Device for dynamic tongue rehabilitation in the context of various dysfunctions

Abstract

Endo-oral appliance intended for dynamic myofunctional rehabilitation of the tongue during wakefulness in the context of dysfunctions such as tongue kinematics during the oral phase of swallowing or the resting position of the tongue in the mouth. The appliance precisely guides the tongue's pressure on the hard palate, it comprises a rigid plate transfixed by an elastic strap, the assembly is supported by an orthosis stabilized on all or part of the teeth of the upper jaw.

Description

Title of the invention: Apparatus for dynamic tongue rehabilitation in the context of various dysfunctions Technical field

[0001] The invention relates to an apparatus for the rehabilitation of lingual dysfunctions which include, among other things, lingual dynamics during the oral phase of swallowing as well as the resting position of the tongue in the mouth. Prior art

[0002] Any error in the performance of two of the essential physiological functions that the tongue must perform in the mouth, whether during the oral phase of swallowing or during the physiological resting position of the tongue, can compromise the balance, aesthetics, well-being or health of the individual.

[0003] A dysfunctional resting position is always responsible for the appearance of bone and alveolar dysmorphoses, it can play a role in the appearance or aggravation of a sleep apnea hypopnea syndrome in children and adults and thwart the effect of the treatment put in place to treat such a syndrome.

[0004] Dysfunctional swallowing can also cause the appearance of bone and alveolar dysmorphoses, myalgia located in the nape of the neck, and sleep bruxism itself responsible for tooth wear.

[0005] Dysfunctional swallowing can also be the cause of dysphagia, presbyphagia or instant dysphagia after a stroke which seriously endangers the vital prognosis of the patient concerned.

[0006] No endo-oral device for dynamic tongue rehabilitation during wakefulness currently exists. Some existing devices are intended for passive education of static tongue positioning during rest or during swallowing. Their use is mainly indicated during sleep. Rehabilitation of dysfunctional swallowing has been carried out for 50 years by health professionals using various methods; none of these methods uses a device intended to very precisely guide the dynamics of the tongue on the hard palate during the oral phase of normal swallowing. [GENERAL DESCRIPTION OF THE INVENTION]

[0007] The aim of the present invention is to propose a solution which allows dynamic and not only passive lingual rehabilitation. This rehabilitation is aimed exclusively at subjects in a state of wakefulness.

[0008] The invention is based on a lingual rehabilitation device which comprises two parts: a rigid plastic plate as shown in [Fig. 1] and an elastic linear part as shown in [Fig. 2] which supports the former.

[0009] The rigid plastic plate has an ovoid shape, with rounded edges, with dimensions of 18 to 25 mm along its major axis and 10 to 16 mm along its minor axis, its thickness is 2 to 3 mm [Fig.l]. This plate has a curved shape along both the major and minor axis. The face thus curved is oriented towards the roof of the palate. This plate is pierced at each of the two ends of its major axis but at a distance from the edges by an orifice which allows the passage of the elastic part as shown in [Fig.3]. The flexible part of the invention is an elastic strap as a high-strength elastic orthodontic chain [Fig.2] which supports the rigid plate by the fact that it transfixes the rigid plate through the two orifices which are provided therein [Fig.3]. This flexible strap is not, however, fixed to the rigid plate which can thus slide and occupy various positions depending on the anatomy of the palate and the agility of the subject's tongue.

[0010] The invention is intended exclusively for endo-oral use in the upper jaw and cannot operate in isolation in the mouth; it is always fixed to a support itself fitted onto the teeth of the upper jaw. The support can be of different types: either an orthosis manufactured solely for this purpose, or a bruxism orthosis manufactured to measure or prefabricated, or a mandibular advancement orthosis intended for the treatment of sleep apnea hypopnea syndrome, whether it is manufactured to measure or prefabricated, or a removable orthodontic treatment appliance, or an orthodontic aligner, or a partial removable dental prosthesis, depending on the type of therapeutic indication, the age or the dental condition of the subjects.The support which carries the lingual rehabilitation appliance, whatever any of the forms described above, is always equipped with two fixing systems which can receive each of the two free ends of the elastic part of the invention. If it is a maxillary orthosis, this has the form of a gutter made of rigid or semi-rigid plastic material, it fits onto the teeth to ensure that the invention and support assembly is held in place. This orthosis can have different shapes, include different materials and concern all or part of the teeth of the upper jaw. It can be custom-made or prefabricated.

[0011] The orthosis thus comprises a vestibular wall oriented towards the outside of the mouth which covers all or part of the visible surface of the teeth and a palatal wall, oriented towards the inside of the mouth, covering the hidden face of the teeth. The palatal face of the orthosis covers all or preferably part of the emerged surface of the teeth and in any case must avoid any pressure on the palatal mucosa or on the retro-incisive papilla so as not to interfere with the kinematics of the tongue during swallowing or in the resting position. These two walls are connected together by an occlusal wall which covers the top of the teeth, the thickness of the material constituting the orthosis at this level should ideally not exceed one millimeter in order to best reproduce the natural conditions of dental occlusion which is one of the conditions necessary for the proper realization of normal swallowing.

[0012] The two palatal walls of the support which carries the invention on the left and on the right are each equipped with a fixing point which receives one of the two ends of the flexible part of the invention. The two fixing points can be two metal ball hooks included in the material constituting the orthosis or two cutouts made at the expense of this material, produced by two slots cut in the thickness of the material over a height of 3 to 7 millimeters, two slots spaced from each other by 2 to 4 millimeters are thus made on the left side and on the right side.

