Mandibular activator apparatus

Abstract

The invention relates to a mandibular activator apparatus comprising two separate parts, an upper part (2) and a lower part (3), each consisting of a custom-made piece in the form of a cover, such that same exactly cover the crowns of all the teeth of the upper and lower jaw, respectively. The apparatus comprises a protrusion ramp (4), firmly attached to the bottom of the upper piece (2), the protrusion ramp being formed by a piece which makes contact at the bottom thereof with the lower piece (3) and acts as an advancement platform, preventing controlled occlusion between the two arches.

Description

[0001] JAW ACTIVATOR DEVICE

[0002] DESCRIPTION

[0003] FIELD OF APPLICATION OF THE INVENTION

[0004] The field of application of the present invention falls within the sector of the industry dedicated to the manufacture of orthopedic devices, focusing particularly on the field of mandibular advancement orthopedic devices.

[0005] BACKGROUND OF THE INVENTION

[0006] As is well known, mandibular advancement is a physiological movement of the mandible as a structural and organic part of the stomatognathic complex. This movement occurs not only in the sagittal plane but also in the vertical and transverse planes, closely linked to the mandibular condylar movements and trajectories, related to the temporal (glenoid fossae, eminences, etc.), articular, and muscular structures of both sides, which must function in a synchronized manner.

[0007] There are not two temporomandibular joints, but a single, double joint, with a right and a left temporomandibular joint. One cannot function independently of the other.

[0008] The physiological stimulus exerted on bone structures by muscles, through ligamentous insertions and joints, determines an increase in the growth of primary and secondary cartilages, and the remodeling of bones.

[0009] When the functions of the stomatognathic system are adequate and balanced, all parts will develop and grow harmoniously. However, if, due to various etiopathogenic factors, any of these functions are not balanced, the structures will not develop properly, and dental and skeletal malocclusions will arise, which can be highly varied and individual.

[0010] When, after a rigorous analysis and diagnosis, and after considering the chronological moment, dental development, development of the arches, neuromuscular pattern, bone maturation and growth curves of each patient, the need to stimulate the mandibular growth of this particular patient is determined and under strict professional design and control, mandibular advancement orthopedic appliances may be used.

[0011] There are different types of mandibular advancement appliances: - Advancement appliances for Class II malocclusions and mandibular hypoplasia, which, to summarize, can be classified as follows:

[0012] - Tooth-supported. - They force mandibular advancement by tooth support, and can be fixed (Herbst, Forsus, Advancing, POT, etc.) or removable (HBO, Twin-Block, etc.)

[0013] - Functional. - They stimulate advancement by stretching the muscle insertion fibers. They inevitably provide some support and therefore have a dentoalveolar effect. (Franckél, Bimler, etc.)

[0014] - Proprioceptive functional devices. - They effectively stimulate muscle function during forward and lateral movements, as well as during chewing, through nociceptive-proprioceptive contact with the mucous membranes, minimizing tooth contact and the dentoalveolar effect. Their effects are much more structurally basal. (Rivero nociceptive activator, ANAM, Bass plate, etc.)

[0015] - Mandibular advancement devices for sleep apnea. They are called MADs, Mandibular Advancement Devices, although we can also call them MADs, Mandibular Advancement Positioners, because the important thing is that they give stability to the jaw in a static, non-functional position during sleep, and thus increase the permeability of the airways, in the lower pharynx or hypopharynx, with repositioning of the hyoid bone.

[0016] - Advancement appliances for recapturing the articular disc in reversible disc displacements. In those cases, in which, after a correct clinical diagnosis and after an exhaustive analysis of REMg (Dynamic Electromagnetic Resonance of the TMJ (Temporomandibular Joint)), disc recapture is considered, a PAM (Mandibular Advancement Positioner) or a mandibular activator device such as the one that is the subject of the present invention will be used, if at the same time a corrective orthodontic treatment is planned.

[0017] The objective of the present invention is, therefore, to provide an improved mandibular advancement orthopedic appliance device that can be included within the functional proprioceptive type, which provides a simultaneous effect of mandibular advancement and corrective orthodontic treatment.

