Orofacial myofunctional rehabilitation splint

Abstract

This orofacial myofunctional rehabilitation splint is characterized by a lower vertical outer wall (2) with a reduced height of 2 or 3 mm at most, allowing the resting pressure of the orbicularis oris muscle to be exerted on the mandibular alveolar arch. This feature helps prevent, or even reduce after an interceptive treatment phase, unwanted labial tipping of the mandibular incisors. This splint is further characterized by a tongue ramp (3) without a wall along the lingual edge of the upper part of the occlusal plane (8). The tongue ramp (3) thus continues laterally with the occlusal plane (4) via a rounded edge (8). This feature induces passive elevation and propulsion of the tongue, which is accompanied by an opening of the upper airways and helps to reduce snoring and retrain swallowing.The tongue ramp (3) is extended anteriorly by an anterior guide for the tip of the tongue (9). This guide is specifically designed to lift and guide the tip of the tongue forward and upward, ensuring its proprioceptive contact with the retro-incisive papilla, in order to open the upper airways and promote the rehabilitation of swallowing and resting tongue posture. The device according to the invention is particularly intended for the rehabilitation of breathing, swallowing, and tongue posture; the improvement of obstructive sleep-disordered breathing, particularly snoring; and the improvement of dental occlusion.

Description

Title of the invention: Orofacial myofunctional rehabilitation splint

[0001] Description of the invention

[0002] The present invention describes a new type of orofacial myofunctional rehabilitation splint.

[0003] Rehabilitation or functional splints are known. They are generally prefabricated from flexible materials.

[0004] They consist of a double maxillary and mandibular dental arch, with or without an impression of the teeth. The edges of the arches are raised so as to cover the external and internal surfaces of the teeth with an extension towards the gums.

[0005] A device described in the prior art is known, having been the subject of US patent application 5876199 by Earl Bergersen, and also US patent application 5645420, which describe splints with indentations for the maxillary and mandibular teeth. The splints formed by the upper and lower arches are connected in a position allowing for a Class I dental occlusion. The shape of the arches is U-shaped. Furthermore, different sizes of splints exist depending on the size and number of teeth present.

[0006] EP 0400217 Al is also known, which is presented as a guide for the eruption of deciduous teeth up to 30 months. The internal element has the shape of a trough or a channel to receive the teeth without affecting the position of the tongue, which at that age is still in the primary swallowing mode.

[0007] WO2009026659 FARRELL CHRISTOPHER JOHN is also known to describe an orthodontic appliance in the form of a double splint that includes a tongue lifter. Passive elevation of the tongue in contact with the entire palate is hindered by the presence of the inner wall of the upper splint.

[0008] FR2863863 and FR2990128 NICOLLEAU PATRICE are also known, describing functional splints characterized by the fact that their inner wall acts as a tongue lift. Passive elevation of the tongue in contact with the entire palate is hindered by the presence of the inner wall of the upper splint.

[0009] The present invention relates to a rehabilitation splint designed based on the conclusions of published scientific data. These data demonstrate the superiority of orofacial myofunctional rehabilitation (OMHR) combined with wearing a splint. prefabricated orofacial myofunctional rehabilitation (GRMOF) compared to the implementation of an RMOF without GRMOF.

[0010] The present invention aims to eliminate several of the disadvantages of the prior art: significant bulk and discomfort of the devices, low shear strength and short lifespan of the devices, less than perfect efficiency / constraint ratio, delicate maintenance of the devices because they cannot be sterilized at 134°C.

[0011] The present invention therefore aims to improve the effectiveness of orofacial muscle, function, and resting posture rehabilitation (OMFR) and contribute to the optimal establishment of occlusion and the stability of the therapeutic outcome. It also aims to treat rhonchopathy and obstructive sleep apnea.

[0012] It can be used alone or in conjunction with other devices such as a quad helix, a breaker, a multi-bracket appliance, etc. It can be used in primary, mixed, or permanent dentition. Its use is optimal in young children and adolescents, but it can also be used in adults.

[0013] The invention, with its features and advantages, will become clearer upon reading the description made with reference to the drawings attached hereto and given by way of non-limiting examples in which:

[0014] [Fig.1] represents a schematic 3 / 4 top view of the gutter according to the invention. The present view is a representation of the shape with its technical characteristics and not a millimeter-scale representation of the present invention.

[0015] [Fig.2] represents a postero-anterior view.

[0016] [Fig.3] represents a lower view.

[0017] The invention is characterized by the presence of:

[0018] - of an upper vertical external wall located between the lips, cheeks and teeth maxillae (1)

[0019] - of a lower vertical external wall (2) of reduced height, 2 or 3 mm at maximum, and which constitutes one of the key elements of the invention.

[0020] -of an inclined internal wall, the tongue ramp (3), placed between the tongue and the mandibular teeth, which constitutes one of the key elements of the invention.