[0013] The hooks or cutouts are located on the left side and the right side in the area between the palatal face of the second maxillary premolar and the palatal face of the first maxillary molar, so as to allow the correct and precise positioning of the rigid part of the appliance on the hard palate during rehabilitation sessions and to allow rehabilitation to be carried out on the very precise area of ​​the anterior half of the endo buccal part of the tongue. In the inactive position of the appliance, the adjustment of the length of the two heads of the elastic part of the invention must result in the positioning of the rigid plate at a distance from the palatal fibro-mucosa, suspended 1 to 2 millimeters below the contact zone with this fibro-mucosa.The instructions given to the patient to carry out the rehabilitation exercises are to apply the tip of the tongue to the retro-incisive papilla and then to exert upward and forward pressure with the back of the tongue so as to apply the rigid plate of the appliance in contact with the palatal fibromucosa. Depending on the dysfunction that one seeks to correct, the antagonist teeth are spaced for the rest position, they are closed in occlusion for swallowing rehabilitation. Depending on the depth of the palatal vault, the length of the heads of the elastic part of the invention should be adjusted; this must be done without the aid of specific tools. Brief description of the drawings

[0014] The invention will be better understood and other characteristics and advantages will appear more clearly on reading the description given below by way of purely illustrative and non-limiting examples, with reference to the appended drawings in which:

[0015] [Fig. l] represents the rigid part of the invention

[0016] [Fig. 2] represents the flexible part of the invention

[0017] [Fig. 3] represents the whole of the invention

Claims

1.

2. Claims Tongue dysfunction rehabilitation device comprising a rigid plastic plate and an elastic support characterized in that the rigid plate is pierced with two diametrically opposed orifices and in that the elastic support of linear shape and provided with two ends is inserted through these two orifices so that the rigid plate is held by the elastic support without being fixed thereto, this device is intended exclusively for endo-oral use in the upper jaw and cannot operate independently it is always fixed to a support itself fitted onto the teeth of the upper jaw, the support can be of different types: either an orthosis manufactured solely for this purpose or a bruxism orthosis manufactured to measure or prefabricated or a mandibular advancement orthosis or an orthodontic aligner,the support which carries the lingual rehabilitation device, whatever any of the forms described previously, is always equipped with two fixing systems which can receive each of the two free ends of the elastic part of the invention, if it is a maxillary orthosis, this has the form of a gutter made of rigid or semi-rigid plastic material, it fits onto the teeth to ensure that the invention and support assembly is held in place, it thus comprises a vestibular wall oriented towards the outside of the mouth which covers all or part of the visible surface of the teeth and a palatal wall, oriented towards the inside of the mouth, covering the hidden face of the teeth., Lingual rehabilitation device according to the preceding claim, characterized in that it comprises a rigid plate made of plastic material, of ovoid shape, with rounded edges of dimensions of 18 to 25 millimeters along its major axis, dimensions of 10 to 16 millimeters along its minor axis and a thickness of 2 to 3 millimeters, this rigid plate has a curved shape both along its major axis and along its minor axis, the face thus curved is oriented towards the roof of the palate, the plate is pierced at each of the two ends of its major axis but at a distance from the edges by an orifice which allows the passage of the elastic part

3. Lingual rehabilitation device according to any one of the preceding claims, characterized in that it comprises a linear elastic support, as an elastic orthodontic chain which transfixes the rigid plate through the two orifices provided therein, this flexible strap is not, however, fixed to the rigid plate which can thus slide and occupy various positions depending on the anatomy of the palate and the agility of the subject's tongue, the two free ends of the elastic support are fixed on the left side and on the right side to two fixing points which equip the two palatal walls of the support of the invention, these two fixing points can be two metal ball hooks included in the material constituting the orthosis or two cutouts made at the expense of this material by the production,on each of the two left and right sides of two slits spaced from each other by 2 to 4 millimeters cut into the palatal mass of the material to a height of 3 to 7 millimeters.,

4. Lingual rehabilitation appliance according to the preceding claim, characterized in that the hooks or cutouts which allow the attachment of the two free ends of the elastic support of the appliance are located on the left side and on the right side in the area between the palatal face of the second maxillary premolar and the palatal face of the first maxillary molar so as to allow the positioning of the rigid part of the invention on the hard palate during rehabilitation sessions and to allow rehabilitation to be carried out on the very precise area of ​​the anterior half of the endobuccal part of the tongue.

5. Tongue rehabilitation device according to any one of the preceding claims, characterized in that in the inactive position of the device, the adjustment of the length of the two heads of the elastic part of the invention must result in the positioning of the rigid plate at a distance from the palatine fibro-mucosa, suspended 1 to 2 mm below the contact zone with this fibro-mucosa.

6. A tongue rehabilitation device according to any one of the preceding claims, characterized in that the adjustment of the length of the heads of the elastic part of the invention must be carried out without the aid of specific tools.

7. Tongue rehabilitation device according to any one of the preceding claims, characterized in that the instructions indicated to the patient to carry out the rehabilitation exercises are to apply the tip of the tongue on the retro-incisive papilla then to exert with the back of the tongue an upward and forward pressure so as to apply the rigid plate of the device in contact with the palatine fibro-mucosa, depending on the dysfunction that one seeks to correct the antagonist teeth are spaced for the rest position, they are closed in occlusion for the rehabilitation of swallowing.

8. Lingual rehabilitation device according to any one of the preceding claims, characterized in that the thickness of the material constituting the support orthosis should ideally not exceed 1 mm at the level of its occlusal wall which covers the top of the teeth.

9. Lingual rehabilitation device according to any one of the preceding claims, characterized in that the palatal face of the orthosis which covers all or preferably part of the emerged surface of the teeth must avoid any pressure on the palatal mucosa or on the retro-incisive papilla so as not to interfere with the kinematics of the tongue during swallowing or in the resting position.

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