[0018] EXPLANATION OF THE INVENTION

[0019] The mandibular activator device proposed by the invention represents an improvement over what is already known, with the characterizing details that make it possible and that distinguish it being conveniently included in the final claims that accompany this description.

[0020] What the invention proposes, as previously mentioned, is a mandibular activator consisting of a mandibular advancement orthodontic appliance that, being one of those that stimulate muscle function while minimizing tooth contact and the dento-alveolar effect, has the advantage that, at the same time, it acts as an orthodontic corrector.To this end, the activator that is the subject of the invention is essentially made up of two sequential aligners, each consisting of two independent parts, one upper and one lower, in the form of transparent covers designed as caps to cover the crowns of the teeth of the respective upper and lower jaws, with the particularity that between these caps there is a protrusion ramp or advancement platform, which emerges from the lower part of the upper cap to which it is attached, and which touches internally with the lower cap, producing a posterior and anterior disocclusion between both arches that advances the jaw, allowing, at the same time, all the individual tooth movements that are necessary.

[0021] More specifically, the mandibular activator that is the subject of the invention is a double appliance, with two independent upper and lower parts, of the thermoset methacrylate cap type, 0.75 mm thick, ESSIX, or manufactured by stereolithography or 3D printing, which precisely covers the clinical crowns of all teeth. Generically referred to

[0022] 10 sequential transparent aligners. The unique feature is that the upper coping (maxillary arch) incorporates a protrusion ramp, which we call an advancement platform, and which, in a sagittal view, resembles an "Elephant's Trunk".

[0023] This way, it starts from the contour of the incisal edge of the upper central and lateral incisors and reaches the lingual mucosa of the lower incisors, avoiding contact with their lingual surfaces, which are also covered by the plastic of the lower aligner.

[0024] The procedure for the manufacture and use of the mandibular activator comprises the following:

[0025] Taking records of the working models.- It is obtained by intraoral scanning of both dental arches, and of the palatal and lingual mucosa.

[0026] Interocclusal record taking.- The advanced construction bite is obtained using a flame-heated Godiva guide. At 2 / 3 of the maximum clinical advancement.

[0027] The device is manufactured or made to measure for each patient and each stage of treatment, by heat curing, by stereolithography, or by 3D printing.

[0028] Since physiologically there is a posterior and anterior disocclusion between both arches, motivated by the condylar path following the articular eminences, and because it is intimately related to the neuromuscular pattern of each patient (the more brachyfacial, the more posterior disocclusion), the vertical development of the posterior dentoalveolar processes and the anterior dentoalveolar (incisal) dimension must be managed according to whether it is necessary to intrude or extrude one or the other, while at the same time the transverse parameters will be corrected by correlating both arches.

[0029] Normally, when the jaw is advanced, expansion of the upper arch will have to be done or, in severe cases, maxillary disjunction will have to be performed.

[0030] In any case, by incorporating the advancement platform into the aligners of the invention, it will also be possible to perform all the individual tooth movements that are necessary, incorporating as many attachments and auxiliary designs as needed to correct dental malocclusions during the advancement phase or phases, since there are no occlusal wings or ramps in the posterolateral sectors, as occurs with other appliances (Smart Wings, Twin-Block type ramps, Occlusal Ramps, etc.)

[0031] All teeth have their clinical crowns and occlusal surfaces completely covered, so the control of the upper and lower occlusal plane is total.

[0032] If it is necessary to achieve more anchorage of the appliance, the appliance can be designed to be trimmed more towards the gingiva, approaching the mucosal ridge of maximum contour of the inserted, keratinized gingiva (Wala Ridge), avoiding the insertion of the buccal and lingual frenula.

[0033] The mandibular activator is also suitable for use in cases of apnea or disc recapture.

[0034] In both situations, the aim is not to stimulate mandibular growth, but rather to change position with a positive impact on the airways and / or the TMJ.

[0035] The constructive bite should be taken once the patient has been trained, so that they can identify the recapture click upon mouth opening, and at that moment record the mandibular position in which the patient places the appliance in the mouth, with the disc recaptured.