[0021] - of a horizontal connection, the occlusal plane (4), between these previous elements and on in which the maxillary and mandibular teeth rest, in a position specific to the invention.

[0022] According to an innovative feature, the device according to the invention is made of thermoplastic elastomer (TPE) with a hardness of about 80 Shore A and sterilizable at 134°C. This feature makes it possible to prevent the degradation of the splint while maintaining excellent wearing comfort thanks to the innovation of the small size of the splint.

[0023] According to another innovative feature, the upper part of the outer wall (5) is of limited height and stops slightly above the neck of the maxillary teeth so as not to injure the vestibular maxillary mucosa, particularly at the canine eminences, and the intraoral mucosa of the cheeks and lips. This innovative element eliminates the need to adjust the height of the outer wall with a chisel and polishing bur. It remains sufficient to ensure good stability of the splint in the mouth and to enforce nasal ventilation.

[0024] The anterior rounding of the rigid upper vertical external wall improves the arch shape at the level of the incisor-canine sector (6).

[0025] The edge of the upper external wall has a median notch (7) which serves as a reference for its positioning in the mouth and avoids any interference with a possible median upper labial frenulum that is too short.

[0026] According to another innovative feature, the device according to the invention is characterized by the absence of any edge wall (8) on the lingual side of the upper part of the occlusal plane. The inclined tongue ramp (3), which has a curved cross-section, therefore continues laterally with the occlusal plane via a rounded edge (8). This innovative feature induces passive elevation and propulsion of the tongue, which is accompanied by an opening of the upper airways and helps to reduce snoring and retrain swallowing.

[0027] According to another innovative feature, the tongue ramp according to the invention is extended anteriorly by an anterior guide for the tip of the tongue (9). It is specifically designed to lift and guide the tip of the tongue forward and upward and ensure its proprioceptive contact with the retro-incisive papilla. It is designed to overcome the defect of the tongue positioning tabs generally offered by manufacturers to ensure the correct position of the tongue, which are contrary to their intended purpose because they prevent proprioceptive contact of the tongue with the retro-incisive papilla.

[0028] Also, a notch in the tongue ramp at the level of the lingual frenulum (10) ensures its free movement. The thinness and shape of this innovative tongue ramp prevent any injury to the sublingual mucosa and the need for adjustments with a polishing bur to adapt the splint.

[0029] All these elements allow the tongue to come into free contact with the entire palatal mucosa, including the retro-incisive papilla, and with the entire palatal faces of the maxillary premolar-molar sectors, in order to ensure the stability of the transverse dimension of the maxilla.

[0030] This innovative tongue ramp prevents the tongue from coming into contact with the lips and cheeks to ensure an oral seal. The impossibility of tongue-lip / cheek contact, which initiates primary (dysfunctional) swallowing, forces the patient to Passively swallowing with closed dental arches and tongue against the palate. This passive and automatic retraining, induced by wearing the mouthguard, is particularly useful and essential during sleep.

[0031] According to another innovative feature, the device according to the invention has a low height of the lower vertical outer wall (2), at most 2 to 3 mm. This innovation allows muscular pressure to be exerted on the mandibular alveolar arch while helping the patient to properly position their mandibular dental arch in the splint. This innovation allows the resting pressure of the orbicularis oris muscle to prevent, or even reduce after an interceptive treatment phase, unwanted labial tipping of the mandibular incisors.

[0032] This innovation of a low height of the lower vertical external wall (2) also allows the continued wearing of the splint during the beginning of multi-bracket treatment, between the bonding of the mandibular dental arch and that, subsequently, of the maxillary dental arch.

[0033] This innovation of a low height of the lower vertical external wall (2) also limits the mandibular excursions of the patients and prevents them from propelling themselves to place their mandibular incisors in front of the gutter, resting on the bottom of the upper vestibular band, with the consequence of a predictable and undesirable vestibuloversion of the mandibular incisors.

[0034] Advantageously, this innovation of a low lower vertical outer wall height (2) reassures the patient and their family that their mandible can be freed from the splint if necessary. The patient can thus temporarily adopt mouth-to-mouth ventilation if temporary nasal dyspermeability develops during treatment.

[0035] The rigid occlusal plane is sufficiently long posteriorly (11) to ensure the mesial positioning of the second molars. The objective is to prevent the occurrence of an anterior open bite caused by the premature eruption of the second molars behind the distal part of the splint.

[0036] According to another innovative feature of the device according to the invention, the rigidity of the occlusal plane makes it possible to initiate the lifting of an incisal overbite during the rehabilitation phase before the start of multi-bracket treatment.

