 and slightly to the right and left of it, indentations 224 and 225 are provided. These extend toward each other. In a modified embodiment, they extend in an anterior direction, i.e., toward the lip tensioning element (not shown here).

[0129] Further lateral to the indentation 224, bulges 512 and 514 are formed, and further lateral to the indentation 225, bulges 516 and 518. As can be seen from Figure 16 As can be seen, the clamping element 520 thus forms approximately a rectangle with rounded corners, wherein in particular the radius of the corners - i.e. the bulges 512 to 518 - is between 1 cm and 7 cm, in particular 2 to 4 cm.

[0130] The clamping element 520 according to Figure 16is not oval, and certainly not circular. Rather, the bulges 512 to 518 extend into areas outside the mouth oval 505, and the clamping element 520 is incongruent or geometrically dissimilar to the mouth oval.

[0131] Since this is about the vestibular tensioning element 520, when inserted, it rests with the bulges 512 to 518 on the inside of the lips and cheek, specifically at the locations where bulges 512 to 518 are formed.

[0132] Here, a comparatively large mouth opening 505 is shown. Its size is, of course, patient-specific. As can be seen, there is also a considerable overlap between the inside of the mouth and the clamping element 520, specifically at the bulges 512 to 518.

[0133] When the same covering device is used with a smaller mouth opening 505, the bulges 512 to 518 are relatively even larger.

[0134] Nevertheless, the covering device in this embodiment has a considerable wearing comfort, because the lateral areas of the tensioning element 520 with the bulges 512 to 518 slide on the inner sides of the cheeks obliquely outwards and at the same time backwards, i.e. distally or posteriorly.

[0135] Inserting the cover device is easy, even with a small mouth opening. The lateral section is conveniently inserted first in the center and then pushed laterally. Preferably, this is done until the other lateral section is close to the center and can also be inserted. Only then does centering occur, which essentially occurs automatically due to the action of the elastic film 530.

[0136] The lip clamping element 510 can be used in the embodiment according to Figure 16 have any shape. For this purpose, the representation according to the Figures 1 to 15However, it can also have the same shape as the vestibular tensioning element 520, or be congruent therewith, or have a slight shape deviation of, for example, 10% compared to it.

[0137] In this embodiment, the indentations 224 and 225 according to Figure 16 . The vestibular tensioning element 520 extends with a straight or substantially straight horizontal section between the upper bulges 512 and 514 on the one hand, and the lower bulges 516 and 518 on the other hand.

[0138] Mixed forms are also possible, i.e. those in which a straight section is combined with one of the indentations 224 or 225.

[0139] In Figure 17 A further embodiment of the covering device is shown. In this embodiment, the illustrated lip tensioning element 510 is congruent or geometrically similar to the vestibular tensioning element 520, which is only partially visible.

[0140] The radially outward tension through the film 530 deforms the mouth opening 505.

[0141] Even in the embodiment according to Figure 17 the vestibular tensioning element 520 is incongruent and also geometrically dissimilar to the oval or pointed oval shape of the mouth opening 505.

[0142] The bulges 512, 514, 516 and 518 extend radially outward and convexly corresponding to the visible bulges 612, 614, 616 and 618 and extend laterally along the inside of the patient's cheeks.

[0143] The bulges 512, 514, 516, and 518 extend as bulge corners, diverging from each other in four spatial directions: in the example, left / up, right / up, left / down, and right / down. They extend at an oblique angle, both horizontally and vertically, into areas along the inside of the cheeks that are particularly pain-free and yielding.

[0144] Due to the preferred recesses 524 and 525 ( Figure 16 ) of the vestibular tensioning element, corresponding to the indentations 624 and 625 of the lip tensioning element, the labial frenulum and the vestibule oris are also relieved of pressure and protected, so that overall the wearing comfort of the covering device is significantly improved compared to the prior art.

[0145] In the embodiment according to Figure 17 A plurality of ribs of the webs 632 are formed in the region of the indentation 624. These ribs can extend parallel to one another in or on the film 530 and originate from the lip-tensioning element 510. However, they can also diverge from one another in the direction of the vestibular-tensioning element or converge towards one another. They can be made of film material or of a different material. They can be curved and intersect one another, but they can also run without crossing. They can also run straight.

[0146] A corresponding plurality of ribs or webs 628 is formed on the indentation 625. The same design options apply to these.

Claims

1. A covering device, in particular for covering the lips and labial angles and for holding the lips, cheeks and labial angles away from the rows of teeth in the mouth of a patient, comprising an elastic lip clamping element (110, 210, 310), at least one elastic vestibular clamping element (120, 220, 320) and a film (130, 230, 330) connecting the clamping elements, wherein the clamping elements are arranged along two opposite end regions of the film, wherein the clamping elements (110, 210, 310; 120, 220, 320) are elastically deformable and span the film (130, 230, 330) in a relaxed state, in particular in the shape of a ring or the shape of a tube, characterized in that the vestibular clamping element (120, 220, 320) comprises four bulges or bulging corners (512, 514, 516, 518) which project convexly towards the outside compared to a pointed oval (505) or an oval, and in that the shape of the vestibular clamping element (520) is incongruent or geometrically dissimilar compared to the pointed oval (505) or oval.

2. The covering device as claimed in claim 1, characterized in that the vestibular clamping element (520) has substantially the shape of a rectangular with rounded corners in the top view, wherein in particular the radius of the corners is between 0.1 cm and 7 cm, in particular 0.2 to 4 cm.