[0036] The use of the device will be during sleep hours and at the patient's discretion, outside of mealtimes.

[0037] DESCRIPTION OF THE DRAWINGS

[0038] To complement the description being made and in order to help a better understanding of the characteristics of the invention, this descriptive document is accompanied, as an integral part thereof, by a set of drawings in which the following has been represented for illustrative and non-limiting purposes:

[0039] Figure 1 shows a sagittal schematic view of an example of the mandibular activator device represented in the position of use by a patient, showing its parts and its configuration and arrangement between both jaws.

[0040] Figure number 2.- Shows a schematic side perspective view of the activator device placed in the position of use in a patient, showing the disocclusion effect caused by the advancement platform.

[0041] And figure number 3.- Shows a front perspective view of the mandibular activator apparatus, in this case represented independently, without being incorporated into the patient's mouth.

[0042] PREFERRED EMBODIMENT OF THE INVENTION

[0043] In view of the aforementioned figures, and in accordance with the numbering adopted, an example of a non-limiting embodiment of the mandibular activator device of the invention can be observed, which comprises what is indicated and described in detail below. Thus, as can be seen in said figures, the device (1) of the invention is of the type comprising two independent parts, an upper (2) and a lower (3), consisting of two custom-made pieces in the form of a cover so as to precisely cover the crowns of all the teeth of the respective upper and lower jaws, which may include means of fixing or attachments to the teeth (not shown), and, preferably, act as sequential aligners.

[0044] And, based on this already known configuration, the mandibular activator (1) is distinguished by comprising, rigidly attached to the lower part of the upper piece (2), a protrusion ramp (4) consisting of a piece that touches the lower piece (3) and acts as an advancement platform preventing controlled occlusion between both arches.

[0045] Preferably, this protrusion ramp (4) has a configuration inclined towards the inside of the mouth on the lower part, where it touches the inside of the lower piece (3), and is as shown in figure 1.

[0046] Preferably, the upper piece (2) with the protrusion ramp (4) and the lower piece (3) are made of transparent material and obtained by thermo-cured methacrylate technique or made by stereolithography or by 3D printing.

[0047] The appliance is manufactured to suit each patient and each stage of treatment, at regular intervals, usually several weeks, to adjust the position of the protrusion ramp (4) according to the needs of each case and, if necessary, at the same time, to correct the dental alignment.

[0048] Having sufficiently described the nature of the present invention, as well as the manner of putting it into practice, it is not considered necessary to make its explanation more extensive so that any expert in the field may understand its scope and the advantages that derive from it, it being noted that, within its essentiality, it may be put into practice in other forms of embodiment that differ in detail from the one indicated as an example, and which will also achieve the protection sought provided that its fundamental principle is not altered, changed or modified.

Claims

CLAIMS 1.- Mandibular activator device comprising two independent parts, an upper (2) and a lower (3), consisting of two custom-made pieces in the form of a sleeve so as to accurately cover the crowns of all the teeth of the respective upper and lower jaws, is characterized by comprising, rigidly attached to the lower part of the upper piece (2), a protrusion ramp (4) consisting of a piece that touches the lower part of the lower piece (3) and acts as an advancement platform preventing controlled occlusion between both arches.

2. Mandibular activator apparatus, according to claim 1, characterized in that the protrusion ramp (4) has a configuration inclined towards the inside of the mouth on the lower part, where it touches the inside of the lower piece (3), and is of decreasing thickness such that, in a sagittal view, it resembles an "elephant's trunk". 3.- Mandibular activator apparatus, according to claim 1 or 2, characterized in that the upper piece (2) and the lower piece (3) comprise means of fixing or attachments to the teeth. 4.- Mandibular activator device, according to claim 3, characterized in that the upper piece (2) and the lower piece (3) act as sequential aligners.

5. Mandibular activator device, according to any of the preceding claims, characterized in that the upper piece (2) with the protrusion ramp (4) and the lower piece (3) are made of transparent material and obtained by thermo-cured methacrylate technique or made by stereolithography or by impression.

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