[0037] The splint according to the invention has no indentations so that it can be used regardless of the particularities of the dentition (transpositions, agenesis, changes in dentition). Furthermore, the teeth are left free and are guided into better occlusion only by the action of orofacial muscle pressures. The splint acts as an eruption guide for the development of the lateral dental sectors. The anterior rounded shape of the rigid upper vertical outer wall serves as a template to improve the arch form at the incisor-canine level.

[0038] The mode of action of the gutter according to the invention will become clearer upon reading the description below. On ventilation

[0039] Regular ventilation should be nasal, day and night. Oral ventilation is a backup ventilation method that is not physiological and disrupts dentofacial development and sleep quality.

[0040] The upper vertical outer wall (1) of the splint requires nasal ventilation. In case of temporary nasal dyspermeability, the low height of the lower vertical outer wall (2) allows the patient to free their mandible from the splint and resort to alternative oral ventilation.

[0041] Also, the tongue ramp (3) which continues on the sides with the occlusal plane by a rounded (8) and which extends anteriorly by an anterior guide for the tip of the tongue (9), contributes to a passive elevation and a lingual propulsion, which induce nasal ventilation, are accompanied by a clearing of the upper airways and help to limit snoring. Regarding tongue posture

[0042] The high and anterior position of the tongue at rest helps to counterbalance the centripetal pressures developed by the lips and cheeks, to impose nasal ventilation and to reduce snoring.

[0043] The innovative features of the tongue ramp allow the tongue to freely come into contact with the entire palatal mucosa, including the retro-incisive papilla, and with all the palatal surfaces of the maxillary premolar-molar regions, in order to ensure the stability of the transverse dimension of the maxilla. These innovative features of the tongue ramp also induce passive elevation and propulsion of the tongue, which is accompanied by an opening of the upper airways and helps to reduce snoring and retrain swallowing. On the lips and cheeks

[0044] The innovative design of the tongue ramp prevents the tongue from coming into contact with the lips and cheeks to ensure an oral seal. The inability to make contact between the tongue and lips / cheeks, which initiates primary (dysfunctional) swallowing, forces the patient to passively swallow with closed dental arches and the tongue against the palate, particularly during sleep. This passive and automatic retraining, induced by wearing the splint, is very effective and absolutely essential for continuing retraining during sleep.

[0045] The innovative feature of a low height of the lower vertical outer wall (2), at most 2 to 3 mm, leaves the pressure at rest on the orbicularis oris muscle. to practice on the mandibular alveolodental arch, which prevents or even reduces unwanted vestibuloversion of the mandibular incisors. On evolving teeth and arch shapes

[0046] The splint according to the present invention can be used in interceptive treatment or between two phases of treatment, early then multi-bracket, or even before and at the beginning of multi-bracket treatment.

[0047] The splint according to the invention has no indentations. The teeth are left free and are guided into better occlusion only by the action of orofacial muscle pressures. The splint acts as an eruption guide for the development of the lateral dental sectors. The rigid anterior curve of the upper vertical outer wall (6) serves as a template to improve the arch shape at the incisor-canine level. Regarding the position of the permanent teeth

[0048] According to another innovative feature of the device according to the invention, the rigidity of the occlusal plane makes it possible to initiate the lifting of an incisal overbite during the rehabilitation phase before and at the beginning of multi-bracket treatment.

Claims

Demands

1. Orofacial rehabilitation splint intended to cover the external and internal surfaces of the teeth formed of: - an upper vertical external wall (1), - an lower vertical external wall (2), - an inclined internal wall, the tongue ramp (3), and - a horizontal connection, the occlusal plane (4), between the lower vertical external wall (2) and the tongue ramp (3) characterized in that: - the lower vertical external wall (2) is less than 2 mm high and - the tongue ramp (3) is inclined and has a curved cross-section - the occlusal plane is horizontal, rigid, and extends backwards at least to the mesial quarter of the second molars, the tongue ramp (3) continuing laterally with the occlusal plane (4) by a rounded end (8).

2. Rehabilitation splint according to claim 1 characterized in that the tongue ramp (3) is extended anteriorly by an anterior guide for the tip of the tongue (9).

3. Rehabilitation splint according to any one of the preceding claims characterized in that it is made of hard material, thermoplastic elastomer (TPE) of a hardness of about 80 Shore A and sterilizable at 134° C.

4. Rehabilitation splint according to any one of the preceding claims characterized in that the upper part of the outer wall (5) stops slightly above the neck of the maxillary teeth.

5. Rehabilitation splint according to any one of the preceding claims characterized in that the upper vertical outer wall is rigid, and includes an anterior rounded end (6).

6. Rehabilitation splint according to any one of the preceding claims characterized in that the edge of the upper outer wall has a median notch (7).

7. Rehabilitation splint according to any one of the preceding claims characterized in that the tongue ramp (3) has a notch at the level of the lingual frenulum (10).

8. Rehabilitation splint according to any one of the preceding claims characterized in that it has no indentation.

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